Exercise during first trimester

Antenatal exercises

This leaflet explains several exercises that will help you look after yourself during pregnancy. It has been designed using what you have learned from your physiotherapist during

your antenatal classes, however it will also be useful if you haven’t had the opportunity to attend antenatal classes.

They will help you to:

• Improve your circulation

• Strengthen your pelvic floor muscles

• Prevent backache

Please consult your doctor before undertaking these exercises if you have a history of backache or other health problems.

Deep breathing and foot and ankle exercises

Exercise and relaxation are essential to help you feel good in mind and body at any time.

These gentle exercises help to improve you circulation as the amount of

fluid in your body increases during pregnancy. This creates extra work for your heart and veins, especially the veins in your legs, through which blood is pumped back to your heart. Poor circulation can lead to varicose veins, vuval veins and cramps.

ALWAYS rest with your legs up as illustrated.

Deep breathing exercises

• Breathe in deeply through your nose

• Sigh out through your mouth

• Repeat five times

• Do this exercise six times a day

Foot and ankle exercise

Keep your knees relaxed for both exercises.

• Bend and stretch your ankles vigorously up and down for 30 seconds

• Circle both feet 10 times in each direction

• Repeat both of these exercises 10 times a day

This will help to reduce swollen ankles and varicose veins.

Strengthen your pelvic floor muscles

The floor of your pelvis is formed by very elastic muscles which act like a small trampoline to support your baby during pregnancy. These muscles may become weak, leading to a leakage of urine when you cough or sneeze. Many women experience this problem during pregnancy. Exercise now to strengthen your pelvic floor. Do at least 80 exercises each day.

Strong pelvic floor muscles stop leaks from both your bladder and bowel.

Strong pelvic floor muscles enable you and your partner to continue to enjoy intercourse.

How to do pelvic floor exercises

• Sit with your knees apart

• Don’t hold your breath

• Don’t clench your buttocks

Tighten your back passage as if you were trying to stop passing wind. Now tighten the muscles you would use to stop a flow of urine. Do both together and you should feel your back passage, vagina and front passage all lift and close at the same time.

Now you know what to do, you can do this exercise while standing, sitting or lying down.

Each day you need to do:

• Slow exercises – tighten, hold (aim for up to 10 seconds) and relax

• Fast exercises – tighten and relax quickly. Repeat up to 10 times

How often?

Always do a mixture of fast and slow exercises while seated on the loo after you have emptied your bladder. Make this a lifetime habit.

You can exercise in the shower, as you wash your hands, while ironing, etc.

Protect your pelvic floor:

Make a habit of always pulling up your pelvic floor before you lift, carry, push or pull light to moderate weights.

Lift and squeeze as you cough or sneeze.

Your abdominal muscles – “Nature’s perfect corset”

You have four pairs of muscles arranged in four layers (it is only possible to show two layers in the diagram: the rectus and transversus muscles).

The rectus muscles run vertically up and down the centre of your tummy

• The transversus muscles are the deepest horizontal muscles encircling your waist
• The oblique muscles crisscross diagonally on your sides
• These muscles work together to hold your spine firm, tilt your pelvis upward and to pull your tummy in tight. These muscles bend and twist your spine.

During pregnancy, your tummy muscles will soften, separate and lengthen to accommodate your growing baby. This is a natural change due to pregnancy hormones circulating in your body. The gap (linea alba) will gradually close after birth. Tummy exercises prevent over-stretching and encourage closure of the separation after birth.

Weight gain

Excessive weight gained during pregnancy is difficult to lose after the birth. On avergage, it is advised that you gain between 12 and 15kg over the entire pregnancy if you are normal weight (which breaks down to 7kg during the first 20 weeks and then a ½ kg a week thereafter). If you are overweight, it is recommended that you gain no more than 8kg over the entire pregnancy.
Exercise to prevent backache

Bad posture, stretched tummy muscles and a growing baby can lead to backache during pregnancy. Overstretched tummy muscles can contribute to back pain and constipation.

Good posture

• Stand tall
• Bottom tucked in
• Tummy in – always
• Relaxed knees
  
• Pelvic floor up
  

These exercises can be done when kneeling, sitting and standing

Transversus abdominus – “Nature’s belt”

Lift your tummy button in and up towards your spine. Hold 3-4 seconds. (Your shoulders, ribs and spine do not move). Repeat 5-10 times twice a day.

Pelvic tilting

Lift your tummy button in and up towards your spine. Tighten your buttocks, hump up your back and tuck your “tail” under. Hold 3-4 seconds. Repeat 5-10 times a day.

Simple ways of caring for your body

DO

Rest as often as you can with your feet raised slightly higher than the level of your hips.

To get out of bed, draw your tummy in, keep knees together, roll on your side and push up on your arms.

Take some exercise every day. Walk briskly for 20-30 minutes, if able. Swimming is a very good exercise – swim at a comfortable pace. Stop and rest often. Women with painful pelvic joints should avoid doing breaststroke as this action may increase your pain.

DON’T

Do not stand still or sit for long periods.

Do not stoop. When lifting, you should bend your knees, keep your back straight and pull up your pelvic floor as you take the weight of the object.

Do not lift or carry heavy weights. Toddlers can be too heavy to carry. Encourage them to be independent.

Stress, tension and relaxation

Some women feel extremely tired. Others develop aches and pains which are not due to specific illness, but are related to tension. Tension causes an increase in blood pressure, heart rate and rate of breathing which can lead to feelings of panic as well as overloading the systems of the body. Knowing how to prevent tension is a valuable skill which everyone could use when life is more challenging than usual.

Learning a relaxation technique and using it regularly has been shown to reduce mildly increased blood pressure. Women who learn and use it during labour generally cope better with pain and feel more in control. During pregnancy, practising relaxation will help you to rest more effectively and can also help you to get sleep again if you wake during the night.

Relaxation

You can relax in either a sitting or lying position. Using a pillow, make sure your head is supported, as well as your arms and legs.

Go through the following movements

Complete one movement, let go or stop the movement, then check that the joint is resting in a comfortable position.

• Pull your shoulders down towards your feet. Let go.
• Move your elbows outwards from you sides. Let go
• Stretch all your fingers out. Let go
  
• Roll your knees outwards. Let go
  
• Point your feet downwards. Let go
  
• Raise and separate your eyebrows. Let go
  
• Look up towards your hairline. Let go
  
• Drag your bottom jaw downwards. Let go
  
• Focus on your breathing
  

Take some time to enjoy this sensation. Focus your thoughts on something pleasant.

Helpful positions for labour and birth

During contractions, stay upright and change your position frequently.

Your baby will be moved through your pelvis more easily if you stay upright.

Breathing awareness for labour

Relaxed breathing:

• Helps you concentrate
• Helps you cope
  
• Encourages relaxation all over your body
  
• Reduces pain

Early labour

Sigh out slowly as each contraction begins (SOS). When you feel ready, breathe in deeply but gently through your nose. Sigh out slowly. Repeat until the contraction fades. Concentrate hard on breathing out. Closing your eyes will help you focus on your breathing.

Advanced labour

Once contractions are very strong, sigh out slowly as each contraction begins. At the peak of each contraction, change to light upper chest breathing. Again concentrate on breathing out. Return to relaxed, deep breathing as soon as the pain starts to fade and continue until the contraction is over.

During delivery, help your midwife to protect your pelvic floor

Listen carefully to your midwife, she will tell you NOT to push as your baby’s head emerges. Pant lightly with your mouth open. This will stop you pushing and will allow your baby’s head to come out gently.

Minor problems during pregnancy

Swollen ankles and varicose veins

Regular exercise will reduce symptoms. Consider wearing support tights.

Numb/swollen fingers

For safety reasons, rings should be removed if your fingers have a tendency to swell. This may be a problem first thing in the morning and is due to extra fluid in the body, increasing pressure at the wrist. Your physiotherapist may supply you with wrist supports to wear at night which may solve the problem.

If swollen ankles and/or fingers are accompanied by a puffy face, headaches or flashing lights, seek medical advice at once.

Rib flare

This problem is due to the growing baby pushing the ribs out of their normal position. Try to change position frequently and avoid sitting on low chairs and other positions which bring your ribs close to your pelvis. You may get temporary relief by lifting the arm on the affected side and bending sideways away from the ache. Sitting cross-legged (tailor fashion) with hands on head also provides some relief.

Emotional changes

The hormone changes during pregnancy lead to emotional “ups and downs” and sometimes forgetfulness. After birth, these problems will gradually improve.