- The Washington Times - Tuesday, February 12, 2002

Ute Kraidy, who is due to give birth to a son this month, exercises about five times a week, saying it makes her feel better both physically and mentally. "I had a backache earlier in the pregnancy, but since I started with water aerobics, it's completely disappeared," says the Silver Spring resident, who participated in a 45-minute water aerobics class at the Silver Spring YMCA on a recent evening.
"It's also relaxing to be in the water. It's a low-key class, and I just enjoy the water together with the baby," Mrs. Kraidy says.
She complements her twice-a-week water-aerobics class with one-hour walks at least three times a week.
Today's obstetricians endorse regular exercise for pregnant women as long as the woman is healthy and not at risk for preterm labor and other complications.
The trend in the past decade has been for prenatal exercise guidelines to start to mimic recommendations for non-pregnant persons.
The American College of Obstetricians and Gynecologists came out last month with new exercise guidelines for pregnant women, recommending that they exercise every day of the week. The old guidelines recommended three days a week.
"I strongly believe that pregnancy should not be a state of confinement," says Dr. Raul Artal, professor and chairman of obstetrics, gynecology and women's health at St. Louis University School of Medicine and co-author of the new guidelines.
"We know from research, including my own research for the last 25 years, that it's safe and we know there are health benefits," Dr. Artal says.
Doctors' guidelines for prenatal exercise have changed drastically through the years. The second-most-recent guidelines from the American College of Obstetricians and Gynecologists came out in 1994.
Four or five decades ago, doctors recommended that pregnant women avoid physical exertion and limit weight gain to 10 or 15 pounds a difficult thing to do and now considered unhealthy. To help pregnant women stay thin while sedentary, some doctors in those days prescribed diet pills. A weight gain of 25 to 35 pounds is now considered normal.
Back in the Victorian era in England, pregnant women were "supposed to stay inside and be hidden," to avoid infections and contagious conditions, Dr. Artal says.

Things have changed, and among the health benefits of exercising while pregnant especially if the woman is obese is diabetes prevention. Obese women who exercise regularly are half as likely to develop gestational diabetes as those who don't exercise, Dr. Artal says.
Another benefit is the sense of well-being that physical fitness gives non-pregnant and pregnant persons alike. "We know there is nothing better than exercise to maintain a healthy soul and body," the doctor says.
Several women in Mrs. Kraidy's water-aerobics class say they feel much better mentally when they exercise, and they notice a big difference if they don't exercise. "I took two weeks off [from water aerobics], and I felt totally different," says Jennifer Herlihy of Silver Spring, who also is due this month. "I didn't sleep as well, and I could feel it in my back."
Other benefits include maintaining one's endurance and stamina, which will help once the baby is born, says Dr. Susanne Bathgate, an obstetrician and gynecologist and specialist in maternal fetal medicine at George Washington University Hospital.
"Women who exercise during pregnancy generally seem to have an easier time recovering," Dr. Bathgate says.
When picking an appropriate exercise program of any kind, a pregnant woman should ask her obstetrician what type of physical activity might be the most beneficial and safest in her case.
Activities that generally should be avoided are those that may increase the risk for abdominal trauma or falling, such as ice hockey, skiing, soccer, gymnastics and horseback riding.
Scuba diving should be avoided because the fetus is at an increased risk for decompression sickness during this activity.
Also, after the first trimester, women should avoid lying flat on their backs when doing, for example, sit-ups. Lying flat on the back decreases the blood flow, which can be harmful to the fetus.

Though gaining weight is inevitable and normal during pregnancy, many women take the opportunity to adopt a healthier lifestyle, improving not only their diets, but also their exercise routines, Dr. Bathgate says.
"It's a very unique time in a woman's life, and many women pay more attention to their lifestyle," she says.
The new guidelines recommend a half-hour of moderate exercise a day. Among "moderate" exercise forms are brisk walking, swimming, water aerobics and cycling on a stationary bike (to avoid possible trauma from a fall), Dr. Bathgate says.
She adds that exercising "moderately" means being able to conduct a conversation during the activity. If the pregnant woman gets out of breath while exercising, it's a sure sign she needs to slow down.
Another way of measuring moderate exercise is to monitor one's heart rate. A pregnant woman's heart rate should be between 60 percent and 80 percent of her maximum heart rate. That number is calculated by taking the number 220 and deducting the woman's age: If the woman is 30, the maximum heart rate is 190. Then figure 60 to 80 percent of that, which is 114 to 152 beats per minute.
Besides cardiovascular activity, light weight training, stretching and balancing exercises also can be beneficial.
With any exercise, though, it's important to listen to your body and to use common sense, Dr. Bathgate says.
Prenatal yoga has become very popular and can be very beneficial, she says, but be sure you don't lose your balance which may cause you to fall or lie flat on your back.
"Always keep in mind the limitations of the pregnant body," Dr. Bathgate says. "Use common sense."
Though doctors' recommendations for exercise during pregnancy have undergone drastic changes in the past hundred years, Dr. Artal predicts the newest ones are here to stay for a long time.
"I think these guidelines will last for a century," he says. "They are so close to the guidelines for non-pregnant individuals."

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