Active Pregnancy — the rationale

Mov­ing into Motherhood

It’s time to hit the main theme again:  Aer­o­bi­cally fit women are at reduced risk for things that go wrong in preg­nancy, improve their tol­er­ance for labor and birth, and recover more rapidly in the post­par­tum period.

Mov­ing into Motherhood

The arrival of the hol­i­days pro­vides a good rea­son to bring this up, yet again! Preg­nancy is a gate­way time in women’s lives…we become more aware of our bod­ies, our sen­sa­tions, our feel­ings, our needs, and how ver­sa­tile and amaz­ing our bod­ies are. We can make peo­ple with our bod­ies! Dur­ing preg­nancy, we often take precautions…we eat more care­fully, avoid tox­ins, try to avoid stress. When the hol­i­days arrive, we see indul­gent behav­ior in a dif­fer­ent light.

Yet, even with all this focus on behav­ior, we some­times miss the biggest aid to a healthy preg­nancy:  phys­i­cal fit­ness. Research clearly demon­strates that fit women do bet­ter, are health­ier and hap­pier. More and more in the U.S. we see dis­or­ders of nor­mal organ func­tion that accom­pany seden­tary pregnancy.

Let’s look at this a lit­tle closer (yes, I am going to repeat myself some more, but it is an impor­tant con­cept to spread). We live in a body model that rewards an active lifestyle.

Being seden­tary causes things to go wrong

Not mov­ing cre­ates bio­chem­i­cal imbal­ances because the car­dio­vas­cu­lar sys­tem atro­phies and mol­e­cules cre­ated in the brain or brought in through the diges­tion may not get where they need to go for a healthy metabolism.

Your car­dio­vas­cu­la­ture is the high­way that brings usable sub­stances to the place they are used. You have to help it grow and develop, use it to pump things around and give it a chance to be healthy. Aer­o­bic fit­ness does all these things.

Advice for young women of child­bear­ing age

If you are think­ing of preg­nancy, have recently become preg­nant, or work with women of child­bear­ing age, we encour­age you to open avenues of activ­ity for your­self or oth­ers in this pop­u­la­tion. You can learn more from our blog dancingthrupregnancy.wordpress.com. You can seek out local pre/postnatal fit­ness experts on this site. Yoga is nice…we use some of it in our work, along other spe­cific exer­cises for which there is a direct health ben­e­fit. But, we also see yoga con­verts who come into our pro­gram in mid preg­nancy unable to breathe after walk­ing up a flight of stairs. How will they do in labor? Not as well as those who have been doing aer­o­bic dance or an ellip­ti­cal machine 2 or 3 times a week.

The AHA/ACSM guide­lines for the amount of aer­o­bic exer­cise needed to improve car­dio­vas­cu­lar sta­tus hold true for preg­nant women just as they do for the rest of the pop­u­la­tion – a min­i­mum of 150 min­utes of mod­er­ate, or 75 min­utes of vig­or­ous, or a com­bi­na­tion of these lev­els of inten­sity, per week. If you are not get­ting this level of activ­ity, you are putting your health – and that of your off­spring – at risk.

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Buy the Book!

Recently, we have expe­ri­enced grow­ing inter­est in infor­ma­tion included in the text­book, Women’s Fit­ness Pro­gram Devel­op­ment. So, we decided that site read­ers might want to pur­chase this text if they are seri­ously inter­ested in sub­jects per­tain­ing to women’s health fit­ness. The book opens with a chap­ter on how women dif­fer from men in their phys­i­cal, men­tal, emo­tional and social devel­op­ment and how these dif­fer­ences affect our moti­va­tion to be active. Sec­tions on ado­les­cence, preg­nancy, the post­par­tum period and menopause explain what hap­pens dur­ing these crit­i­cal and uniquely female life tran­si­tions, what is known about the impact of exer­cise on health dur­ing these times, and how to develop effec­tive pro­gram­ming for these pop­u­la­tions. It is avail­able through the pub­lisher, Human Kinet­ics, or through Ama­zon or Barnes & Noble.

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Fitness Starts Early!

Preg­nancy fit­ness is not only impor­tant for moms, but for the fetus as well. Evi­dence is clear that aer­o­bic fit­ness improves brain, heart, immune and meta­bolic function…at all ages, includ­ing in utero. If con­tin­ued early in life, healthy phys­i­cal adap­ta­tions that occur in the uterus become rein­forced behav­ior, prepar­ing a good foun­da­tion for a healthy lifestyle. Babies are acute observers of move­ment and activ­ity, and learn from each other. A key com­po­nent of a good mom-baby pro­gram is the inter­ac­tion of the babies them­selves. A good teacher will facil­i­tate healthy activ­ity among our small­est class members!

There is grow­ing evi­dence that at all ages, aer­o­bic fit­ness pro­duces the great­est num­ber of ben­e­fits. Recently, researchers deter­mined that aer­o­bic fit­ness in 9 and 10 year olds pro­duced ben­e­fits in the devel­op­ment of two impor­tant brain regions — the basal gan­glia and the hip­pocam­pus — that are sig­nif­i­cant fac­tors in problem-solving intel­li­gence. This is just one of the lat­est reports that tells us the capac­ity to absorb and use oxy­gen (which improves with aer­o­bic fit­ness) is a key to health, qual­ity and length of life…beginning in the womb!

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CDC Fitness Guidelines Include Pregnancy

Recent CDC Guide­lines on Exer­cise for the gen­eral pop­u­la­tion include preg­nant and post­par­tum women. Spe­cific infor­ma­tion for preg­nant women is included at this URL:

http://www.cdc.gov/physicalactivity/everyone/guidelines/pregnancy.html

James Pivarnik, PhD, pres­i­dent of the Amer­i­can Col­lege of Sports Med­i­cine has released a Med­scape video for health care providers encour­ag­ing them to be aware of the fact that the CDC con­sid­ers a min­i­mum of 150 min­utes per week of mod­er­ate activ­ity (or 75 min­utes of vig­or­ous activ­ity for ath­letic women, or a com­bi­na­tion of inten­sity for fit women) to be impor­tant for preg­nant women, along with the gen­eral population.

DTP’s Total Preg­nancy Fit­ness instruc­tors learn how to com­bine activ­i­ties so that women receive an ade­quate amount of exer­cise each week dur­ing their preg­nancy. To find out about becom­ing a teacher, click on Become a Teacher above.

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New Mom Reports

We’re happy to report our baby was born on Sat­ur­day at 12:31 am…our exer­cise classes were ESSENTIAL in the later part of labor — the doc­tor and nurse described me as a “nat­ural” at push­ing, but I had to admit I’d been prac­tic­ing my c-curves twice a week!” — G.S.

We arrived at the hos­pi­tal at 8pm on Fri­day and I was 6 cm dilated…I deliv­ered by 1 am with­out pain meds.  It was an amaz­ing expe­ri­ence. You really do focus inward.  I found sit­ting in the shower hold­ing the sprayer to be help­ful.  Def­i­nitely try dif­fer­ent posi­tions.  I used the bar for when it can time to push.  Just know that there is an end in sight and just hold­ing your baby at the end is the most won­der­ful, amaz­ing feel­ing in the world!”  — P.E.

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Beyond Yoga

Beyond Yoga

I love Yoga. But…Power Yoga, Hot Yoga, Fast Yoga, Pilates-Yoga, Fresh Yoga, Baby Yoga and even Pre­na­tal Yoga…not so much. I find these phe­nom­ena strange.

Why? Well, 40 years ago – when I first learned Yoga – it was a priv­i­lege. A per­son came to Yoga in the search for a mean­ing­ful life path. It was a blend of the spir­i­tual and the phys­i­cal, and it required a com­mit­ment to what was revealed within the prac­tice. Before being allowed to take my first class, I had to demon­strate that I already prac­ticed med­i­ta­tion. It was not exer­cise per se.

It was not adapt­able like it is today. Depend­ing on the teacher, you learned an ancient sys­tem – Hatha, Vinyasa, Ash­tanga, Iyen­gar, or Kun­dalini. Those were the major meth­ods that have Hindu roots, and those who prac­ticed these art forms knew what they were doing. The teach­ers them­selves had worked on their craft for decades. Today, I know only a few teach­ers who have a pro­found grasp of each of these methods.

Why is Yoga so popular?

Is there some­thing within the work itself – even in the diluted forms, hybrid ver­sions and the celebrity/competitive stu­dios – that allows it to thrive in the self-centered, free-wheeling, branding-crazy mar­ket­place of the early 21st cen­tury devel­oped world?

I find the answer to this in a strange place:  Zen prac­tice, Bhud­dism. One of my favorite notions is from Suzuki’s text Zen Mind, Beginner’s Mind. “When you feel dis­agree­able, it is best to sit.” This is an ele­ment of nin – con­stancy – or being present in the moment. Not patience, which requires a rejec­tion of impa­tience and there­fore can­not accept the present as it is. When you sit – just sit period, that’s it – all that is real is the moment. This is at the heart of all spir­i­tual experience.

I’m not an expert in Yoga. I don’t teach Yoga, although I have inte­grated Yoga-based skills into my work. I have prac­ticed Hatha and Vinyasa over the years enough to learn how cer­tain skills are treated…belly breath­ing, slow deep breath­ing, main­tain­ing posi­tion and lis­ten­ing to the wis­dom of the body, and iso­met­ric strength­en­ing in prepa­ra­tion for more expan­sive shapes or motions. Long ago, I inte­grated these skills from my Yoga expe­ri­ence into my teach­ing style because these skills are effec­tive for the pop­u­la­tions with which I work. But, I do not teach Yoga.

Can Research Help Us?

Researchers find Yoga a night­mare. There is so much vari­ance now in the prac­tice that find­ings from any one study can­not be trans­ferred to the gen­eral pop­u­la­tion. One of the most reveal­ing experimental-design stud­ies found that none of the claims of Yoga improv­ing metab­o­lism could be demon­strated. When asked why they thought this out­come had occurred, the teach­ers who were used in the study said they thought the par­tic­i­pants in the study were not fit enough to do Yoga!

One of the most suc­cess­ful Yoga teach­ers in my area, and one of my favorites, has for decades used a bicy­cle for her pri­mary mode of trans­porta­tion. She cred­its her longevity and suc­cess to Yoga. I attribute it to bicy­cling. Dr. Cooper is right…fitness (which means aer­o­bic fit­ness) is the biggest bang for the buck. Unless you are fit, it is hard to exe­cute some of the more sub­tle demands of many exer­cise regimens.

Some Yoga teach­ers will say that you can make Yoga aer­o­bic or that some forms are aer­o­bic. OK, then it’s aer­o­bics, not Yoga. When­ever I see “aer­o­bic Yoga” it reminds me of aer­o­bic danc­ing. It’s help­ful to remem­ber that Yoga devel­oped in a time and place where sur­vival was depen­dent upon fit­ness. Peo­ple didn’t need to do more aer­o­bics to find enlight­en­ment. They needed reflec­tion and to be present in the moment.

So, I insist on aer­o­bic fit­ness as the first goal of a fit­ness reg­i­men. In the pre/postnatal field, this is the only con­sis­tently demon­strated fac­tor in improved out­comes. As a birth prepa­ra­tion there are Yoga-based fac­tors that will help in labor and birth IF THE WOMAN IS FIT ENOUGH. It is the fact that some Yoga-based skills help fit peo­ple find nin that is my jus­ti­fi­ca­tion for con­tin­u­ing to use them in con­junc­tion with aer­o­bics and spe­cial pre/postnatal prepa­ra­tion and recov­ery exercises.

But, there are cau­tions. Not all Yoga assanas (posi­tions) are safe for preg­nancy. Down-dog, in par­tic­u­lar, scares me because of inci­dents reported in obstet­ri­cal lit­er­a­ture in the 1980s and 1990s that indi­cate such a posi­tion is impli­cated in fatal embolisms. Some shapes are just not doable and oth­ers become less com­fort­able over time. The ones that work have been iden­ti­fied since the 1940s and 1950s and inte­grated into birth prepa­ra­tion courses.

What’s Next?

All exer­cise components -

  • Mind/Body
  • Strength
  • Flex­i­bil­ity
  • Aer­o­bic or Car­dio­vas­cu­lar Fitness

- are nec­es­sary for a bal­anced fit­ness rou­tine. Too much empha­sis on any one fac­tor often results in injury. Aer­o­bics is where the great­est health ben­e­fits reside. Recent research has demon­strated that it is phys­i­cal “fit­ness” (which we can mea­sure) as opposed to just spend­ing time in phys­i­cal activ­ity (which can be a wide range of inten­si­ties) that is respon­si­ble for improved health out­comes. Strength and flex­i­bil­ity train­ing need to be pur­po­sive. There are things we don’t need to do unless we are going to play pro foot­ball or dance Swan Lake! Mind/Body skills help us recover and prepare.

I for one will be glad when we get beyond yoga and back to cross training!

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Fetal Programming

What is fetal pro­gram­ming? Every per­son liv­ing on earth was first exposed to a uter­ine envi­ron­ment that helped deter­mine their life­time health and devel­op­ment. The term for this phe­nom­e­non is fetal pro­gram­ming. It is a hot topic and deserves attention.

Accept­ing the impor­tance of fetal pro­gram­ming places respon­si­bil­ity on the mother-to-be to do all she can to insure her body pro­vides nutri­ents and oxy­gen to her grow­ing infant while avoid­ing pos­si­ble risks and tox­ins. At the same time, genetic and envi­ron­men­tal fac­tors con­tribute greatly to the poten­tial for some dis­or­ders and prob­lems that arise. Thus, we must be care­ful in assign­ing guide­lines for accept­able behav­ior or blame for poor out­comes to preg­nant women.

On the one hand, we can all see the neg­a­tive con­se­quences of some­thing like fetal alco­hol syndrome…clearly the result of mater­nal behav­ior. Is a preg­nant woman whose baby has been dam­aged in this way guilty of abuse?

But, what if a mother is obese, eats poorly and ends up with an infant with a dis­turbed metab­o­lism. Is this abuse? What if the mother has an infec­tion that results in cere­bral palsy? Or what if she lives near a high­way and invol­un­tar­ily inhales fumes that neg­a­tively affect the placenta?

How do you get a healthy baby? Of course, there are no guar­an­tees. There remain many unknown fac­tors that can affect the course and out­come of a preg­nancy. Some fac­tors we are aware of, such as avoid­ing cer­tain fumes or chem­i­cals.  There are some behav­iors we know can max­i­mize the poten­tial for a good out­come, such as eat­ing ade­quate pro­tein, aer­o­bic con­di­tion­ing and strength train­ing. [Note for new readers…lots of these fac­tors have been cov­ered in our pre­vi­ous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cau­tion­ary tale:  There is a species of goat that, if they eat a cer­tain type of skunk grass on day 14 (and only day 14) of preg­nancy, will not go into labor. Why? Plant tox­ins in this grass inter­fere with the devel­op­ment of a small por­tion of fetal brain, the par­aven­tric­u­lar nucleus. This nucleus is involved in the sig­nal­ing cycle of labor. With­out it, the mother will not go into labor!

What are the take-home mes­sages here?

  • Prob­a­bly no one is ever a per­fect fetus…too many pos­si­ble threats.
  • There are some threats we can avoid…being lazy, over-eating, smoking.
  • There are some threats we can­not avoid, so we do the best we can.

Do the best you can by your baby…aerobic fit­ness, good nour­ish­ment, sleep, good hygiene and de-stressing your life.

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Mom-Baby Fitness in Spanish on YouTube!

El Show de Analeh — on Uni­vi­sion — a seg­ment on Healthy Moms, Healthy Babies, fea­tures DTP’s Mom-Baby Fit­ness and par­tic­i­pant Car­olina Baffi. Now avail­able on YouTube!  Check it out!!

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More on Preventing Childhood Obesity!

Rachael Blum of Santa Mon­ica, CA, has alerted us to an excel­lent arti­cle in the New Eng­land Jour­nal of Med­i­cine con­cern­ing the evi­dence for the role of exer­cise in preg­nancy in help­ing pre­vent child­hood obe­sity:  http://healthcarereform.nejm.org/?p=3321&query=home. Rachael, our newest DTP fam­ily mem­ber, has also alerted us to an LA Times arti­cle on this sub­ject:  LA Times arti­cle.

With the recent empha­sis on the impor­tance of move­ment in the fight against child­hood obe­sity, there is recog­ni­tion that ben­e­fi­cial fetal pro­gram­ming through mater­nal exer­cise can make a big con­tri­bu­tion to this effort. A com­bi­na­tion of proper mater­nal nutri­tion and mater­nal fit­ness may well prove to be most effi­cient and poten­tially effec­tive way to help chil­dren develop an appetite for motion!

One fac­tor in this is the find­ing that reg­u­lar, moderate-intensity exer­cise helps pre­vent obe­sity in the new­born: http://www.nlm.nih.gov/medlineplus/news/fullstory_97212.htmlt. This, may in turn, help pre­vent child­hood obesity.

Recess for everyone!!!

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The 51% Factor: Pregnancy, Power & Health

In the U.S. and most of the devel­oped world, approx­i­mately 51% of the pop­u­la­tion is female. Most females give birth at some point in their lives, although, in any year, only about 2% of the pop­u­la­tion gives birth.

No one liv­ing on earth got here any other way than ges­ta­tion, so there ought to be some power attached to being part of that 51%. His­tor­i­cally, it might be said that the power has been merely for survival…the good breed­ers sur­vived long enough to pro­duce heirs and those who lived on knew where the roots and fruit grew.

Only women can make more peo­ple with their bodies.

Here are some things to consider:

  • Women make people
  • Women’s health and fit­ness before preg­nancy affects whether the preg­nancy is healthy
  • Women’s health and fit­ness dur­ing preg­nancy affects her life­time health and that of her offspring
  • Mater­nal sur­vival is impor­tant to off­spring well-being
  • Mater­nal health and fit­ness affects mater­nal adap­ta­tion and thereby off­spring well-being

Thus, is it not a san­guine notion that the health and sur­vival of women is crit­i­cal to the health of every­one? After all, the health of nations is asso­ci­ated with this slight major­ity of females, and the wealth of nations is asso­ci­ated with its health.

The good news is that peo­ple work­ing from this under­stand­ing are mak­ing some head­way around the globe. Recently, the World Health Orga­ni­za­tion noted that mater­nal death among preg­nant and birthing women world-wide has been dra­mat­i­cally reduced from the 1980’s to recently. This is very good news!

Here is the inter­est­ing foot­note:  Mater­nal death in the U.S. has risen 42% in the same period. While the absolute num­bers remain small, this is a dis­turb­ing pic­ture. What could be caus­ing this?

Time will tell if we can fig­ure it out and fix it. I ven­ture to sug­gest some direc­tions for consideration:

  • The ele­vated cesarean birth rate with its sequel­lae of car­dio­vas­cu­lar and immune sys­tem disorders
  • Obe­sity
  • Meta­bolic syndromes
  • Dia­betes
  • Heart dis­ease

Why am I hope­ful, then? I see among our cur­rent edu­cated gen­er­a­tion of new moms and moms-to-be a will­ing­ness to exert their influ­ence – as breed­ers – over the health care scene. They want less tech­no­log­i­cal birth. They want sup­port. They want more infor­ma­tion. They want to be healthy. These are won­der­ful things. I salute these young women…they also make my job eas­ier in the process.

In addi­tion, I see among young health care prac­ti­tion­ers an under­stand­ing of the value of these things. Among prac­ti­tion­ers work­ing in pub­lic health clin­ics there is a sense of des­per­a­tion on the one hand that the poor and indi­gent have no capac­ity or will to take care of them­selves. On the other hand, the first step is always edu­ca­tion and there are a lot of peo­ple work­ing on this issue.

Which brings me to the clos­ing point:  How do we bring more resources and intel­li­gence to help­ing women be healthy, pre­pare for preg­nancy, have healthy babies, reduce preg­nancy com­pli­ca­tions, and improve infant and mater­nal death rates? I, for one, will keep blog­ging on this issue. You, I hope, will vote for peo­ple who under­stand this issue. The polit­i­cal power and will is in our hands.

51% of us are women…some day 51% of us can set priorities

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