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People are in the false sense that they are eating for two, and so a lot of women who have been very good about maintaining fairly healthy eating habits often use pregnancy as an excuse to let that go a little bit. And so I stressed to women that it is all about balance, so I am not talking about dieting, I am talking about over eating, I am talking about making healthy food choices. Getting women to eat a wide variety of food options, so a lot of women are deficient both in the vegetable intake and in their calcium intake, so making sure that women are hitting both of those goals, but in general that is really just about balance in getting a well balanced healthy variety of foods that are nutritionally sound. So I try and say to women that sure it is okay to indulge a little bit, but you got to remember that those are empty calories and that you are getting calories and you are gaining weight without getting the nutrition that you need from those calories.
I think women have to be careful about things that are high impact, so we know that the body goes through a lot of changes when you are pregnant, that a lot of the hormones in pregnancy relax a lot of the joints and so women can be more prone to some joint and ligament injury if they are not careful about that. And that is one of the things that I always talk about. We obviously will limit women from exercises in which I think there is a potential for harm to the abdomen. So I do not let women play soccer when they are pregnant even if they tell me they are really good because we know that there is a potential, there are things like water skiing and skiing are dangerous not because of the demands of the sport but because of the potential for injury.
Beyond that, I think women need to have realistic expectations and women often surprised by the limits that their changing body will put on their activity level. So women have been very used to doing marathon running or long distance running or often surprised that they really do need to cut back. So we talk about limits in terms of not too much heart rates but just being able to talk through your exercise, being able to keep your self or you are not pushing your self beyond safe limits. Making sure women are well hydrated during their exercise programs, making sure women are not becoming over heated. So these are all things that we talk about. One of my greatest exercise favorites during pregnancy is swimming and it is often something that is neglected in this country. Swimming is a fantastic exercise when you are pregnant because first of all women light in the water and so that is always a very pleasant feeling for women, it is great for your back, women can really improve their cardio vascular fitness’s as well and it is really easy on the joints.
So I think there is a lot of benefits, I think during the pregnancy, I think people handle pregnancy better. I think their back is stronger, I think their body carriage is better. I think they can handle the aches and pains of pregnancy in a much more comfortable fashion that people are acted. I think it helps maintain people’s weight at a comfortable level and so I am not talking about limiting weight gain during pregnancy but I am talking about preventing too much weight gain during pregnancy, which can put a lot of extra strain and stress on the ligaments and joints. I think that certainly in labor and delivery it is probably where we see the biggest benefit if I had to pick one. So we know that labor is a very demanding time in women’s life, probably the most energy women will ever expend in sort of one fitness period and so that being active can really help in so many ways.
We know that the muscles of the pelvis are better developed; we know that the oxygen level is probably part of that, so increasing oxygen levels to the pelvis. Women cope better, they are able to position themselves better in labor, they are able to push longer, they are able to push more effectively, they are able to control their musculature in a way that really seems to help them with their actual delivery. We know that women who are active have lower rates of operative delivery, they have lower caesarian section rates, lower rates of operative deliveries of forceps and vacuums and so I think that is really where probably the biggest benefit is. In the post partum period though, I mean so many women forget that, that is a really challenging physical time as well.
People focus all their energy on labor and delivery, they forget about how much it takes to recover from the whole process, and so women that are in better shape to start with are much more able to bounce back quickly. And are back on their feet much earlier, I think that women who have been physically active during their pregnancy are more motivated to work fitness into their recovery period. And so it is a tiring time, there is no question about it and so there is not a lot of excess time to go around and there is a lot of demands for that small amount of personal time. But I think women who are motivated to become active, work harder to use that time and I really find that they are able to be back on their feet and feeling much more like themselves at a much quicker rate.
They are happier too because of the weight lost, so there is no question about it that a lot of women come to see me in their post partum period. And they are frustrated because they really thought that their weight would melt away right after that they had the baby and they are frustrated that it is not coming off as quickly.
I think it is hard for women, especially women who have been physically active and has been in control of their weight for a long time, it is hard to let that go. And so a lot of times my initial talk with women is that you know what you are going to gain weight during your pregnancy and you have to. It is important for both your physical health and for the baby’s health as well. And so first of all, women have to accept that they are going to gain weight and their body image is going to change during pregnancy. My goal is to help that in a positive fashion. So I want women to have to walk away seeing that their body changes but being happy with those changes.
Again, I think that there are a lot of problems of gaining too much weight during pregnancy and so exercise and healthy eating is really one way to control that. I do not want women dieting when they are pregnant, I do not want women loosing weight when they are pregnant. But for women who start of a little bit over weight then being physically active during the pregnancy is one way of helping control that.
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