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The Rotunda was the first maternity hospital in dublin to get the national baby friendly hospital award

Exercise in Pregnancy


Two women swimming in pool

To stay healthy and well, pregnant women should take regular exercise. As well as being good for your heart, breathing and muscle tone, exercise helps reduce stress levels, improve sleep and helps prevent you from getting pain around the pelvis and low back areas. Exercise can also help you manage your blood sugars, gestational diabetes and help you from putting on too much weight.

Exercising regularly, will help you get ready for labour and after your baby’s birth, will help you get back into shape.

If you are healthy and well, and have no problems with your health before or during your pregnancy, you should do 30 minutes of moderate exercise at least five days a week. You can divide this up into two 15 minute sessions if it is easier for you.

If you have medical or pregnancy problems, or are worried about your health, you should talk to your doctor, midwife or physiotherapist before exercising.

Helpful hints

  • Moderate exercise means that you are doing something that is quite hard but that you can still carry on a conversation. This is known as the ‘talk test’.
  • If you didn’t do any exercise before you got pregnant, start by doing some gentle exercise and build up to moderate exercise. 
  • Pregnancy hormones can soften your ligaments; therefore it is important to protect your joints during exercise. We recommend that you do low impact exercises and avoid exercises with a risk of falling. Walking is a great free way to exercise.
  • Start with a gentle warm up and finish with a cool down.
  • Drink plenty of water and avoid getting too warm during exercising.
  • Listen to your body and stop when you feel tired or if it hurts. Never exercise if you are feeling unwell.
  • Wear good supportive shoes and a supportive bra and underwear when exercising.
  • If you go to exercise classes, make sure that your teacher knows that you are pregnant. 
  • Swimming is a great way to exercise during pregnancy and the water will support your extra pregnancy weight. If you have pain around the bones of your pelvis, it is best to avoid the breast stroke as the movements might make the pain worse.
  • From the 16 week of your pregnancy avoid lying on your back to do exercises because you might feel faint or short of breath
  • Always avoid doing sit-ups because it can harm your tummy muscles and lead to back pain

Pelvic girdle pain (PGP)

Pelvic girdle pain describes pain in any of the three pelvic joints. It is common but not normal and can affect 1 in 5 women during pregnancy. There are many causes which include:

  • Uneven movement of the pelvic joints
  • Changes in the activity of the tummy, pelvic girdle, hip and /or pelvic floor muscles can affect the stability of the pelvic girdle
  • Previous injury to the pelvis
  • Hormonal changes that occur during pregnancy
  • The position of the baby can cause symptoms related to pelvic girdle pain in some women

pelvis

Signs and symptoms

Pain can vary from mild to severe. It may affect the symphysis pubis joint at the front of your pelvis, the groin, inner thighs or the sacroiliac joints at the back. Pain may be referred into your buttocks, hips or perineum.

You may experience:

  • Difficulty walking 
  • Difficulty with activities requiring standing on one leg e.g. climbing the stairs, dressing or getting in or out of the bath 
  • Pain and/or difficulty moving your legs apart e.g. getting in and out of the car 
  • Clicking or grinding in the pelvic area – you may hear or feel this 
  • Limited or painful hip movements e.g. turning over in bed 
  • Difficulty lying in some positions e.g. on you back or side 
  • Pain during normal daily activities 
  • Pain and difficulty during sexual intercourse

With pelvic girdle pain the degree of discomfort you are feeling may vary from being intermittent and irritating to being very wearing and upsetting.

Management of pelvic girdle pain during pregnancy:

  • Your doctor or midwife may refer you to a physiotherapist. You will be given an appointment for our special class which provides advice, exercises and information to help you manage your pain and daily activities.
  • Your physiotherapist may then arrange a one to one appointment and do an assessment of your spine and pelvis and she can recommend a range of treatment options.
  • Manual therapy, which is a ‘hands on’ assessment may be required to ensure your spinal, pelvic and hip joints are functioning normally.
  • A pelvic belt may be given to provide added stability, if appropriate.
  • Crutches may be used if pain is severe on weight bearing.

Things you can do to help reduce the pain:

  • Be as active as possible within pain limits and avoid activities that make the pain worse 
  • Rest when you can – you may need to rest and sit down more often 
  • Ask for and accept help with household chores from your partner, family and friends
  • Pull in your tummy before going from sitting to standing and from standing to sitting 
  • Go up stairs one leg at a time with the pain free leg first. You may need to try going upstairs backwards or on your bottom
  • If getting in and out of the car is painful, sit on the seat first and try to keep your knees together or step them (lift one up and then the other) into the car; a plastic carrier bag on the seat may help you to swivel
  • Sit down to get dressed and undressed and wear flat supportive shoes 
  • Sleep in a comfortable position e.g. lie on your side with a pillow between your legs and feet
  • When turning in bed, it can help to keep both knees together and try to turn under rather than over on your back in one smooth movement
  • Roll in and out of bed keeping your knees together
  • Maintain a good posture by standing tall and keep a gentle curve in your lower back
  • If using crutches have a small rucksack to carry things in 
  • Have a toddler at waist height when changing their nappy and kneel beside the bath when bathing other children

lying downgetting up


AVOID activities which make the pain worse:

  • Avoid or reduce unnecessary weight bearing activities, for example, shopping, lifting or activities on one side, such as carrying a toddler on one hip 
  • Lifting or pushing heavy objects or carrying anything in only one hand 
  • Plan your day – avoid unnecessary trips up and down the stairs 
  • Standing on one leg, crossing your legs or sitting twisted
  • Sitting or standing for long periods

Pelvic floor muscles

These are very important muscles as they control the bladder and bowel. During pregnancy they become weakened due to pregnancy hormones and the extra weight of your baby. It is important for all women to strengthen their pelvic floor muscles during pregnancy, whether they plan to have a vaginal delivery or caesarean section

pelvic floor

Exercises for your pelvic floor muscles

To begin with, lie on your back with your knees bent and your feet hip width apart.

Long holds
  • Squeeze and lift your pelvic floor. Starting at the back passage, squeeze as if you are trying to stop yourself passing wind and then urine. You may feel your lower tummy tighten gently. 
  • Hold for 3 seconds; keep your tummy, buttocks and thigh muscles relaxed and breathe normally. 
  • Relax completely for 3 seconds. Repeat this exercise 5 times. Repeat 3 times a day.
  • As your pelvic floor muscles get stronger, practice in sitting and standing.
  • Gradually increase the length of time and number of repetitions until you can do a 10 second hold 10 times. Always stop exercising when the muscle gets tired.
Quick holds
  • Quickly tighten the pelvic floor muscles and hold for a second before letting go fully. 
  • Repeat 5 times in a row. Repeat 3 times a day. 
  • Gradually increase your repetitions until you can do 20 quick squeezes in a row; it may take a few months to be able to do this.

The knack

Quickly squeeze and hold your pelvic floor muscles BEFORE coughing, sneezing, laughing and when lifting your baby. This will give you more control of your bladder and will help to keep your muscles strong. To be effective you need to do your pelvic floor muscle training 3 times a day.


Pelvic Floor Muscle Exercises - Information Videos

Knowing how to do your pelvic floor muscle exercises is really important and can help you prevent or stop urine from leaking. 

The physiotherapists in the Rotunda Hospital have made five videos on learning about pelvic floor muscles, doing your pelvic floor muscle exercises, leaking urine and doing exercises after you have your baby. 

We made the videos so that all women can receive reliable, trustworthy, free information and to let women know that:: 

  • Leaking urine is not normal and can be treated 
  • Doing pelvic floor muscle exercises regularly helps treat and prevent urine from leaking. 

Leaking urine or wetting yourself when you do not mean to (also known as urinary incontinence), can be treated with pelvic floor muscle exercises (PFME).  PFME help reduce symptoms of urinary leakage; in some cases leading to temporary or even permanent relief. 

We know from research done at the Rotunda Hospital as part of the MAMMI study, that: 

  • one in three women leak urine occasionally (less than once per month) before their first pregnancy
  • one in three first time mothers leak urine once a month or more frequently during pregnancy
  • as many as one in two first time mothers leak urine 3 months after the birth of their first baby. The numbers are higher in women who have had more than one baby. 

We also know from looking at our antenatal class attendance records that only half of first time mothers and fewer than one in twenty women having their second or subsequent baby received PFME education, taught during the antenatal classes in the Rotunda Hospital. 

Each video is just 3-6 minutes long. Please click on the relevant video to watch:

Introduction to the videos from the Rotunda's physiotherapy manager, Cinny Cusack

Video 1: Getting to know your pelvic floor


Video 2: Leaking urine/Urinary Incontinence

 

 Video 3: How to do your pelvic floor muscle exercises 

 

Video 4: Exercise and poise

Once you have watched the videos, we would love to hear what you thought of them, and in particular, if you found them a good way of providing information.  

We would also like to know if you did pelvic floor muscle exercises in the past and if you have ever experienced leaking of urine. To give us your feedback, please click on this PFME Survey link to provide it.  


Yoga for pregnancy and birth

The word ’yoga’ means ’union’ in Sanskrit, the classical Indian language. The practice of yoga is a coming together of the mind, body and spirit. Although yoga in pregnancy follows the same principles as all yoga, it is quite different from regular yoga because it is designed with the specific needs of the pregnant woman in mind. Because of this, yoga in pregnancy is always safe and gentle.

The benefits of yoga during pregnancy are:

  • Yoga exercises gently work on the reproductive organs and pelvis and may help you have a smooth pregnancy and a relatively easy birth; 
  • Practising yoga might help to develop self-awareness and harmony between body and mind; 
  • As a therapeutic tool, yoga meditation might help you resolve your fears and worries which are so common during pregnancy.
  • Yoga improves deep breathing, which allows more oxygen to enter the bloodstream; 
  • Yoga promotes good posture, easing upper and lower back pain;
  • Regular practice will improve muscle tone and strength, with improved control of  balance and co-ordination; 
  • Yoga can help to increase the circulation of blood and lymphatic drainage which reduces the risk of swelling, varicose veins and piles (haemorrhoids); 
  • Yoga can help to increase stamina and endurance for labour and birth. Research has shown that flexibility and fitness can result in a shorter labour, fewer medical  interventions and less exhaustion during labour; 
  • Yoga can help to promote a greater sense of strength, peace and security around the whole birth process; and 
  • Yoga helps you to breathe deeply which, in turn, helps you to cope with pain. 

three ladies on exercise balls

The benefits of yoga can continue after the birth of your baby, when deep breathing is used to tone the pelvic floor into peak condition and keep your energy levels balanced. Yoga can improve lactation (production of milk supply) and relaxed yoga mothers tend to have relaxed babies.

Yoga classes are held in the Rotunda. The content of the classes includes various breathing techniques, postures and movements followed by deep relaxation. Yoga may help to make you feel calm and help you to deal with whatever challenges lie ahead.  The breathing techniques and relaxation are very beneficial for mothers coping with contractions during labour. Women doing yoga with instructor showing her what to do

Most healthy women can join the yoga classes. Minor disorders of pregnancy generally do not pose a problem. No previous experience of yoga is necessary and you join the classes by phoning up yourself or by getting a letter from your doctor or midwife.  The classes are provided by a midwife, are held in the evenings and last about 1 hour 15 minutes to 1 hour 30 minutes. The classes run for six weeks and there is an associated cost. Courses can be repeated. 

To make an appointment phone 01 817 6883, between 8.30 am and 4.00 pm, Monday to Friday. If there is no reply, please leave a message with your name and phone number and your call will be returned as soon as possible. 


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