Can Exercise Prevent Incontinence in Pregnancy? The Guide for Women Over 35 My Baba 20 October, 2014 Expert, Health & Fitness, Health and Symptoms, Living, Pregnancy, X - Features By Suzy Clarkson, author of Fit for Birth and Beyond, The Guide For Women Over 35 I had my first baby at 39. Prior to then my life had been largely career dominated and I didn’t meet my husband until I was 37. It wasn’t that I had consciously chosen briefcase versus bassinet, it’s just the way things unfolded. What it meant was I was now part of the ‘older mum’ crowd. Then having my second baby at age 44 further pushed the bounds of fertility and, as I confide in my book ‘Fit to Birth and Beyond’, my journey to get pregnant the second time was not an easy one. I share a brief account of my infertility battles in one chapter but my book is not actually about infertility, it’s about being safely healthy and fit during the three trimesters of pregnancy and beyond. I also decided to include some personal diary entries alongside the more practical and prescriptive exercise information for each stage as an insight into the typical ups and downs experienced during the nine months gestation. I mean when you’re 38 weeks pregnant, the size of a whale and the thought of being able to trim toenails is a distant memory – there’s only one thing to do, see the lighter brighter side of life and laugh! Pregnancy is a unique journey for every woman and being an older mum presents its own challenges. My book is aimed at the over 35 age group reflecting an established upward trend of women choosing to have babies later in life. Physically the optimum time for a woman to have a baby is in her twenties when she has plenty of energy as well as the life skills to cope with being a mum. However there’s a lot of be said for becoming a mum in the decades that follow: more emotional maturity, more settled and worldly (after having probably travelled or at very least experienced more of life) more financially stable and more willing to make the necessary sacrifices that having a baby inevitability involves. Crayon on the walls or paint on the carpet are definitely annoying but can be treated with a perspective that comes from relaxing about the ‘immaculate house’ you probably once ran. Some of the themes running throughout my book dispel myths about pregnancy and exercise and reinforce what is an absolute must and what is optional. For example there are a couple of specific exercises involving the pelvic floor muscles and a deep layer of abdominal muscle that are critically important for preventing injury and to fundamentally assist a woman to return to her pre pregnancy body shape. There are also many factors that go into what is right for each pregnant woman to undertake, however consider these more universal principles: Doing something is better than doing nothing and during pregnancy moderate is a good word to apply to exercise intensity Exercise is now viewed by the medical fraternity as far more than just something to consider but instead it’s an important part of a healthy pregnancy for both mother and baby Always discuss any exercise programme you do with your lead maternity carer I have a section at the back of the book which is called the “Bare Essentials” this is a short series of appropriate exercise designed for when you are feeling tired and unable to face more vigorous exercise. It will give you a valuable sense of achievement in being able to complete ‘something’ manageable The general recommendation for adults exercising is to do 30 minutes of exercise a day most days of the week but in my book I further tailor that prescription to what’s important during each of the three trimesters of pregnancy Many common pregnancy ‘niggles’ are alleviated by regular moderate exercise. In an uncomplicated pregnancy exercising gives you and your baby a head start in the health stakes. So here are five reasons why I rate exercise during pregnancy: 1) Exercise helps manage weight gain and shape change that goes with pregnancy. More specifically it helps prevent excessive weight gain and helps you regain your pre-pregnancy shape more quickly. Normal weight gain is 10-15 kilos, however women who have been exercising prior to pregnancy and continue doing so throughout can affect whether they are likely to hang on to that pregnancy accumulated fat. In some studies the weight different between those who exercised and those who did not equated to around 3 kilograms, that can make a fairly significant difference to how a pregnant woman looks and equally important, how she feels about herself. Women who have not exercised prior to pregnancy but who start a regular regime during or after their first trimester can also influence their weight gain and fatty deposits, but only if the right amount of moderate exercise is done, for example about 3 hours total a week. It may sound a lot but consider how that total could be split into 30 minutes sessions 6 days a week. 2) Exercise prevents urinary incontinence. I have purposely written that dramatic sentence to get your attention, after all who wants to ‘leak’? I get cross when I see advertisements for urinary incontinence pads suggesting that ‘leaking’ is normal and you just need a pad to soak it up. No! You need to pay careful attention to maintaining your pelvic floor muscles during pregnancy with an understanding that they will then have to stretch beyond imagination for a vaginal birth. Then phase two of pelvic floor re-education comes into play with you gently but persistently coaxing them back to working action so that for the rest of your life you don’t ‘leak’ when you cough, sneeze or jump! Pelvic floor exercises as part of pre-birth and post birth exercise routines are critical. They are in my opinion -non-negotiable. 3) Exercise helps maintain a positive attitude throughout your pregnancy and afterwards. Exercise has a positive effect on mood, sense of achievement, and allows you a feeling of control over at least some part of your body while your middle region swells to the size of a basketball and increased hormones surge around your body. Exercising can also be a social opportunity especially if you partner up with a friend to get out and powerwalk whilst pregnant or perhaps in the new mum stage you head out for a brisk pram walk and finish with a cafe stop as a reward. There’s also research to show exercising decreases the rate of post natal depression. 4) Exercising means you will be more likely to practise good nutrition habits. This is vital for your growing baby’s health and your future health. Babies born to mothers who have poor nutrition during pregnancy can exhibit learning difficulties, reduced growth, dental problems, allergies and be more prone to illness. Obviously taking the right amount of folic acid (a minimum of 600 micrograms, usually 800mcg) is a must but there are a host of other nutritional considerations during pregnancy. Other must haves include: extra protein, twice as much iron, extra fluid, calcium, zinc, magnesium and vitamins B, C and D. 5) Exercise reduces pregnancy symptoms and niggles like swollen veins, insomnia and anxiety. There is some evidence to show that weight-bearing exercise (e.g. brisk walking) can reduce the length of labour and decrease delivery complications. Exercise gives improved strength for the lifting and carrying required with a new-born, reduces your chance of gestational diabetes and gives you increased resistance to fatigue. Keeping fit and healthy is not rocket science but it does involve a daily discipline of keeping exercise and good nutrition as priorities. Of course there are always blips that will rock your routine as a new mum: sick kids, holidays, and so on, but provided you get back on track as soon as possible then it is just that – a blip, not a blockage. I wish you well on your own journey. Suzy, a very lucky mum of two wonderful boys. Suzy Clarkson is the author of Fit for Birth & Beyond: The Guide for Women Over 35, published by Exisle Publishing at £12.95.