In pregnancy, every task performed during the day may have some impact on gestation, such as work hours, laying in the sun, drinking alcohol, etc. So the concept of exercise should be taken out of the realm of performance or aesthetics, and should be part of the pregnant women's health regime throughout pregnancy.

Since many types of equipment are not applicable to pregnancy, it has been historically difficult for pregnant women to perform machine exercises such as biking, rowing, and cross-country skiing without modifying the machines. Recently, there have been some advancements in the fitness community that may benefit pregnant women who wish to continue to perform exercise programs throughout their pregnancies.

The first area of enhancement is in aerobic machines. A few years ago a research study was performed on different types of aerobic machines to find out which ones may be safe to use throughout pregnancy, particularly ones that did not cause any unnecessary uterine contractions. Of all the machines tested, the upper body ergometer, or UBE performed the best. It is thought that the UBE, because it is used with the arms, tends not to disturb the fetus as much as exercise performed with the lower aspect of the body. Jarring, rhythmic movement of the legs, bouncing, etc. all cause some type of stress to the body overall. Movement of the arms in a seated position may be able to produce an aerobic effect without as much overall body stress. Since there was no discernable uterine contractions, and no effect on fetal heart rate, it is thought that the blood supply to the fetus was not disturbed much during the exercise itself.

Upper body aerobic exercise may play an important role in getting larger numbers of pregnant women to continue, or even begin an exercise program safely during their pregnancies.

The second area of interest is the buoyancy flotation devise known as the Aqua-Jogger^TM. The Aqua Jogger is a semi-floatation belt worn around the waist and used in the deep end of a pool. When using the belt, the exerciser is able to "jog" around the deep end at any given pace, or heart rate, while keeping the head and shoulders out of the water.

The beauty of the Aqua Jogger is that you do not have to be a swimmer to use the belt. Exercise has been touted as the perfect exercise for pregnant women, because it places virtually no stress on joints, it tones muscles though progressive resistance exercise, provides an aerobic component, and cools the body while performing exercise. The only drawback was that if the exerciser did not know how to swim, then they would not choose swimming as their main form of exercise. With the Aqua Jogger, that element has been eliminated.

The cost of the jogger is around $50, so it may be one of the smarter investments for a fitness program. If there is a community pool, or an exercise program that has a pool, it would be easy to use the jogger in the deep end of any facility. The jogger can be used long after pregnancy, as well.

The fourth area of exercise and pregnancy that would be beneficial for pregnant women is by using a heart rate monitor during classes, and general exercise. A heart rate monitor consists of an elastic strap around the ribs that has sensors picking up heart rate tones. The second part of the apparatus is the heart rate monitor, usually in the form of a wrist watch that has the actual reading of the heart rate. It is a very handy apparatus to have, if you are.

The third area of health enhancement is learning how to recognize a uterine contraction. When the uterus experiences excess stress, it usually starts to contract. Most of the time these contractions are not noticeable, except to the touch.

Fitness and health professionals who prescribe exercise during pregnancy should be aware that exercise itself may precipitate uterine contractions. In most cases, they are not harmful. but are an indicator that exercise may be too intense and should be halted. A uterine contraction, as in any other type of muscle contraction, feels hard to the touch. By placing the fingers just below the diaphragm, it is possible to palpate the top of the uterus to contraction. It is experienced simultaneously by the mother-to-be. Working with an obstetrician or nurse midwife could help you recognize what a contraction feels like.

Area number five is the most important. It is to use common sense. It comes from the cumulative experiences and perceptions that the health and fitness specialist understands the complexities of prescribing exercise during pregnancy. In most cases, it is simple. In others, it is more difficult. Nevertheless, each case is different and should be approached with professionalism and courtesy towards others who work with pregnant women.

Fitness professionals may be able to negotiate with medical groups to work with pregnant women in a preventive or therapeutic exercise format, but knowing the physiology of pregnancy, and how to construct a safe and effective program are paramount.

Enabling women to engage in exercise may improve their overall health, impact their birth process, and save medical costs. These are three compelling reasons to educate and instruct women in exercise routines prior to pregnancy, and during their entire gestation.

Suggested Reading:
1. Olkin, S.K. Positive Pregnancy Fitness. Avery Publishing Group, Garden City Park, NY, 1987.

2. Artal, R., Drinkwater, B. Wiswell, R.A. Exercise in Pregnancy. 2nd edition. Williams and Wilkens Publishers, Baltimore, MD, 1992.

3. Pirie, L. Exercise and Sports Fitness. Fisher Books, Tucson, AZ, 1987.

4. Durak, E.P. Exercise and Pregnancy. Medical Health and Fitness Publications, Santa Barbara, CA 1994.