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Fit and in a family way.

in the 1950s, it was discovered that a widely-used hormonal treatment for bleeding in pregnant women led to cancer risk and reproductive problems in their offspring. In the 1960s, a commonly prescribed sedative was linked to fetal heart and limb defects. Subsequent discoveries about smoking, alcohol intake and nutrition deficiencies reinforced the emerging cultural attitude that pregnancy is not a part of normal life, but a risky condition during which your choice of behaviors can have lifelong effects. While this is undoubtedly the case, it is important to remember that use of hormone therapy, sedatives, alcohol and tobacco is not best viewed as part of normal life. It is pregnancy that is natural, not these other behaviors.

Aversion to exercise evolved from this concern over behavior during pregnancy, but it is unfounded. To the contrary, there is plenty of evidence and great consensus now that the changes produced during exercise are helpful to pregnancy. Exercise increases blood volume, both in circulation and for each beat pumped, and so improves the body's ability to deliver oxygen to tissues.

Regular, vigorous exercise throughout early pregnancy does not increase the incidence of miscarriage or birth defects. Workplace stress such as standing hours on end or frequent heavy lifting are not recommended during pregnancy, but this is a far cry from even vigorous recreational exercise such as running.

For exercised babies, all aspects of fetal growth and development after birth have been shown to be equal to or better than non-exercised babies. Neither starting an exercise regimen nor continuing one results in preterm labor. Neither results in decreased fetal growth either--just decreased fetal fat, which does not result in low body temperatures as was once thought. Also, the blood glucose of these less plump infants is perfectly normal. What's more, babies of pregnant exercisers tend to be easier to care for. They sleep through the night earlier, do not typically have colic and often selfquiet. Blind evaluations of exercised and non-exercised babies repeatedly show exercised babies need less consolation when disturbed.

Since stimuli are an important aspect of development, it is thought that these babies, having been stimulated through their exercising moms, have developed better than others. Changes in heart rate and in oxygen levels attribute to this, as well as the sounds and vibrations they perceive in the womb during bouts of fitness.

And finally, women who exercise during pregnancy report less physical discomfort, a hastened recovery and no increase in exercise-related injury.

The benefits of exercise are different depending on the stage of pregnancy. Early on, exercise improves the growth of the baby and decreases maternal symptoms; late pregnancy exercise maintains fitness, limits weight gain and shortens labor. Moderately hard to hard exercise routines for 20 minutes a day three days a week can be sustained throughout the third trimester.

How will the baby let the mother know when the exercise is too much? The baby will not move much after the exercise. A rule of thumb is in mid- to late pregnancy, the baby should move two to three times within the first 30 minutes post-exercise. You may also have someone listen to the baby's heart rate response to the activity, though fetal heart rate has a great deal of normal variability. Up to the 32nd week, a normal response is an increase of five to 25 bpm. After that, as much as 35 bpm is probably fine. If the stress is severe, it will rise above that; if it is very severe, it may fall 20 to 60 bpm lower than before exercise. Arrange a medical evaluation if any of these occur, and do not exercise in the meantime.

If it feels good, it's probably okay. Obviously, avoid any sport with the risk of projectile trauma. Also best avoided are high altitudes, scuba diving and competition in general. But even bouncing on a trampoline with proper back support is fine if there is no discomfort. Proper attention to discomfort, particularly abdominal or pelvic pain, is as important as the exercise itself. If this occurs, do not continue until the situation is clarified by your doctor. The big four contraindications to exercise are injury, disease, pain and bleeding. Also, take care to avoid low blood sugar and never ignore fatigue.

Current medical practice advises restricted maternal activity if you're carrying triplets (or beyond!). Premature births are common in these pregnancies, and this complicates matters for would-be exercisers. However, if you've delivered early in a previous pregnancy, you may continue exercising into mid-and late pregnancy under your doctor's supervision (unless there is evidence of womb structural damage).

(Adapted from Exercising Through Your Pregnancy by James F. Clapp III, MD, Addicus Books, Omaha, NE, 2002, 245 pp. $17.95)
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Title Annotation:Looking at Alternatives
Author:Clapp, James F.III
Publication:Running & FitNews
Date:Sep 1, 2003
Previous Article:Four exercises to increase your running speed.
Next Article:Public health scare.

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