Month: October 2020

You probably already know that exercise helps your body deal with pregnancy changes by keeping you strong and flexible. But, did you know that maintaining an exercise routine throughout your pregnancy may help you have a lower chance of a complication during your labor and delivery?

Research in the field of prenatal exercise has suggested that there may be birthing benefits that include a lower incidence of preterm labor and cesarean section in women who exercised to the end of their pregnancy. Some research has found that exercise significantly reduce the duration of the second stage of labor in women who exercising throughout pregnancy. Exercise, such as walking, during pregnancy can also lower the odds of you needing to be induced! There’s even evidence that exercise such as yoga may help ease pain perception during labor—possibly by training the mind to focus more effectively and incorporate relaxation techniques during times of stress. Knowing that exercise may positively impact your labor and delivery can provide even more motivation to keep fit.

Here are the takeaway points for improving your odds of complication-free labor and delivery:

• Do some type of aerobic exercise 5-6 days a week.
• Add flexibility training and yoga to your routine.
• Make sure you strength train three days a week.
• Modify your fitness routine as needed so you’re able to continue exercising to the end of your pregnancy (that’s important for keeping weight gain within normal limits and, in turn, keeping baby weight from getting too high, which can increase the risk of C-section).

References

Am J Obstet Gynecol 2017;216:335–7.Berghella V, Saccone G. Exercise in pregnancy

J Gynecol Obstet Hum Reproduction 2020 Jun;49(6):101736. The effect of antenatal exercise on delivery outcomes: A systematic review and meta-analysis of randomized controlled trials. Ahmed Taher Masoud¹, Mohammed M AbdelGawad¹, Norihan Hatem Elshamy¹, Omar Magdy Mohamed¹, Zeinab Y Hashem¹, Ahmed K Abd Eltawab¹, Ahmed Samy², Ahmed M Abbas

Int J Environ Res Public Health. 2020 Aug; 17(15): 5274.  Effect of Antenatal Exercises, Including Yoga, on the Course of Labor, Delivery, and Pregnancy: A Retrospective Study

Yogyata Wadhwa,¹ 

Pereira IB, Silva R, Ayres-de-Campos D, Clode N. Physical exercise at term for enhancing the spontaneous onset of labor: a randomized clinical trial [published online ahead of print, 2020 Mar 29]. J Matern Fetal Neonatal Med. 2020;1-5. doi:10.1080/14767058.2020.1732341

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If you fell and broke your leg, you wouldn’t hesitate to call your doctor and seek help. Mental health is just as important as physical health! If you think you are depressed, stressed, anxious, or sadder than normal during pregnancy, you should talk to your doctor.

One in every four pregnant women experience a mental health concern, and this is nothing to be ashamed of! That is almost 4 times more common than gestational diabetes, yet all pregnant women get screened for that and talk openly about the results. For some women pregnancy is the happiest time of their life, for others, it is a really difficult time both mentally and physically. A big change is on the horizon, and change can be stressful! Just because you feel sad, doesn’t mean you don’t love your unborn baby or that there is anything wrong with you! This can be totally normal!! Pregnancy is hard enough without the added challenge of fighting mental health concerns. There are many options for helping you to feel better and be the happiest version of yourself!

https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/

Vesga-López O, Blanco C, Keyes K, Olfson M, Grant BF, Hasin DS. Psychiatric Disorders in Pregnant and Postpartum Women in the United States. Arch Gen Psychiatry. 2008;65(7):805–815. doi:10.1001/archpsyc.65.7.805

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Your body is supporting and growing a child.  It is essential you are at your best in order to carry to term, deliver, and care for this life.  A WHPT understands the needs of women and the changes that occur during pregnancy, labor and delivery, and postpartum.  During pregnancy a women’s health PT can help address the pains associated with your changing body. These include but are not limited to lower back pain,, pelvic pain/pressure, neck/shoulder pain, bladder and bowel issues (leaking, constipation), and abdominal wall concerns (e.g. diastasis recti).   Although many attribute these as “normal” conditions, these are issues that are manageable and treatable!  A women’s health specialist can improve your quality of life through the pregnancy, prepare you for delivery, and prepare you to care for your new baby postpartum.

A Women’s health physical therapist (WHPT) is a licensed clinician trained to evaluate and treat neuromuscular conditions related to pregnancy, postpartum, and pelvic pain. We commit ourselves to learning and caring for women in all phases of life. 

Written by Women’s Health Physical Therapist: Dr. Emily Davenport, PT, DPT, WCS

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A kegel is an important exercise to do both during pregnancy and postpartum. This pelvic floor contraction can help strengthen the pelvic floor muscles, support the pelvic organs (uterus, bowel, and bladder), and help reduce the chance of pelvic floor disorders such as incontinence and pelvic organ prolapse. However, 1 in 2 women do not know how to perform a kegel correctly even if given verbal directions. This is why seeing a pelvic health physical therapist is very important, as they will assess your ability to activate these muscles and provide individualized coaching to help optimize your muscle performance and eliminate/prevent symptoms.

The kegel is a two-fold exercise of contraction and relaxation; both are equally important. To do a kegel, you’ll want to contract and lift the pelvic floor, try longer holds of 5-10 seconds and shorter holds of 1-2 seconds, then fully relax.

When contracting and lifting the pelvic floor, here are a few do’s and don’ts to help you get it right.

Do:

– Do be sure you lift the pelvic muscles up and in. If you place a flat hand under your perineum (the space between the vagina and anus) either directly on skin or over your clothing, you should feel the perineum pull away from your hand. When you relax, you should feel the perineum gently rest back into your hand with the same amount of pressure you felt before starting the kegel exercise. 

– Do fully relax at the end of the kegel

Don’t:

– Don’t contract surrounding muscles like your glutes, abs, or thighs

– Don’t squeeze as hard as you can. More isn’t necessarily better.

– Don’t do kegels while you are in the middle of urinating or having bowel movement unless specifically prescribed by a pelvic floor physical therapist

Having trouble with targeting the correct muscles?

– Visualization can be helpful. Imagine picking up a blueberry with your vagina. Strange, I know, but this can help you target the lifting action of the kegel as well as reminding you to lift gently.

– Check yourself. As long as you are comfortable, you can check yourself internally as you perform a kegel. Simply insert 1 clean finger into your vagina. As you perform a kegel, confirm that you feel both a contraction and a lift of muscles around your finger and that the contraction happens equally all around. Don’t feel comfortable inserting a finger? That’s OK!! You can follow the same steps over your underwear with a flat hand and fingers on your perineum (the space between the vagina and the anus). You should feel this area lift away from your hand/fingers as your squeeze and feel it fall back into your hand as you relax. Still uncomfortable? You can also check this using a hand held mirror with your underwear off. Instead of feeling, you will be watching in the mirror to see the perineum pull up and in on the squeeze and return to the starting position on the relax.

– Schedule an appointment with a pelvic floor physical therapist. They can do internal and external checks to ensure you are properly performing a kegel as well as prescribe specific kegel exercise patterns as needed.

Casey Thomas-Hardesty, MS, NTP & Jenny LaCross, PT, DPT, PhD(c), WCS, ATC, CLT-LANA

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Everyone loves a good snack. Here is a list of healthy snack ideas to keep you full and satisfied as you go through your day. It is also important to eat a snack before exercising or prior to attending a physical therapy session.

• Hard boiled eggs
• Apples and nut butter
• Smoothie
• Chia pudding
• Full fat greek yogurt with berries
• Edamame
• Carrots and string cheese
• Raw vegetables and yogurt based or hummus dip
• Grapes and cheddar cheese
• Orange and pumpkin seeds
• Guacamole and bell pepper
• Whole grain crackers and cheese
• Pineapple and cottage cheese
• Dark chocolate and nuts

Casey Thomas-Hardesty, MS, NTP

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Pregnancy is a great time to quit smoking. Not only will it have a positive benefit on your long term health, but quitting smoking (and reducing your exposure to second hand smoke) will also greatly benefit your baby as well.

Risks of smoking during pregnancy

• When you smoke, the toxins from the cigarette (and e-cigarette) pass through the placenta and keep your baby from getting the proper nutrients and oxygen that they need.
• Smoking during pregnancy can lead to long term health risks for your baby, including an increased risk of colds, lung problems, ear infections, and growth restriction.
• Smoking during pregnancy can lead to a preterm delivery.

How to quit smoking

• Many states offer free smoking cessation programs that pair you with a dedicated coach for increased accountability and support.
• Have a support team that you can reach out to whenever needed.
• Set a quit date – and stick to it!
• Talk to your OBGYN or midwife about available local resources to increase your chance of success.

There are resources and support persons out there to help you quit smoking. You don’t have to do it on your own.

Casey Thomas-Hardesty, MS, NTP

Two Peas Wellness

Long term health risks

https://americanpregnancy.org/pregnancy-health/smoking-during-pregnancy/

Smoking cessation programs

https://chfs.ky.gov/agencies/dph/dpqi/cdpb/hpdocs/QNKFactSheetPregnancy.pdf

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