Tag: Pregnancy Article 9

What Are Kegels?

If you have ever been pregnant, you’ve probably been told to “do your kegels!”, but what are they? Kegels are a pelvic floor muscle exercise in which you tighten the muscles of your pelvic floor and then relax them. You may be coached to hold the contraction for a certain amount of time before relaxing or just squeeze and immediately release (sometimes called “quick flicks”). While they are incredibly effective at helping many pelvic floor symptoms, there are also situations when they are not helpful. Getting a more comprehensive exam by a qualified pelvic health physical therapist will equip you with more tools to prepare your body and pelvic floor for labor and delivery, including if doing kegels is right for you at this time.

Kegels are traditionally performed during pregnancy to help improve the function of your pelvic floor, but what is the pelvic floor? If your core is like a mason jar, the bottom of the jar is your pelvic floor. This group of muscles is designed to support the weight of the organs in your pelvis. Strengthening the pelvic floor during pregnancy may help you learn how to connect with those muscles better during labor and delivery. Some studies show that having a strong pelvic floor can help decrease urinary leakage, and reduce symptoms of pelvic heaviness.

Here’s the Kick

Not all women would benefit from doing kegels every day. Kegels help to strengthen the pelvic floor. During labor, it is the uterus that contracts to push your baby out. For this to happen, the pelvic floor needs to relax and move out of the way. If you are only practicing contracting the pelvic floor and not relaxing it, this can make labor more challenging. Muscles need to be able to move through their full range of motion.

Women experiencing symptoms of pelvic pain, pain with sex, and/or constipation should avoid doing kegels until consulting with their OBGYN or pelvic health physical therapist. A physical therapist will be able to assess the cause of your symptoms, your ability to correctly perform a pelvic floor contraction and relaxation, and then give you exercises and stretches to help prepare your pelvic floor for labor.

Additional Exercises to Try

In addition or pelvic floor specific exercises, incorporating functional training and full body strength workouts into your routine will result in other health benefits for you and your baby. I recommend practicing diaphragmatic breathing regularly. It can be done during any trimester, including immediately postpartum, and in any position. Diaphragmatic breathing promotes full body relaxation and can help your brain to connect with your pelvic floor.

Some of my favorite daily stretches are:

• Child’s Pose*
• Deep Seated Squat*
• Cat/Cow
• Runner’s Lunge*

*NOTE: If you have a history of hip pain or current hip pain, these stretches may make your symptoms worse and should be avoided until consulting with a healthcare professional.

Some of my favorite lower body strength exercises are:

• Squat
• Deadlift
• Reverse Lunge
• Glute Bridge

As you can see, preparing your pelvic floor for labor is very nuanced and is so much more involved than simply doing or not doing kegels. The body works together as a unit, never in isolation. Try some of these stretches and exercises during your next workout and watch how amazed you will be at the results! Remember, there is no better time to start than right now. Your body and your baby will thank you. You got this!

Sara French, ACSM CPT, NASM CNC

Sources

https://my.clevelandclinic.org/health/diseases/22870-hypertonic-pelvic-floor

https://www.yalemedicine.org/news/kegels#:~:text=Would%20all%20women%20benefit%20from,along%20with%20other%20muscle%20groups.%E2%80%9D

https://utswmed.org/medblog/prepare-body-labor-delivery/#:~:text=Deep%20squat-,Deep%20squats%20help%20relax%20and%20lengthen%20the%20pelvic%20floor%20muscles,deep%20squats%20you%20should%20do.

https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/kegel-exercises/#:~:text=Pregnant%20women%20who%20perform%20Kegel,knows%20you’re%20doing%20them.

Anyone who has ever been pregnant knows to expect a gestational diabetes test in the latter half of the pregnancy. To put it plainly, gestational diabetes is a condition during pregnancy when the body cannot make enough insulin. The placenta is a powerful organ that makes its own hormones to support your growing baby. Sometimes, these hormones make it harder for the body to use insulin. Gestational diabetes typically resolves itself after pregnancy, but there are definitely things you can do to help your body during pregnancy if you receive this diagnosis. In this article, we will discuss what to expect for the traditional screening, explore options outside of the standard glucola drink, and assess lifestyle changes you can make to improve your blood sugar during pregnancy. 

Routine Screening: What to Expect

Traditionally, in the United States, your OB will perform a routine screening for gestational diabetes sometime between week 24 and 28 of pregnancy. If everything goes well, you should only have to do this once. You can expect to drink a syrup-like sugar drink in a brief amount of time. After one hour, your OB will take a blood test and learn how your body responds to sugar. Ideally, your blood sugar should be below 140 mg/dL. If your blood sugar is too high, over 190 mg/dL, a follow-up test will be required in order to determine if you have gestational diabetes. 

The follow-up test is similar to the initial test. However, you will be required to drink even more sugar. Your blood sugar will then be monitored every hour for the next three hours. You will not be allowed to eat anything during this time, as your OB wants to learn how your body responds to a significant amount of sugar over a period of time. If two out of three of the readings are abnormally high, you will have a gestational diabetes diagnosis. 

You might be feeling discouraged, but there are lifestyle changes you can make immediately to help your body better respond to sugar! At this point, after failing both glucose screenings, your OB will probably recommend that you monitor your blood sugar at home with a finger prick kit. 

Exploring Alternative Screening Methods

We discussed the traditional method that OBs use to screen for gestational diabetes. Did you know you have options outside of the standard glucola drink? What happens if you fail both traditional methods at your OB office? You will likely have to check your sugars at home. Some people opt to monitor their blood sugar this way right from the start. If you choose this option, you will work closely with your birth team to establish a rigid protocol. In my experience, I took home a finger prick kit and a log to record my levels. For four days, I recorded my fasting glucose first thing in the morning. Then, I recorded what I ate for breakfast and waited two hours before testing my glucose. If I ate anything in that two hour waiting period, the clock would have to restart. I did this for lunch and dinner also. If I got any high readings, I would have had to discuss adjusting my diet. I also would have been required to measure my levels for more than four days. 

I enjoyed this screening method because it allowed my midwife to get an accurate snapshot into my everyday diet. She was able to see how my body responded to a normal amount of sugar over a set amount of days. It also enabled me to monitor everything from the comfort of my home, and I did not have to fast. 

If this method isn’t for you, but you are hesitant to drink the standard glucola drink, there is another option! First, you can ask your provider for the dye-free version of the glucola drink. If you are still unsatisfied with this method, ask about The Fresh Test. This is a more natural alternative to the glucola drink. The Fresh Test has only a few ingredients and no additives whatsoever. If you are about that holistic life, this option is for you! Your midwife or OB will not have this in their office, so you will have to order it. The Fresh Test offers different options to choose from (50g, 75g, and 100g) depending on what protocol your birth team will use. The test itself is the same as the traditional method. You just bring the fresh test to your OB’s office, drink it up, and wait one whole hour before measuring your blood sugar levels. 

Tips for Managing Blood Sugar During Pregnancy

If you have been diagnosed with gestational diabetes, don’t be discouraged. Your birth team will likely discuss some changes you can make to your lifestyle to help manage your blood sugar. First, try walking for about ten minutes after each meal. This will stimulate digestion and help level out those sugars! Second, prioritize protein at every meal. Aim for roughly 30g of protein at each meal. Lastly, if you are craving a snack that is high in carbohydrates, always pair it with a buddy! Never eat carbs by themselves, try to pair them with a protein and a fat. Following these three tips will help you better manage your blood sugar during pregnancy, which will have beneficial outcomes for you and your baby! You’ve got this momma!

Sara French, ACSM CPT, NASM CNC

Sources

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483546/#:~:text=Limitations%20of%20these%20tests%20are,those%20with%20GDM%20are%20needed.

https://www.cdc.gov/diabetes/about/gestational-diabetes.html#:~:text=Gestational%20diabetes%20happens%20when%20your,to%20develop%20type%202%20diabetes.

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/diagnosis-treatment/drc-20355345

https://drkaylaborchers.com/holistic-alternatives-gestational-diabetes-screenings/#:~:text=Holistic%20Gestational%20Diabetes%20Screening%20Alternative,-%233:%20Blood%20Sugar&text=Another%20option%20is%20to%20work,to%20screen%20for%20gestational%20diabetes.