Staying Healthy during Pregnancy yields Benefits afterwards:   written by Niva Herzig, PT

Staying healthy while you are pregnant is not only beneficial to your baby, but to you too.  This holds true whether it’s your first child or your tenth.  What does staying healthy mean?  A combination of proper diet, exercise and sleep. 

Just because you are pregnant, doesn’t mean you need to double your caloric intake.  In fact, caloric increase only needs to occur during the 2^nd and 3^rd trimesters and by 300 calories.  Take in fluids regularly in order to maintain hydration, especially when pregnant during warmer months and during exercise.  Continue eating meals consisting of all food groups and keep sugars at a minimum.  Include in your diet fruits and vegetables, whole grains and protein.  Remember to eat foods rich in Calcium, Iron, Folic Acid and Vitamin C.  Be aware of foods that may harm your baby such as unpasteurized cheeses or raw fish and meats.   Make sure all meats are cooked and are not eaten raw to avoid exposure to harmful bacteria.  Additionally, minimize the intake of caffeine.  Once your baby is born, remember to continue eating a well balanced diet and increase fluids especially if breast feeding.  For more specific issues and concerns speak with your physician or consult with a nutritionist. 

 Staying active is very beneficial to you and your baby.  If you are not a gym person, don’t worry.  Before you begin any new exercise program while you are pregnant, you should always consult your physician.  Stop any exercise if you notice dizziness, faint, shortness of breath, vaginal bleeding or pain.  Avoid any exercise that may injure your abdomen or ones involving increased jumping and bouncing or contact sports.  A few exercises I recommend which will benefit you during your pregnancy and afterwards include cardio, stretching, core and stability exercises. Of course, if you are already strengthening, swimming, involved in yoga or other pregnancy safe exercises, by all means continue.  Walking outside or on a treadmill or using an elliptical machine are good ways of getting some aerobic (cardio) exercise. 

A good exercise which involves both back and abdominal muscles is opposite arm and leg raises.   This exercise is done on all fours.  While maintaining a neutral spine (not arched, not flexed) and keeping the abdominals tightened, raise one arm straight out in front to shoulder level, palm facing inward and the opposite leg to buttock level at the same time.  Repeat the exercise with the opposite arm and leg for 10 repetitions per arm/leg combination.  If this exercise seems too difficult, begin with arm or leg raises alone. 

Maintaining a strong pelvic floor is important during pregnancy and afterwards.  A healthy pelvic floor knows how to contract (as if stopping the urine flow) and how to relax.  Pelvic floor exercises, known as Kegels, are a good way to keep the pelvic muscles in shape.  Practice quick (1-2 second) contractions as well as longer held (5-10 seconds) contractions.  Start with 5 repetitions and work up to 10 repetitions.  Make sure to rest between contractions and make sure not to hold your breath as you are doing this (or any) exercise.  Do not perform repetitions of this exercise while urinating.  To keep the abdomen strong, you can perform abdominal contractions in any position (sitting, standing, all 4’s or on the back when it is still safe and comfortable).  As you exhale, bring your lower abdomen, belly button and below, towards the spine.  Imagine a string pulling your belly button towards your spine.  Make sure not to just “suck in.”  You should feel the muscles in the lower abdomen tightening, but do not over tighten.  Hold this contraction for 5-10 seconds and repeat up to 10 repetitions.  There should be no movement except the flattening of the abdominal muscles.  This exercise will focus on the Transverse Abdominus muscle, a muscle which wraps around from the front to the back and helps to flatten the stomach. 

A final important exercise which strengthens the legs and buttock is the squat.  This can be performed with or without the support of a wall or chair.  Stand with feet hip width apart (increase the width as the pregnancy progresses and balance is more of a challenge).  Keep your heels flat on the floor and toes slightly turned out as you bend your hips and knees lowering yourself downward.  Make sure you knees stay over the toes.  Perform 10-15 repetitions. 

Stretching is as important as strengthening.  Stretching can help ease some aches occurring during and after pregnancy.  A second type of squat, full squat, will help you stretch and strengthen your hips in preparation for birth.  Start in the same position as the above squat.  This time lower yourself down as far as you can go while keeping your feet flat on the floor.  Hold the position from 30 seconds up to a few minute.  Angry cat is a stretch performed while on all fours.  In this neutral spine position, place you hands under the shoulders and knees below the hips.  As you exhale, tighten the abdominals (similar to abdominal contractions described above) as your round the back.  Inhale and return to neutral position.  Repeat 5 times. 

Finally, I always add breathing, especially diaphragmatic breathing to the program.  Inhale air through the nose, and down low into the abdomen. Let the abdomen expand as you breathe in, and relax as you breathe out through your mouth. By practicing breathing techniques during pregnancy, you can be more prepared for breathing while birthing.     

Do not forget to rest and get good nights of sleep.  Stay active while pregnant as long as you are comfortable, but also make sure not to overdo it.  By balancing your diet, activity and sleep, you are bound to feel good during and after the pregnancy. 

Niva Herzig is a licensed physical therapist specializing in women’s health.  She is the owner of Core Dynamics Physical Therapy in Englewood, NJ.  She can be contacted by email: niva@coredynamicspt.com.  For more information regarding prenatal and postpartum physical therapy as well as pelvic floor dysfunction, please visit www.coredynamicspt.com. 

Select a Pediatrician
Choosing the right pediatrician is one of the most important decisions you make prior to your baby’s birth. Getting personal referrals from friends and family is one of the best ways to narrow down your options before you start searching for further information. Consider both the logistical and philosophical aspects of the practice and pediatrician. Make sure all of the doctors you’re considering are taking on new patients and will accept your health insurance. Take time to speak or meet with prospective doctors.

Most offices will accommodate your request for an interview with the doctor.
A good time to start looking for a Pediatrician is seven to eight months
into your pregnancy. The American Academy of Pediatrics (AAP) offers referrals to certified practitioners at www.aap.org/referral.
Get a Car Seat Inspection
Keeping your baby safe is one of the most important jobs you will
have as a parent, which is why using the proper car seat and installing it correctly are essential. The type of car seat you should use depends on several factors including the baby’s size and the type of car you drive. The American Academy of Pediatrics (AAP) recommends that all infants should ride rear-facing until they reach the maximum height or weight allowed by the manufacturer. To learn more about car safety seats, go to www.aap.org/family/carseatguide.htm.
Be sure to have your car seat installed and inspected a few weeks before your due date. To find an inspection location near you, visit www.seatcheck.org.

Take a CPR Class
Learning how to correctly administer CPR to an infant before your baby’s birth can be a valuable life-saving technique. Performing CPR on an infant is very different from an adult and requires different levels of pressure. Classes are offered at hospitals, community centers and local chapters of the American Red Cross and American Heart Association. To find a class in your area, visit www.redcross.org or www.americanheart.org.
Consider Cord Blood Banking
Cord blood banking is a once-in-a-lifetime opportunity to collect and store your baby’s umbilical cord blood. Cord blood is a rich, non-controversial source of stem cells that is being used to treat over 70 life-threatening diseases. Many families bank their baby’s cord blood for peace of mind that their family’s stem cells are readily available should they need them. Others save cord blood because of its emerging use in treating Type 1 Diabetes and Cerebral Palsy, which requires a child’s own cord blood. Stem cells from a related source are the preferred option for all treatment, and transplants using cord blood from a family member are twice as successful as transplants using cord blood from a non-relative (i.e., a public source).1
Start researching cord blood banking during your second trimester and arrange the collection in advance – the only time collection can occur is at the time of delivery. Learn more about cord blood banking at www.parentsguidecordblood.org.

Make a Breastfeeding Decision
As a mother, one of the best things that only you can do for your baby is to breastfeed. Breastfeeding is more than a lifestyle choice — it is an important health choice. Any amount of time that you can do it will help both you and your baby. Breast milk has disease-fighting cells called antibodies that help protect infants from germs, illness, and even SIDS. Research also indicates that women who breastfeed may have lower rates of certain breast and ovarian cancers. Breast-feeding resources are available at www.womenshealth.gov/breastfeeding and www.cdc.gov/breastfeeding.
Taking a breastfeeding class before your baby arrives is a wonderful way to be prepared. To find a class, check with your OBGYN or visit La Leche League’s website at www.llli.org.
1 Gluckman, et al. New England Journal of Medicine, 1997; 337:373.