Although it is not an illness, a pregnant woman shows signs denoting "pathological" changing throughout pregnancy.
This pregnancy is characterized primarily by a aménhorée (no rules) that will last until the baby is born. Follows a spate of bodily changes, both physiological and biomechanical purely.
The development of a plan such changes will better understand the needs, functions in advanced pregnancy.
physical activity can adapt or re-adapt to constraints muscular and cardio-respiratory.
Once you are insured with your doctor cons-no medical indication could hinder any exercise, it will be easy to follow suitable work. Here in non-exhaustive problems can survenirs if no activity is performed during pregnancy:
- Mismatch in the effort, breathlessness even with small efforts, resulting in a decrease in the strength and the ability to produce lprolongés efforts, and thus fatigue. By changing the center of gravity and anatomical changes, decreased agility and balance you will ressentirs.
- Evil be general
- Weight gain "excessive", 92% of women not involved in physical activity are 30 to 70% more weight than women with regular physical activity.
- Increased risk of gestational diabetes, hypertension, preeclampsia, back pain;
- Greater difficulty in recovering from childbirth (weight loss longer poor or non-recovery of tissues, general muscular weakness, loss of breathing capacity, reduced system imminitaire.
Is there real risks to the practice of physical activity for pregnant women?
1. Hyperthermia
The main fear engendered by exercise in pregnant women were higher than (normal) body temperature during exercise is harmful to the developing baby. Some scientific evidence (Karzel 1991), a body temperature above 39.2 ° C during the first quarter could be a potential teratogen. ie can induce malformations in the embryo. The embryonic period is known as being particularly sensitive to external influences.
In general, the embryos are more sensitive to heat than the fetus and this is due to the rate of high cellular activity during organogenesis. According to the recommendations of most authors, the pregnant women should not be exposed to temperatures likely to increase their body temperature in excess of 39 or 39.5 ° C during the first three months of pregnancy.
The official position of the Canadian Academy of Sports Medicine after an exhaustive review of scientific literature on the subject held that women who are allowed to set their own rate of physical activity during pregnancy, the temperature increase is not large enough to harm the child.
Moreover, according to a literature review conducted by the Society of Obstetricians and Gynecologists of Canada and the Canadian Society for Exercise Physiology in the development of the guideline on physical activity and pregnancy, no studies on Pregnant women who exercise, has yet demonstrated a teratogenic effect (1) any due to high internal body temperature in early first trimester (SCOG, 2003)
Indeed, the mechanisms of maternal thermoregulation at rest and during exercise, as the evaporation of perspiration, increased ventilation / minute and the redistribution of blood flow to the body surface cancels the potentially thermogenic physical exertion and thus keeps the body temperature below the limit of 39 ° C.
Figure 1: Using a negative feedback system involving the hypothalamus, the human body can maintain a proper temperature, even during physical exertion produces a lot of heat (by action of sweat glands in our example).
It is wise to cons drink before, during and after the exercise session, and avoid exercise during hot weather and / or when the humidity is very high precisely because the mechanisms of thermoregulation mother could be thwarted, which could pose a danger to the embryo. These precautions are even more important during the first three months of pregnancy.
2. Reduced blood flow to the placenta
During exercise, blood flow is diverted from the viscera to active muscles (shunt blood). This is because working muscles have an increased need for nutrients (such as glucose, oxygen and free fatty acids) content in the blood. One hypothesis is that uterine blood flow is reduced in favor of active muscles, placenta and fetus would receive less oxygen.
For cons, the scientific literature on this subject seems to conclude that this assumption is incorrect and that the phenomenon advance stroke no impact on the health of the baby.
3. Exercise and fetal distress
The studies in pregnant women who are physically active showed no evidence of fetal distress during exercise.
4. Exercise and miscarriage
According to the Canadian Academy of Sports Medicine, there are very few studies on the effect of regular physical activity continues in the first quarter, but a prospective study conducted among 158 women who were already form and have continued to exercise at a level above the current guidelines during pregnancy found no significant difference in the frequency of spontaneous abortions, birth defects or other implementation issues.
Potential benefits of exercise during pregnancy
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increase in physical capacity.
-muscle strength and endurance
-aerobic capacity (faster recovery)
-flexibility and proprioception
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lower prevalence of hypertension induced by pregnancy.
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reduced time to return to normal after the postpartum labor.
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greater energy reserve.
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better control of weight (ideal weight gain = 25 pounds).
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Prevention of gestational diabetes.
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reducing the incidence of depression, anxiety, and increased self-esteem.
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improve posture and decrease back pain related to pregnancy.
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better understanding of his body.
(Artal, 1999, CASI, 1998, SCOG, 2003)
Risks associated with lack of exercise during pregnancy
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Excessive weight gain
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increased risk of gestational diabetes or hypertension
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psychological adaptation to adverse physical changes of pregnancy
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varicose veins and deep vein thrombosis
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dyspnea
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back pain
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decline in cardiovascular and muscular form
(Houde, 2004)
Moreover, it is important to know that:
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the objective of training during pregnancy should be to preserve a reasonable level of fitness during this period, without attempting to reach the summits or training for sports competitions.
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pregnant women should choose activities in which they are less likely to lose balance or cause injury to fetus
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the pelvic floor exercises, which began shortly after birth, could reduce the future risk of urinary incontinence.
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moderate exercise during lactation does not affect the quantity or composition of milk or growth of the child.
(Artal, 1999, CASI, 1998, SCOG, 2003)
Physical training
The objective of the training during pregnancy should be to maintain a reasonable level of fitness during this period,
The organization must focus primarily on developing baby and not to the enhancement of functional capacity.
The physiological adaptations resulting from training should be regarded as supporting or even as an adjuvant to the means that we take to promote optimum development of children and pregnancy as pleasant as possible for the mother. We must therefore evaluate the cons-absolute and relative indications to weigh the advantages and disadvantages of a program of physical activity during pregnancy.
In First Quarter
During the first trimester of pregnancy, women who were physically active can continue, but without increasing the intensity or frequency of these exercises.
We are talking of keeping those who trained before. If you wish to adjust the setting load increases, it is preferable to increase the volume (length and / or frequency) and not the intensity. If you wish to reduce them down (as is often the case because of "physiological changes" and inconvenience that follows), we must reduce the intensity of first and if this maneuver is insufficient , then decrease the volume.
When the mode, it is obviously necessary to eliminate or at least restrict the activities with potential falls of the mother or with potential for direct or indirect trauma to the fetus. It is obviously necessary to eliminate the dual-sports action.
We do not advise women not to begin an exercise program during the first trimester of pregnancy, especially if they suffer inconvenience "classics" such as nausea, dizziness, extreme fatigue, etc..
B Second and third quarter
The second quarter is the ideal time to begin or continue a fitness program, especially for women who were sedentary before. The periodization of the training load should be oriented so that the volume is initially increased gradually and progressively.
By cons, if the mother feels great persistent fatigue, dizziness, contractions following periods of training, the presence of bleeding or unusual pain in the pelvis and / or abdomen, the mother should consult .
Cons-indications to exercise during pregnancy
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rupture of membranes
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preterm labor
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hypertension in pregnancy
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incompetent cervix (x)
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Fetal growth retardation
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multiple pregnancy (triplets)
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placenta previa (x) after the 28th week
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persistent bleeding during the 2nd or 3rd quarters
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Type 1 diabetes uncontrolled, thyroid disease or other serious disorders such as cardiovascular, respiratory or general
Cons-indications for exercise during pregnancy
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previous spontaneous abortion
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Previous premature birth
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cardiovascular dysfunction Mild to moderate
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respiratory disorder light or moderate
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anemia (Hb <100 g / l)
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Malnutrition or eating disorder
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twin pregnancy after 28 weeks (twins or twins)
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other significant medical problem
(SCOG, 2003, Houde, 2004)
Consult a specialist and your doctor if:
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persistent fatigue
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dizziness
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contractions following periods of training
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presence of bleeding or unusual pain in the pelvis and / or abdomen
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significant loss of motivation
