Should I disregard advice from LPN?

Kelly814

Member
Hi everyone! First time poster, long time lurker here. Anyways, I am 6 weeks pregnant and had my first doctor's appt last week. I saw the LPN since the doctor was delivering a baby and it was just a prenatal counseling visit. When I told her that I did step, high impact, weight training, etc. she gasped and told me I had to modify this immediately! No ab exercises! Take the step out completely! Only low impact movements! I asked if I could do ab exercises on a stability ball (she didn't know what I was talking about) and she insisted I would tear my abdominal muscles!

I have been doing Cathe workouts for about three years and have had no discomfort at all sticking with them in my pregnancy. I am wondering if I should heed her advice 100%? It seems extreme to me.
 
[font size="1" color="#FF0000"]LAST EDITED ON Jan-20-03 AT 01:39PM (Est)[/font][p]Congratulations and welcome Kelly814!

I am so sorry that you were subject to this misinformation. That is why I'm in the business that I'm in - to educate women, their healthcare providers and fitness professionals in the rapidly changing field of prenatal exercise. Talk about perpetuating the "myth of the delicate condition!" It is a shame that your nurse was put in the position of educating patients regarding prenatal exercise. Sounds like she needs to take my certification course! I should say that I am kidding, but I am not....

As far as her advice goes, here's my professional opinion..... Sounds like you are early in your first trimester. First rule, you should always listen to your body. If you are feeling good on any particular day, there is no reason for you to "bring it down" just because you are pregnant right now. A lot is going on in your body, even now when you can't see those changes. You may have good days and days that "aren't as good as the good ones." On those "not so good days" give yourself permission to take it easy. During the first trimester when those hormones are going gangbusters, you may experience extreme fatigue, nausea, etc. which could definitely affect your workout. Again, listening to your body is the key. Step aerobics is fine as long as you feel good on the step. Your center of gravity will change during pregnancy and this may have an effect on any training mode. Many on this forum, as well as myself, did step all the way through pregnancy.

As for high impact... there are numerous posts on the forum regarding impact during pregnancy. You are not going to "tear the baby loose" if you do high impact as some women are told. Yes, I've had women come to me for fitness counseling who have been told this! If you've lurked on the forum, you have probably seen posts regarding relaxin, that infamous hormone secreted during pregnancy that softens connective tissue (i.e. tendons, ligaments, etc.) potentially decreasing their stability. Therefore, theoretically the joints are less stable. No two women are affected exactly the same with regard to relaxin. Some women report extreme instability and discomfort in their hips, ankles, knees. Others report little or no increase in joint flexibility or instability. Again, each woman is different and each pregnancy within the same woman can be different as well. In my training experience with over 1800 pregnant women and new moms I have found that relaxin's effects in subsequent pregnancies seem much more noticeable than the "first time around."

Regarding what the nurse said about weight training.... Resistance (weight) training is very beneficial in pregnancy. How do you stabilize a joint? You stabilize a joint by strengthening the muscles around the joint. And how do you strengthen muscles? You strengthen muscles by resistance training. Obviously the woman was unaware of this relationship. Also, strength training during pregnancy prepares mom for the tasks of motherhood (i.e. picking up the baby, the stroller, the diaper bag, etc. many times daily). See what I mean by perpetuating the "myth of the delicate condition?"

Also, as to the question as to whether high impact is appropriate during pregnancy... Here is the Healthy Moms(R) guideline that we teach our instructors. If the mom can do high impact activities while pain free and while HOLDING HER KEGELS UP (i.e. SHE MUST BE ABLE TO EXECUTE THE MOVE WHILE HOLDING A KEGEL CONTRACTION) then that is an appropriate activity for her. However, if she executes impact moves and is either leaking urine while doing them and/ or feels discomfort during or AFTER her workout(i.e. aching in the joints, especially joints of the pelvis, hips, knees, ankles) then that mode of exercise is probably not appropriate for her. The pelvic floor is under great stress during pregnancy due to the weight of the pregnant uterus and placenta placed upon it as well as the effects of relaxin. Remember the kegel advice.... You don't want to have to seek out the Depends aisle in the grocery store. Not kidding.... Are you aware of how many women perceive urine leaking as normal? It is sad....

As for abdominal training during pregnancy..... What a shame that she counsels women to delete it during pregnancy. Here is an excerpt from the HM instructor training manual regarding abdominal training during this time:

"During pregnancy the abdominal muscles lengthen and thin (stretch out) over the expanding uterus. They also support the weight of the growing baby. Strong and supple abdominal muscles, which have been exercised, lengthen easily during pregnancy and return to their pre-pregnancy strength and tone more quickly after delivery. Strong abdominals also assist in the return of the abdominopelvic contents to their pre-pregnancy locations Women were told in the past not to exercise their abdominals due to their stretched state. The supportive role of the abdominals will become compromised if they are neglected during pregnancy and their postpartum recovery will take longer. Abdominal strengthening may alleviate or prevent the backache commonly experienced by pregnant women by taking the weight of the baby off the spine.

Abdominal training during pregnancy will also help mom during the second stage of labor by increasing the effectiveness of her pushing.

The stability ball is a wonderful training tool for pregnant clients. Since almost every exercise involves the core in some way, it is very appropriate for prenatal exercisers. I have worked with pregnant clients on the ball since 1995. In fact in late 2002, Resistaball, the fitness industry leader in stability ball education and training, released "Resistaball Prenatal" an entire program comprised of 45-50 exercises and stretches utilizing the stability ball. I am particularly proud of "Prenatal Resistaball" because I developed and wrote it for the Resistaball company. I am now traveling the country presenting this program. It has been well received so far by both fitness and health professionals. Any pregnant woman can reap the benefits of the ball from the most deconditioned to the most highly trained pregnant mom.

One more very important thing. Stay hydrated. Drink, drink, drink before, during and after you exercise.

Welcome again and please keep in touch.

Sincerely,

Sheila

Sheila S. Watkins, MLSci.
Founder and National Program Director
Healthy Moms(R) Fitness
www.healthymomsfitness.com
 
Hi Kelly, wow, Sheila has given you some fabulous advice!!! I'm going to print her post off and save it - thank you very much Shelia. I just wanted to mention. Kelly , you are not alone in getting this sort of advice from a medical professional. I'm now at 22 weeks of pregnancy with my first child (I'm 35) but when I went to my intial visit around 8-10 weeks, the doctor told me not too exercise. When I said, well I have been working out for years regularly and just ran this past weekend for about 1 1/2 hours, she said, well, just run 5 minutes a day. YES, she said 5 minutes. When I asked her about Pilates, she didn't know what it was (which, I'm not attacking her for, I can understand this) but then I asked her about doing ab work and she said, (and this is doctor on staff at a major Toronto hospital who delivers baby), don't do any ab work at all. She went on to tell me that abdominal muscles are NOT used during labour and I shouldn't endanger the fetus. Then she told me that my running of 5-10 minutes a day would strengthen my back (YES, MY BACK!) and a strong back was all I needed to give birth. Luckily, I didn't listen to a thing this woman said and have been basically doing my regular workouts and modifying as my body tells me too. I have cut out though high impact and if I run, I do it only on a treadmill for maybe 30-40 minutes at a very slow pace. Actually, I don't think I've run since 17 weeks anyway. I use my stability ball and I absolutely love it - it's been so helpful in giving me support and comfort while doing ab work and also while doing weight work.

After visiting my family doctor (i'm now getting a new one), I told my dad about what this woman told me. He is a family doctor with 30 years experience. He just rolled his eyes and said don't listen to her. He said if it was this easy to lose a baby, the human species wouldn't have survived all these thousands of years. Another friend of mine also said, and I don't mean to offend with this comment but it made me think: if it's that easy to lose a baby, why don't women who need or want abortions just go out and do a bunch of ab work or better yet, go for a long run? " So, I have just been doing my regular routines, following guidelines like those of Shelia's. Certainly, as you get further into your pregnancy, your body will let you know what you can handle!!
 
Kelly,

Sheila and Helen have given you excellent advice! But I just thought I would add that exercise is good to do when pregnant as long as you do not overdo it. I have 10 children, I have exercised through the last 7 pregnancies. With each pregnancy I did exercise a little more, because I had gotten in better shape with each one.

I did weight training ( not real heavy) - All of my children were healthy and four of them were over 9 pounds. I have never had back problems being pregnant. Alot of women suffer from incontinence ( leakage of urine) I have never experienced this while pregnant or not pregnant and since I delivered ten children I think the exercising helped me immensely. My pelvic floor muscles are in great shape.

The exercise will also help you when you are post partum.

Hey, I am 47 years old - I delivered my last one at age 45, I was climbing stairs 2 at a time 9 months pregnant and he weghed 9 pounds even. I know that had to do with the exercising. Good luck just listen to people who have been there and Sheila (she is th expert). Good Luck

Cheryl
 
Wow!!

[font size="1" color="#FF0000"]LAST EDITED ON Jan-20-03 AT 01:34PM (Est)[/font][p]Hi Cheryl,

Wow, 10 kids... Just wanted to let you know that I am 47 and delivered my last child at 43. Yes, exercise is wonderful, especially when you are pregnant. I attribute it to my problem-free pregnancies at both age 40 and 43.

Sheila

Sheila S. Watkins, MLSci.
Founder and National Program Director
Healthy Moms(R)Fitness
www.healthymomsfitness.com
 
Thank you so much for your reply! This is my first pregnancy, and I'm really not sure what to expect so I am VERY grateful for the detailed info. I did CTX Step and Intervals today and I feel great, so I'm planning to continue and modify when I feel uncomfortable.

Thanks again!
Kelly
 
RE: Wow!!

Sheila,

That is interesting that we are both just 47 years old! I had my last three children over 40, as a matter of fact, I had them at 41, 42 and 45. The thing is I had #8 and #9 just 17 months apart. And I know for a fact that if a didn't exercise - I wouldn't be in the shape I am in now.

I have a few friends that were pregnant in their early 40's too. They could barely walk, and bad back pain - they waddled and complained from six months on. Another friend of mine was 32 with her last one - she couldn't take it either. But of course she never has exercised in her life.

Many of my women friends can't believe I do not suffer from incontinence and I know for a fact it has to do with exercise and having strong pelvic muscles!

You give women great advice on this forum. Keep up the good work! We all need you here.

Cheryl
 
great post, Sheila...

... I'm going to copy it to give to the moms in my prenatal exercise class!

I also find that many of my moms in class have been told by LPNs and OBs alike not to get their heartrates over 140 BPM, too... and that is such old information. The ACOG changed that recommendation back in 1994!

Susan Hyde
Healthy Moms (R) Certified Perinatal Fitness Instructor and freelance contributor to Pregnancy Magazine
 

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