Exercising for Two
Working out helps moms prepare for the 'big event'

Elissa Bass, The New London Day
October 16, 2006

Nicole Robinson of Niantic exercises with her personal trainer Jayne Johnston at Advantage Personal Training in Niantic. (Photo - Dana Jensen , The New London Day)

Frances Mileski of Ledyard with personal trainer Laura Hawkins. (Photo - Dana Jensen , The New London Day)

Frances Mileski with personal trainer Laura Hawkins. (Photo - Dana Jensen , The New London Day)

For Frances Mileski and Nicole Robinson, the second time around is much better.

The 38-year-old Mileski is 12 weeks into her second pregnancy. Robinson, 28, is 36 weeks along. Both say they feel markedly better physically and mentally this time. The difference, they say, is exercise.

Mileski, of Ledyard, joined the Advantage Personal Training gym in Niantic about six months ago. “I definitely needed to shape up and lose weight after my first child,” she says. “And I had been trying to get pregnant for almost a year with no luck, and that was unusual for me. So I thought I would get in the best shape I could, and lo and behold, four months later I got pregnant. I thought I was going to have to discontinue exercising, but my trainer said we could work through till the end.”

It has made a difference already, she says.

“In my first trimester (in her first pregnancy) I had low energy, fatigue and nausea. This time I feel much better. A hundred percent better. The cardio and the weight training definitely helps.”

Dr. David Kalla, an obstetrician in Norwich who has been practicing for almost 20 years, says that there is some evidence that fitter women have an easier time during second-stage labor (pushing), are better able to manage their pain during delivery, and may have reduced chances of developing complications such as gestational diabetes.

“We strongly encourage people to remain active, perhaps with vigorous walking,” Kalla says. “In the first trimester you pretty much can do any sort of exercise regimen that you normally do, even competitive athletics. The only sorts of real restrictions involve things that would cause contact injuries, like hockey or basketball. Many (doctors) recommend not skiing. In the first trimester it's pretty hard to injure your baby because the pregnancy is still inside the bony pelvis.”

In the second trimester, Kalla says “work to your tolerance. ... The other thing is you don't want to do exercises that put you flat on your back. ... That may impact how much blood supply gets to the uterus. So for instance, sit-ups, tilted to the side or not flat, are OK.”
And in the final phase of pregnancy, Kalla says, women need to pay attention to their bodies. “It really has to do with comfort and balance and (their) ability to do things. Many people begin to reduce their exercise just because it becomes difficult to do. (Their) posture has changed, the center of gravity has changed. Pregnant women compensate for that by swaying their back. That's why they get muscular and skeletal aches and pains.”

Modern obstetricians “don't harass” their patients about weight gain, Kalla says, but “in general we recommend a gain of between 25 and 35 pounds for normal weight women. ... I still have to remind people that their caloric requirement is a couple hundred more calories (a day), not twice what you were eating before.”

Advantage co-owners Calvin McCoy and Greg Drab say they have had many clients over the years who have been pregnant. The two most important factors for them, they say, are that as soon as the woman knows, the trainer needs to know. Also, adds McCoy, “the big, bold word: moderation.” Advantage follows the American College of Obstetricians and Gynecologists' guidelines for pregnancy exercise. They also require an individual's doctor's approval.

Mileski says she did not exercise at all during her first pregnancy (her son is 21/2). She works out once a week with Advantage trainer Laura Hawkins, and then does an at-home program four or five times a week.

Jayne Johnston, a trainer at Advantage, began working with Nicole Robinson of Niantic about two months before Robinson became pregnant. Just recently, they cut back her twice-weekly gym visits from 60 minutes to 30. (She takes 30-minute walks at home.) But they continue to focus on her entire body's fitness.

“We've modified some things,” Johnston says. “We are emphasizing back strength and upper body strength. With the lower body, we are thinking endurance. It's important for her to stay strong and to keep up her endurance. She is preparing for a long-distance event. People think pregnant women are in a fragile state. But you need to realize this is a big event, a big physical event.”

During her first pregnancy (her son is also 21/2) Robinson did not exercise. She gained 30 pounds more then than she has now.
“Everything has been a lot less intense,” she says. “In my first pregnancy, I was very heavy and very uncomfortable. I'd get very winded, and very tired doing very little things. This pregnancy is easier.”

The American College of Obstetricians and Gynecologists recommendations for exercise during pregnancy:

• You can continue to exercise and derive health benefits even from mild to moderate exercise routines. Regular exercise (at least three times a week) is preferable to intermittent activity.

• Avoid exercise in the supine (lying on the back) position after the first trimester.

• Be aware of the decreased oxygen available for aerobic exercise during pregnancy. Modify the intensity of the exercise according to maternal symptoms. Pregnant women should stop exercising when fatigued and not exercise to exhaustion. Weight-bearing exercises may, under some circumstances, be continued at intensities similar to those prior to pregnancy. Non-weight-bearing exercises, such as cycling or swimming, will minimize the risk of injury.

• Any type of exercise involving the potential for even mild abdominal trauma should be avoided.

• Women who exercise during pregnancy should be careful to ensure an adequate diet.

When exercising in the first trimester, augment heat dissipation by ensuring adequate hydration, appropriate clothing, and optimal environmental surroundings during exercise.