Antenatal postnatal

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1. Antenatal and Postnatal EXERCISES VINITA M.P.T. 2 nd year

2. ANTENATAL EXERCISES: Being pregnant doesn’t mean stopping exercises. On the contrary, exercises do wonders during pregnancy. It helps to prepa . for childbirth by strengthening your muscles and building endurance. Moreover, it helps getting your body back in shape, once the baby is born. Of course, not every form of sport or exercise is safe to do, but many forms are. Most women will benefit, as long as they are not advised against exercise (e.g. due to medical condition) by the doctor).

3. Benefits of antenatal exercises: Regular exercises can be beneficial as it helps you to relax and makes you feel better. The main benefits include: 1. Improved circulation for mother and baby. 2. Reduction in aches and pains of pregnancy e.g. backache, cramps etc. 3. Improved stamina, giving you more energy to cope with growing demands of pregnancy. 4. Improved posture and body awareness. 5. More controlled weight gain. 6. Improved sleeping patterns. 7. Reduction in minor ailments of pregnancy such as: stiffness, tension, constipation, sleeplessness. 8. Increased circulation minimizing varicose veins and swelling. 9. Enhanced psychological wellbeing. 10. A beneficial effect on the course and outcome of labor.

4. Some points to keep in mind before starting with exercises: 1. If you have always been active, you can probably continue your exercise regime while you’re pregnant, providing your pregnancy isn’t considered high risk. Check with your doctor to make sure the activities you participate in are right for you . Also, if you’ve never been an athlete, your doctor can give you some helpful tips for getting started . Wear loose fitting, breathable clothing and supportive shoes: avoid overheating your body while you are exercising. Just layer your clothes so that they are easy to remove or wear outfits specially designed for exercise. You’ll also need athletic shoes that fit your feet properly. If your shoe size has changed because of mild swelling, buy a new comfortable pair . 4. Warm up before exercising: always warm up your muscles and joints to prepare your body for exercise. If you skip the warm up and jump into strenuous activity before your body is ready, you could strain your ligaments and can hurt yourself.

5. 5. Keep moving: standing motionless for long stretches can decrease blood flow to the uterus and blood pools in your legs, making you feel dizzy. So keep moving- change positions or walk in place. 6. Avoid overdoing it: don’t “go for the burn” and don’t exercise to the exhaustion. A good rule of thumb is to slow down if you can’t comfortably carry on the conversation. 7. If you feel uncomfortable or have pain, stop immediately: listen to your body. When something hurts, something’s wrong, so stop. You should feel like you are working your body, not punishing it. 8. Drink lots of water before, during, and after exercising: if you don’t drink plenty of fluids, you can get dehydrated. Try drinking two glasses of water two hours before you begin exercising. Some points to keep in mind before starting with exercises

6. 9. Get up from the floor slowly and carefully: your centre of gravity shifts during pregnancy. That’s why you should take great care when you shift positions. Getting up quickly can make you dizzy, and cause you to loose your footing and fall. 10. Avoid outdoor activities when it’s hot and humid: take it easy when it’s too hot. On particular hot and humid days, give your workout a miss or exercise indoor in a well ventilated room. 11. Cool down: walk in place for few minutes or stretch. It gives your heart a chance to return gradually to its normal rate.

7. Recommended exercises during pregnancy

8. Recommended exercises during pregnancy: The following exercises are fairly safe for expectant mothers, although some of them may not work for you during the last few months of your pregnancy. To be safe, consult your doctor before embarking on any of these activities. 1. ` Walking: it is one of the best exercises for the pregnant women. Walking keeps you fit without jarring your knees and ankles. It is safe through out the nine months and can be built into your day to day schedule. 2. Jogging / running: going for the jog is the quickest and most efficient way to work your heart and your body. You can tailor it to your schedule-running 15 minutes one day when that’s all you can fit in then 30 minutes the next when you have time. 3. Swimming: fitness experts hail swimming as the best and the safest exercise for the pregnant women. It is ideal because it exercises both large muscle groups (arms and legs), provides good cardiovascular benefits, and allows pregnant women to feel weightless despite the extra weight of pregnancy

9. Walking Swimming Yoga and stretches

10. 4. Yoga and stretches: they can help maintaining muscle tone and keep you flexible with little if any impact on your joints. Be careful not to overdo the stretching. Don’t hold the stretches for too long or try to develop your flexibility too much. 5. Pilates: Pilates are the form of exercises which combines flexibility and strength training with body awareness, breathing and relaxation. The exercises are based on certain movement pattern performed with your tummy and pelvic floor muscles-known in Pilates as “stable core” or base.

11. Try the following exercises to see how your core stability is: • Sit down on your hands and knees then level your back so that it is roughly flat. • Breathe in and then as you breathe out, perform a pelvic floor exercise and at the same time pull your belly button in and up. Try to hold this contraction for 10 seconds without holding your breath and without moving your back. Relax the muscle in the end of the exercise. • If you can easily perform this exercise a lot, then your pelvic floor and the lower abdominal muscles are working well. This exercise is safe at all stages of pregnancy.

12. 6. Pelvic floor exercise: the pelvic floor muscles forms the base of the pelvis. When strong and working properly they play an important role in helping prevent stress incontinence, (so when we laugh, cough, sneeze or lift something up no urine or stool accidentally escapes), and in preventing prolapse , (where the uterus slips down into the vagina). Exercising your pelvic floor muscles during the pregnancy is beneficial when you’re giving birth, as toned muscles will be easier to relax and control .

13. Exercises to avoid: Not everything is ideal for pregnancy and you are advised to avoid several forms of exercises, including the following: • Diving • Water skiing • Gymnastics • Netball • Hockey • Horse riding • Cycling • Rock climbing • Scuba diving etc.

14. Benefits of exercise Reduces the risk of developing and/or dying from heart disease, diabetes, colon cancer and breast cancer . Reduces high blood pressure or the risk of developing high blood pressure, high cholesterol or the risk of developing high cholesterol. Reduces body weight or body fat, depression and anxiety, improves psychological well-being and sleep quality. Builds and maintains healthy muscles, bones, and joints.

15. When beginning exercise it is important to consider the following: Wear loose supportive clothing and strong supportive footwear; shorts, t-shirt and a sturdy sports bra are ideal . Environment : Exercise in a stable environment i.e. a gym or park, not on uneven ground. Avoid exercising in the middle of the day when the sun is at its hottest . Nutrition : Do not exercise on a full stomach; eat a small meal two to three hours prior to exercise. Hydrate adequately – ensure you drink one to two glasses of water half an hour before exercise and several glasses afterwards . Low impact exercise is preferable for the first six months after having a baby.

16. Principles of exercise Frequency – the Health Department and National Heart Foundation currently recommend exercising on most if not all days of the week. As you commence your exercise program, start with one to two days a week and gradually build up to most days of the week. Intensity – Aim to achieve three to five sessions of light to moderate exercise – this equates to feeling slightly breathless, but still able to hold a conversation. When you feel you are coping well with light to moderate exercise add in one to two sessions of moderate to vigorous activity Duration – Current guidelines recommend 30 minutes of exercise per day to maintain good health.

17. Exercise program Warm up – Commence with five minutes of gentle exercise, such as slow walking, gentle arm circles and knee lifts. You can do any gentle movement that is similar to the activity to be performed. This is very important to prepare your body for exercise and help prevent injuries. Stretches – Next, perform all of the following stretches. Hold each stretch for a minimum of 10-15 seconds, breathing slowly through your nose, aiming to exhale out through your mouth as you ease into the stretch.

18. Triceps Front roll (upper back/shoulder Neck I Neck 2 Hamstrings Front of thigh (quadriceps

19. Slow roll (keep knees slighty bent as you roll up and down) Calf ( gastrocnemius Lower calf ( soleus ) Inner thigh (adductors Gluteals

20. Side bend Trunk rotation

21. Pelvic floor muscle exercises The pelvic floor muscles have four main functions: support of the pelvic organs (the bladder, uterus and bowel) control of the bladder and bowel improve vaginal tone to help with sexual enjoyment support the back by working with the abdominal muscles. To keep these muscles working well, make pelvic floor exercises part of your daily routine. See the “ Physiotheraphy After Childbirth” booklet for more details. 1. Sit and lean slightly forward with a straight back. 2. Squeeze and lift the muscles as if you are trying to stop wind and urine. 3. Hold the squeeze for up to five seconds, relax for up to ten seconds. 4. Repeat up to ten times, three to four times a day. 5. Keep breathing while exercising.

22. Cardiovascular fitness Choose something you find relaxing and enjoyable. You can attend a class, such as yoga, fitball , dance, aquarobics or perform your own exercise such as cycling, swimming or walking. Aim to exercise for at least 20 minutes. REMINDER : During all exercises remember to brace your spine by drawing in your lower abdominals and lift and squeeze the pelvic floor. Strength Listed is a set of exercises that are designed to improve strength. Aim to do 10 repetitions of each exercise (1 set). As you improve, progress to 2-3 sets . Squats Stand with feet shoulder width apart. Both feet should be facing straight forward. Squeeze and lift you pelvic floor muscles and draw in your lower abdominal muscles. Keeping you back straight, bend your knees as if lowering into a chair. Bend as far as comfortable. Slowly rise up into an upright position.

23. Core stability Aim to do 10 repetitions of each exercise (1 set). Progress to 2-3 sets. Bridging Laying on a supportive mat or towel, both knees bent and feet flat. Take a deep breath in and as your exhale, curl your pelvis up to flatten the small of your back into the ground. Slowly lift your tailbone up off the ground. Use your bottom muscles to lift your hips into the air. Take a deep breath in at the top and hold. Breathe out and slowly lower your spine back into the ground one vertebrae at a time. At the bottom let your pelvis relax down and create a small space between your lower back and the ground.

24. Four point kneeling Single leg slides Plank Side plank

25. Anterior Deltoid Rotator Cuff

26. Deltoid Biceps

27. Latissimus Dorsi Pectorals Triceps

28. A study by Jane Svensson in his study on effective antenatal education; strategies recommended be expectant and new parents. The 251 women participated age from 24 to 37 year. Finds a good results to improve the education about pregnancy. Augustin conde in his study on antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants <34 weeks’ gestation: a systemic review and meta-analysis. In this the three study evaluate the magnesium sulfate as an infant neuroprotective agent , Rob stephenson studied on community influences on antenatal and delivery care in bangladesh canclude that the antenatal care is diffent in the different areas and different populations.

29. Thank u… …. Love nature