Woman in Fourth Month of Pregnancy Exercise

¶ … Woman in Fourth Month of Pregnancy

Exercise and Diet Plan

The client is in her late twenties and four months pregnant with her first child. She is concerned about maintaining muscle tone and flexibility so that she can have her baby naturally. She does not express any concerns about managing her weight gain during her pregnancy and, indeed, she is tall and proportionately streamlined. However, she confesses to never having truly engaged in an exercise program since she graduated from college.

The considerations we have reviewed and the exercise regime that we have selected for her is outlined below.

A review of the client's history did not reveal any health concerns. Specifically, we discussed the following special conditions that could cause us to limit her exercise routine: heart problems, asthma or chronic lung problems, high blood pressure, muscle or joint problems, any persistent bleeding, and/or placental problems. Extreme weight problems -- either underweight or overweight -- and a history of problems with previous pregnancies were not a concern for this patient. Since the client did not have an existing exercise program, she was reminded to take it relatively easy, listen to her body, and modify exercises as needed.

We also discussed the importance of getting clearance from her attending physician before starting the exercise routine. In addition, we reviewed ways to ensure she was sufficiently hydrated when exercising and what clothing would best contribute to her ability to move freely and yet be supported. We noted several types of bras to choose from, and reviewed shoe styles that would provide the best non-slip treads, Velcro fastenings, and arch support over the course of her pregnancy.

Here are some further considerations. Her center of gravity will change, especially after the fourth month. Exercises should not be done while lying on her back since the enlarged uterus can put pressure on the vena cava, which reduces blood flow to the baby and to the mother. The hormone relaxin softens the ligaments which results in the joints not being as tight as they are when her body is in a non-pregnant state. Particularly because of this, bouncing and jumping exercises are off limits. Avoid over-heating as an elevated core temperature is not good for the baby. Keep your heart rate at about 140 beats per minute, or rely on the talk test -- if she can't converse normally during exercise, then she is pushing too hard. So, in addition to shortness of breath, other signs that she is overextending are: Dizziness, faintness, headaches, heart palpitations, uterine contractions, fluid leaking, and vaginal bleeding.

Table 1. Weekly Exercise Routine Woman in Her Fourth Month of Pregnancy

Day

Exercise

Part of Body

Targeted

Frequency

Intensity

Monday

Stretching & yoga

Whole body

Single set of 6 stretches daily

Guided by comfort levels and body changes during trimesters 2, 3

Tuesday

Stretching & yoga

Whole body

Single set of 6 stretches daily

Guided by comfort levels and body changes during trimesters 2, 3