Great Pregnancy Exercise: Swimming (Week 21)

I am pleased to say I am feeling less breathless and dizzy since my post last week. For one, I doubled my iron dosage, which has helped elevate my daily energy as well as my capacity to climb stairs. I also have started to take it easier in general: I walk, climb stairs, and do everything a bit more slowly than I used to. But what I'm most pleased about is that I've gotten back into the pool and have started a swimming regimen again. This is after  finding a new bathing suit that fit me.

How I Found a Swimsuit in the Fall
Given that it is the fall season and swimsuits in general are harder to come by, I found it difficult to find a maternity store that sold bathing suits. There is a specialty bra and swimsuit shop in Toronto called Melmira that not only offers a great selection of maternity bras, but also maternity swimsuits. Although I did go there to buy two maternity bras a few months ago, they cost me $250. Given the high prices of their bras, I assumed their swimsuits would likewise be expensive.

So instead I paid a visit to Bikini Village, who doesn't sell maternity swimsuits at all. I asked the clerk if there was any way I could find a regular suit that would fit my new body, and she said "of course!". I tried on two swimsuits before deciding on a simple Roots one-piece that was a few sizes larger than what I normally wear. Easy peasy!

Why I Love Swimming Right Now
Although walking is also great exercise when you're pregnant, when I walk for an extended period of time, I tend to feel pressure from the weight of the baby  in my lower abdomen, which is a bit uncomfortable. When I swim, I feel completely comfortable moving around in the water. In fact, it's a easier to move slowly while I'm swimming because I'm so buoyant now!

The Benefits of Swimming During Pregnancy
Swimming is great exercise because it uses both large muscle groups (arms and legs). It is both low-impact (reducing the risk of injury) and it is a great aerobic workout. In general aerobic exercise

• improves circulation
• increases muscle tone and strength
• allows you to sleep better at night
• improves your energy
• helps you cool down from the emotionality caused by pregnancy hormones

Swimming Tips

• If you are new to exercise, check with your doctor or midwife before starting any exercise 
• Drink plenty of water to stay hydrated (swimming in a pool of water doesn't count!)
• If you're in your first trimester
• Try to swim for at least 30 minutes daily (if you have the energy). 
• Swimming first thing in the morning may counteract nausea and energize you for the rest of the day
• If you're in your second trimester
• You don't have to change anything that you were doing in your first trimester--except you might need a new swimsuit
• If you're in your third trimester
• The breast stroke is particularly beneficial in the third trimester, because it lengthens the chest muscles and shortens the back muscles, two areas that typically become misaligned as your body changes during pregnancy

Breathless and Dizzy...and Not in a Good Way (Week 21)

Being a (self-acclaimed) superfit mom, I went into this pregnancy pretty confident that I would be able to maintain a level of fitness that I could be proud of. Of course, life has a funny way of cutting me down to size once-in-a-while--even though I'm short enough as it is.

My Near-Faint Experience

Late last week I experienced something I had never felt before. I was walking with a client around their neighbourhood for our weekly one-hour walk, at our usual moderate pace, when I started to feel out of breath. At first I thought it was funny because a walk like that never used to make me feel like I had just done a 30-second sprint. "Ah, the joys of pregnancy," I thought. Soon enough, it became apparent that my heavy breathing was not subsiding, and I was starting to feel dizzy. I began to feel faint. To my minor embarrassment, I quickly reached a point where if I didn't sit down, I was going to collapse. My poor client, who had no idea what was going on with me, was understandably concerned. I was having a hard time breathing, and my heartbeat was pounding in my ears. Without having much choice, I sat down on the curb to try and recover. It took all of 30 seconds to feel normal again. Without skipping a beat, I got back up and we completed our walk. I had no idea what to make of what had happened, and what was worse was that I couldn't explain it to my client. 

The very next day, I walked home from the cinema with my partner--it's all of a 10 minute walk. We reached our building and headed up the four flights of stairs to our apartment. By the time I had reached the hallway, a huge wave of dizziness came over me. I was breathless yet again, and my heart was going a hundred miles a minute. I needed my partner to help me through the apartment door. I was starting to see stars, and I realized I was close to passing out. After collapsing on the couch, I panted for another 30 seconds, during which time my breathing and heart rate quickly subsided. It was at this point I decided that I should figure out what the heck was going on with me. Thankfully I could easily find out what the problem was--and that it was nothing serious. 

Pregnancy and Breathlessness

In pregnancy, your ribcage widens to allow for an increase in lung capacity. This works to offset the problem that the growing uterus plays in constricting your breathing. As your uterus expands, it pushes up into your diaphragm, making it harder to pull in your usual-sized breaths of air. Moreover, with all those pregnancy hormones that cause your muscles and ligaments to relax, your diaphragm is on a mini vacation, not working as hard to pull air into your lungs. 

To make things worse, the increasing progesterone in your body makes you more sensitive to the carbon dioxide your muscles produce as a waste product when you move. The resulting breathlessness is caused by your body trying to get rid of the carbon dioxide and replace it with oxygen as quickly as it can.  

Breathlessness can also be caused by low blood iron levels, which I am prone to.

Pregnancy and Dizziness

By now, if you've been following my blogs, you've learned that there's a lot of hormone-induced relaxing going on in the body. One of the other parts of the body that are relaxing as your pregnancy progresses are your blood vessels. They are widening to help increase blood flow to your baby. This causes your blood pressure to be lower than usual, which can reduce the blood flow to your brain, temporarily causing dizziness.

Dizziness is also caused by low blood sugar levels that may occur as your body adapts to changes in your metabolism. Women who are anemic or who have varicose veins may be more susceptible to dizziness than others (not only do I have low blood iron levels, I also have varicose veins, which explains the severity of my symptoms).

When you Need to Worry About Breathlessness and Dizziness 

There are not always benign explanations for why you may feel breathless and dizzy during pregnancy. You should contact your health care provider immediately if your dizziness is accompanied by vaginal bleeding and/or pain in your abdomen. This could be a sign of an ectopic pregnancy, a low-lying placenta, or placental abruption.

You should also contact your health care provider immediately if you have persistent dizziness or dizziness accompanied by blurred vision, headaches, or palpitations; this may be a symptom of severe anemia or some other illness that could have a negative effect on your pregnancy.

If you are feeling breathless and you get the feeling that your heart beat is racing, irregular or missing a beat, or if you feel chest pain--especially if it starts when you exert yourself--or if you have difficulty breathing when you're lying down or at night, see your doctor.

Pain in the Hip! (Week 20)

So, remember that article I wrote not-too-long ago about how the back and pelvis slowly may go out of whack as your pregnancy progresses? Well, it couldn't have been more aptly timed. For the past few weeks I have been experiencing pain in my lower back and hip. It first started pretty mildly, and would only hurt if I moved a certain way, like turning or bending over. It was a sharp stabbing pain that would go away whenever I stopped the particular movement I was doing.

As the weeks progressed, I maintained my toned-down exercise regimen that I've implemented since getting into my second trimester. However, the pain became more frequent and more movements became difficult to do. My clients would notice me limping about and would offer to help me do the normal tasks I would do while training them. Hmmm, not cool. It's one thing thing to endure some discomfort, it's another to let it affect my job. On top of which, it became increasingly difficult to exercise.

Katrina Kulhay to the Rescue
Fortunately, one of my clients referred me to a Toronto Chiropractor that specializes in pregnancy, Katrina Kulhay. I met her for the first time today. She is a positive, energetic woman who sincerely got excited over the news that I was pregnant, and began spouting words of advice on nutrition and exercise. Aside from telling me a lot of what I already know, she also told me to tone down the impact of the exercise I've been doing (which is something an active person hates to hear). This is because as my pregnancy progresses, the levels of relaxin (the joint-loosening hormone) will increase to a point where too much impact could cause my joints to slip around "like a banana". Eeesh.

When it came to the treatment, she obviously knew what she was doing. She was quick, efficient, and actually took the time to explain what she was doing to me as she was doing it. Since that single treatment this morning, I have progressively felt better throughout the day. In fact, as I write this, I am fully mobile again and almost completely pain-free.

Changing my Exercise Routine
Dr. Kulhay advised me to perform special exercises to help strengthen my pelvic floor. This will prevent future pain, as well as make it easier to push out my baby during delivery. These exercises included kegels, supine pelvic tilts, and assisted squats.

Assisted squats can be done with two chairs on either side of you. Holding the back of each chair in each hand, slowly lower yourself down into a squat position. Return to standing. While you complete the movement, use your hands to help slow you down as you lower your body, and help push you up as you raise your body.

Kegels and supine pelvic tilts can be done every day. Do 3 sets of 15-20 reps. For squats, do 3 sets of 15-20 reps every other day.

As far as working my abs and upper body, she said I could continue as I had been before. If you are suffering from lower back pain and discomfort like I am, I would recommend performing upper body exercises that are seated or lying down, so as to not stress your back.

The Scoop on Taking Iron and Folic Acid During Pregnancy (Week 19)

**CAUTION**Don't take any vitamins supplements for pregnancy without first consulting with your doctor. Too much of anything isn't good for you or your baby.


I am now well along in my pregnancy, and I have a lot to show for it. I think the breasts have decided to stay the size they are now, which is quite the relief. I shouldn't have to worry about them getting any bigger until I begin nursing, when they're expected to grown again (yikes!). What's even better is that now the tummy has caught up to my chest, so now I actually look pregnant.


There Goes the Iron
Even though my energy has improved significantly since my first trimester, I've started to notice that I'm now getting the midday slump I used to get before I became pregnant, and before I was taking iron supplements. Several months before I became pregnant, my naturopath determined that I had really low blood iron levels. That was why I would feel tired a lot, even though I was pretty active (actually, being active meant I needed even more iron than I was getting from my diet). My naturopath put me on a highly absorbable form of iron, called Glycinate, which in about a month gave me a new lease on life. I finally had energy to get me through the whole day.


Unfortunately, during my first trimester I couldn't really take any supplements because the smell of them would make me nauseous. Now it has caught up with me, and I can feel myself getting tired the way I used to when I was iron deficient. I'm groggy in the morning, tired by about 3PM, and exhausted after eating dinner. This is because at this point in my pregnancy I need double the amount of iron I used to take. The thing about taking iron supplements is that iron stores take a while to build up in your body, so taking them won't appear to make a difference at first. I've been taking them for about a week now, and am hoping to see some improvements in the next few weeks.


Taking in enough iron is so important, especially during pregnancy.Combine the increased blood volume during pregnancy, increased needs of the fetus to grow blood cells, and blood loss that occur during delivery, and you have a strong case to make sure you're getting enough iron. 


Folic Acid
As soon as I became pregnant, my family doctor put me on folic acid supplements. She told me that it is especially important to the development of my embryo in the first trimester, when the neural tube is developing. The neural tube is the precursor to my baby's spine and brain.


In fact, many sources recommend you take folic acid if you are planning on getting pregnant. The reason for this is that it helps to synthesize and repair DNA, and it is especially important during periods of rapid cell division and growth (which is what happens during pregnancy). On top of that, folic acid works hand-in-hand with iron to produce healthy red blood cells for you and your baby. 


Finding Iron and Folic Acid in Your Food
I always tell my clients to try to get as many nutrients as they can from the foods they eat. That's because not only do these foods usually include multiple nutrients, but they are much easier for your body to absorb than in pill form. 


The best sources of iron come from animal sources such as eggs (particularly the yolk), lean red meat, and liver. Good plant-based sources include beans, spinach, and fortified breads, cereals, and oatmeal.


The best sources of folic acid come from similar sources for iron: liver, leafy vegetables such as spinach, asparagus, turnip greens, beans, sunflower seeds, and fortified grain products.

Pregnancy is a Pain in the Neck! (Week 17)

It's funny how many things you eventually realize other people neglected to tell you about the painful changes that happen in your body during pregnancy. Neck and back pain, lower abdominal aches, pain in your pelvis, and sciatica. Not exactly the things you'd find listed in a sales brochure (if there was one) of the fantastic adventure of pregnancy.

Although some things are harder to control than others, there are things you can do to minimize the pains of pregnancy.

Neck and Shoulder Pain

Recently I've been getting headaches and pain in my neck and shoulders. At first I thought it might be the way I was sleeping, since I've taken to sleeping with a body pillow between my knees and arms (which is supposed to help me sleep on my side since sleeping on my stomach and back are out of the picture now that I'm into my second trimester). But now I've realized what the problem really is: my ever-growing breasts. Okay, so not everyone may be sympathizing with me right about now, but let me tell you, when you increase by 3 cup sizes in the span of 4 months, it takes a toll on your body. While not everyone experiences such a dramatic increase in breast size, for those that are carrying around a few extra pounds up above, it can put tremendous strain on your shoulder and neck muscles.

This is where I've had to bite the bullet and realize I'm going to be spending a lot of money on bras during my pregnancy. No more can I go to my local chain lingerie shop, try on a few bras, and come out with something pretty and supportive. Nope, now I am about to book a fitting with a specialty bra shop to find something that transfers the increased weight from my shoulders to my back. I will look for bras with wider, padded straps, a thick back strap, and possibly even a criss-cross  strap in the back to distribute the weight across my back. That should help ease the pain.

A good massage from your partner definitely doesn't hurt, either. I get one as often as I can from mine. :-)

Lower Back Pain

Your back and abs work together to support your torso, and keeping both of them strong helps prevent backache when you're not pregnant. Unfortunately (as I mentioned in my previous blog), your abs are stretching continuously as your baby grows inside of you. This means that they really can't work to support your core like they used to. On top of that, the growing weight throughout the front of your body pulls your back forward out of its normal alignment, so your posture and the curvature of your spine also changes. Then, as if that wasn't enough, your ligaments and muscles are loosening to allow your pelvis to widen to ease the passage of your baby during delivery.

Your best bets for minimizing your discomfort are to avoid activities that may be jarring to your spine like running and jumping; be sure to squat from your knees when you're bending or lifting, avoid sitting or standing in one position for long periods of time; pay attention to your posture; and tuck a pillow between your knees when you're sleeping on your side. Also, you can add exercises to strengthen your lower back, glutes, and hamstrings. Check out this great back exercise routine for pregnancy.

Lower Abdominal Aches and Pelvic Pain

Sorry ladies, but these are two sources of pain that you can't really improve. These issues are related to the  loosening of the ligaments and muscles of your pelvis that I mentioned above. You will find that you may feel the pain right below your growing belly, or even lower in your hips. (For me, I started experiencing lower abdominal pain in my 14th week. Let me tell you, it was pretty disconcerting when I didn't initially know what the pain was caused by.)

Your pelvis is made up of 3 bones that are attached by ligaments. Under normal circumstances, the ligaments holding the bones together are strong enough that they act as a single bone. However, as the weight of your midsection increases during pregnancy, it puts more pressure on your pelvic bones, causing the ligaments holding them together to stretch. This can be pretty uncomfortable, and may, in extreme cases, make it hard to move around.

The only thing you can really do in cases like this is to really take it easy. Rest often, take stairs slowly, and avoid heavy lifting and pushing.

Sciatica

The sciatic nerve is a long nerve that runs from the lower back to the back of the legs and feet. Typically this nerve allows feeling in the muscles of the legs and feet. During pregnancy, as the pressure increases on your back from the growing weight of your tummy, the sciatic nerve can become inflamed. 

Typically the symptoms of sciatica in pregnancy include the following:

• Pins and needles in the lower back or leg, and possibly the affected foot.
• Shooting or burning in the leg, buttock or lower back.
• Pain in the lower back or back of the pelvis that may extend into the foot.
• Numbness in the leg or feet.

For some, sciatica can be extremely painful. If you think you have sciatica, see your doctor. You can find relief from pain through physiotherapy, 

strengthening the pelvic floor, abdominal and back muscles (see the link above), chiropractic therapy, acupuncture, and massage.

How to Train Your Abs During Pregnancy (16 Weeks)

Disclaimer
Consult your physician or obstetrician before you try any of the exercises I recommend below.


Abs, what abs? I don't see no stinking abs...anymore. Actually, I never used to be one of those women who was blessed with the ability to have 6 pack abs that other people could actually see, no matter how much I trained them. The only way I would have been able to show them off would have been to diet to the point of emaciation, which I was never prepared to do. Besides, I think other people like me better when I'm not irritable because I starved myself of carbohydrates for prolonged periods of time.


In spite of the lack of what was visible, I had really strong abs before I became pregnant. And shortly after I became pregnant, I still had strong abs. I trained them in the same way I had trained them pre-pregnancy, using many variations of crunches with equipment like the stability ball and bosu. These were intermediate-advanced types of exercises.


Over time, my belly has stretched as my baby grows inside me. Now, as I approach my fourth month, the advanced ab exercises have gone out the window, replaced by the good-old-regular crunch. Not that I planned it that way, but crunches have become enough of a challenge for my abs that I don't need to do all the fancy-dancy stuff I used to. This goes to show how important it is for you to listen to your body, especially as it changes during pregnancy.


The Benefits of Training your Abs During Pregnancy

Keeping your abs strong during pregnancy can help prevent the common occurrence of back pain as your growing belly puts more stress on your lower back. Strong abs also will help you push during delivery, as well as help to speed your recovery. 

The Not-So-Nice News: Diastasis Recti
"Diastasis what?" Yes ladies, there's something weird and wonderful that happens to your abs as your belly expands into the later months of pregnancy: they separate. This is known as Diastasis Recti, and while most women go though pregnancy without experiencing dramatic changes to their abs, about 45% of women get some degree of ab separation during pregnancy. 


Let me explain what actually happens. The muscle you are looking at when you see someone with a 6-pack on their tummies is called the Rectus Abdominus. This muscles is made up of two sections, one that runs from your ribs down past the left of your belly button, and one on that runs down the right side (see pic below). In the middle holding both sides together is a strip of tissue called the fascia. As your belly expands during pregnancy, this fascia stretches. The bigger you get, the more the fascia will stretch. This creates the appearance that your abs are separating. This is a painless condition, and it tends to happen to women who are overweight, have short torsos, or who've had multiple pregnancies.

I can't tell you how unimpressed I was to learn about the possibility of this happening to me. Although I am not overweight, nor have I had multiple pregnancies (yet), I have a short torso. I won't post any of the pics I saw of post-partum bellies showing separated abs, but suffice it to say it wasn't pretty. Yes, this is purely in an issue of vanity: Diastasis Recti is not a dangerous condition and will not cause you any pain. 

The best way I like to handle a problem is to see if I can do something about it. So I researched ways to minimize the chances that this could happen to me. I'm pleased to report, I found some light at the end of the tunnel.

Prevention and Treatment of Diastasis Recti

While there's no real way to completely prevent your abs from separating during pregnancy, there are ways you can reduce your chances of it happening. First, it's best to start out in good shape: having strong abs and a healthy weight is the first step.

Next, you need to change how you train your abs when you are pregnant and after you give birth. Most ab exercises you did before pregnancy like crunches and oblique crunches (your obliques are the muscles located to the sides of your rectus abdominus; also known as "love handles") focus on our external ab muscles (the ones directly below your skin). You need to change your focus to your inner ab muscle, the Transverse Abdominus (see pic below). Your Transverse Abodominus is your natural stomach girdle; it's the muscle that pulls in your bellybutton whenever you tighten your abs.

Ab Exercises to Do During Pregnancy
Until you reach your 2nd trimester, there's no need to stop doing crunches. In your second trimester onwards, you need to modify these exercises. I'm not going to re-invent the wheel here. There are plenty of great resources online that explain the kinds of ab exercises you can do while you're pregnant. Here are the ones that I liked:


http://www.abs-exercise-advice.com/pregnancy-abdominal-exercise.html
http://www.progressiveparent.com/Pregnancy_postnatal_exercise/pregnancy-exercise-abs.htm

What your Cravings Tell You When you're Pregnant (15 weeks)

Cravings are hard enough to deal with when you're not pregnant, let alone when your hormones are raging and you are starting to realize that your body's not your own anymore. My cravings have changed over time since I became pregnant. In the first couple of months, I would crave a very specific food dish--like pad thai or fried eggs on toast. The next day the same dish would make me feel nauseous at the thought of eating it. I'm also a chocolate lover, and would eat a piece of dark chocolate every day before I was pregnant. Now, chocolate doesn't interest me in the least. In fact, NO sweets interest me anymore. Brownies, cookies, and other baked goods just have no power over me right now.

"Hah!" you think, "leave to the fitness expert to not want to eat junk when she's pregnant"...Not so fast! My cravings for salty foods are at an all-time-high. And when I first became pregnant, I wanted nothing but breads, pasta, and cheese. Not exactly nutrient-rich, low-calorie foods.

Nowadays, in the start of my second trimester, I have found that something bizarre but pleasant has happened to my cravings: I crave veggies and fruits. In fact, just today I ate green beans with my meal--and I actually liked them! When I used to read about other women who said they craved healthy foods during their pregnancy, I scoffed: there's no way that would happen to me. It goes to show, you really have no idea how your body will change during pregnancy.

So what is it that causes pregnancy cravings?
The first and best answer to this question is that our bodies crave what they need. "Yeah right," you think, "I didn't need to eat that whole box of macaroni and cheese dinner." Well, you probably didn't need to eat that much, but your hormones are telling you something when you crave fatty, calorie-dense foods. Your hormones (who will become your worst best friends over the next long while), are helping your body grow your baby. One of the side-effects, of course, is that they tell your body that it needs more calories. Your hormones aren't necessarily great at specifying how many extra calories your body needs, and that's why you may feel like you tend to overeat. In fact, compulsive eating is quite normal during pregnancy.

So why is it that I now crave veggies and fruits? True to form, my body is now telling me that it needs vitamins and nutrients to help my baby grow and develop properly. I'm not a vegetarian, but for those of you who are, you may find yourselves craving red meat, which is because your body is producing a lot of extra blood and it needs the extra iron.

How to Deal with Cravings During Pregnancy
Given that your body is asking for the things it needs via your cravings, it follows that if you are craving something specific while you are pregnant, you should eat it. I don't recommend overindulging, but eat enough to keep the cravings at bay. I know, it's hard when your arm seems to move of its own accord to the third piece of chocolate cake, but take a break from eating for 15 minutes or so to give yourself some time to digest the food. That way, your body has time to tell your brain "hey, I'm good now. I got what I wanted".