Pilates and Pregnancy: Michelle J

 

I would highly recommend Pilates to anyone, but it’s particularly important leading up to, during, and after pregnancy for the following reasons:

1) Less pain and discomfort because skeletal imbalances. Pilates emphasizes working your body in the correct align meant, or working towards bringing you into alignment. This definitely helps prevent common pregnancy aches and pains. I was constantly conscious of trying to work against the lordosis that usually occurs in the lower back during my pregnancy and engage my core to bring myself back to a more neutral alignment.

2) Less chance of diastasis recti because of the focus on strengthening transversus abdominis. This is a common side effect of pregnancy when the two halves of the rectus abdominis separate as a result of over stretching. When this deepest layer of your core (like an internal corset)  is strong and you are mentally connected to how it works, you are better protected from having diastasis recti because you know how to move and use these muscles properly.

3) Pelvic floor, pelvic floor, pelvic floor!  These muscles are SO important during pregnancy, labour, and recovery.  Pilates teaches you how to use these muscles, and they are important in two ways during this time. You need strong pelvic floor muscles to support the growing weight of your baby during pregnancy. Equally important is the ability to relax these muscles during delivery ….trust me! Pilates teaches you an awareness of the pelvic floor that is invaluable.

- Special considerations for the pregnant client:

Again, strengthening and awareness of the pelvic floor muscles and transversus is key. By the time the client reaches the 5th or 6th month, it’s important to avoid exercises that put too much emphasis on flexion or where the torso or specifically abdominals have to work against gravity to prevent diastasis recti. So - traditional ab crunches or roll ups, or rollbacks are out, as are planks and regular push-ups. Push ups can be modified to be done against a wall or slightly elevated. Another concern is the possibility of supine hypotensive syndrome in some pregnant women - where the weight of the baby can compress the inferior vena cava when the mother is lying on her back. This can potentially slow blood flow back to the mother’s heart, which in turn will reduce blood and oxygen flow to the fetus. Because this is potentially dangerous, it is best to avoid working in a supine position by the end of the second trimester. But in both cases, it does depend on the individual.

- Other resources (websites)/best studios in Toronto to train at:

I did my Pilates teacher training at Stott Pilates and also a specialized Prenatal Reformer workshop there - luckily just before I found out I was pregnant.  I find the Instructor Trainers at Stott to be very knowledgeable when it comes to a variety of specialized cases such as pregnancy or injuries. I teach at Misfit Studio on Queen St. West and the owner, Amber Joliat, is a Pilates and yoga instructor who has a great understanding of movement and anatomy, and she is a wonderful teacher.  We also offer Eccentrics at Misfit Studio and I found that to be a great workout during my pregnancy, as much of it is done standing and provides a great amount of stretch and release for muscles and joints that are a little overburdened during that time.

'Nutrition and Pregnancy' by Nathalie Niddam

If you are reading this and you are thinking about getting pregnant then there is a lot you can do to make sure that your body is best prepared to grow a new human!  If you are already pregnant, there is no time like the present to improve your nutrition.  

For the most part, growing babies will get what they need from Mom both during the pregnancy and while nursing - the tricky bit is that in the case of deficiencies on Mom’s part this can leave her open to issues of her own when trying to meet her body’s needs. 

Your body’s needs for virtually all nutrients, vitamins and minerals will increase during pregnancy - on average, women will need to consume in the neighborhood of 300 calories more per day.  It is critical that these calories come from nutrient dense foods that help to shore up nutrient stores and availability for the baby and Mom.  In particular:

•   Protein needs can increase by up to 50%, 

•   calcium (for bones, teeth, muscle and heart function, blood clotting and nerve transmission),

•   iron (your blood volume increases by 50% during pregnancy - iron is critical for red blood cell formation for mom and baby!) (target is around 27mg/day from food and supplement sources)

•   zinc for the normal development of the foetus’s immune system,

•   Folic Acid again to help form red blood cells but also to support the development of the baby’s nervous system and to stimulate Mom’s appetite (!).  Consider taking 800-1000 mcg per day as folate or 5-MTFH as some people have trouble converting folic acid to it’s active form.

•   Vitamins A. C, E, B6 and minerals Iodine, magnesium and sodium are all also needed in greater quantities….in terms of sodium this is not a licence to eat bags of chips and pretzels….use grey or pink sea salt in moderation, consume raw unpasteurized fermented foods like sauerkraut and pickles and try not to overdo it to avoid issues with blood pressure or water retention.

So, what are you to do?  Basically two things -  start with a high quality pre natal vitamin along with vitamin D3 and a good omega 3 supplement.  And then, eat the best diet you can possibly manage - as we are told time and time again there is no better way to give your body what it needs than from food, in the way that nature intended. 

Get your house in order - Ideally before you get pregnant

1.     have a full physical and get your doctor to check on your Vitamin D3, Iron, and B12 status.  If any of these are anywhere other than in the healthy range then you may need to consider taking supplements (in addition to adopting a solid diet plan) to bring up your stores more quickly. 

2.     If you suffer from digestive issues (bloating, gas, constipation, diarrhea) try to finally take the time to try and understand what could be driving these issues.  It could be as simple as improving your diet or you may need to address some underlying cause - whatever it is, it will be easier to deal with now and could well set you up for an easier pregnancy overall.  If necessary, consult with a health practitioner to help you pinpoint what the issue may be.

3.     Pay special attention to constipation - if this is an issue you need to resolve it sooner than later, make sure that you are consuming between 25-45 grams of fibre daily and drinking plenty of water - if that still doesn’t work, get some help pinpointing the cause and an appropriate remedy.

4.     Now is the time to clean up your diet - out with the junk and in with the real, whole food.   Eat organic whenever you are able to minimize the load on your liver and drink the cleanest water that you can get your hands on.

Let’s expand on the principles of a “nutrient dense whole food diet:

1.     Hydrate:  Drink 6-8 glasses of water a day - every day.  Avoid caffeine, pop, fruit juices and alcohol.

2.     Eat loads of vegetables - cooked, raw, steamed, any way you like ‘em (other than deep fried in bad fats) and eat as many different kinds as you can find.  Try to have the most colourful meals ever - orange (carrots, butternut squash, sweet potato, pumpkin), green (avocado, collards, Kale, rapini, arugula, broccoli, asparagus, artichokes), red (beets, peppers, tomatoes, radishes), blue/purple (blueberries, purple potatoes, red cabbage, radicchio) even white and yellow (spaghetti squash, summer squash, lemons, cauliflower).

3.     Consume healthy amounts of the best protein you can afford - grass fed beef, pastured chicken & their eggs, pastured  pork, wild caught fish.  Anytime is a bad time to pick up an unwelcome guest (ie parasite) but before and during pregnancy is especially bad so make sure that your pork and fish are properly cooked and from impeccable sources - you may have to park the sushi habit for now to avoid exposing yourself and your little one to unnecessary risk.

4.     Healthy fat is needed to absorb fat soluble vitamins, for energy, to help you feel satiated and to avoid excessive cravings.  Use extra virgin coconut oil, extra virgin olive oil, avocado oil, butter from grass fed cows, ghee, nut butters, nuts and seeds and whole eggs.  About 1-2 thumb size portions per meal is a rough guide to how much.

5.     Grains:  If you eat grains pick whole organic grains and ideally sprouted to make them most nutritious and digestible.  Try not to eat grains at the expense of your daily needs for protein, vegetables and healthy fats - they will be important to meet your calorie needs but they simply do not measure up on the nutrition scale compared to these other food groups.

6.     Pre and probiotic foods:  the gut microbiome - that colony of bacteria living in your gut is one of the most active areas of research in all areas of medicine these days and there is increasing evidence that Mom’s micro biome status plays an important role in establishing baby’s immunity both immediately after birth and into childhood.  There is some evidence that indicates it may be wise to take probiotics during pregnancy but it’s a good idea to consult a health practitioner to determine if this is right for you and what type to buy.  Having said that, there are foods you can eat that will support that micro biome including:

•   organic, plain, whole milk yogurt and kefir (assuming dairy agrees with you) either from cow, sheep or goats milk - if dairy doesn’t work for you there are also options made from coconut milk

•   raw and unpasteurized sauerkraut and kimchi

•   kombucha (always choose naturally lower sugar varieties like ginger)

•   eat prebiotic foods like raw asparagus, jicama, jerusalem artichokes, raw and cooked onions, raw garlic (in small amounts), green plantain chips, cooked and cooled potato and white rice.

•   and of course, the foods to avoid:  excess sugar, processed foods, bad fats (trans and hydrogenated fats, vegetable oils, corn oil, soybean oil…almost anything that is not on the “good fat” list above).

** Certainly nausea in the first trimester can complicate matters somewhat and this is one of the many reasons why a good prenatal vitamin is always a good idea.  You can also drink ginger tea to try and manage the nausea, and eat smaller, more frequent meals.  This last point will also come into play in the third trimester when your growing baby starts to take up more space and leave less room for your own organs.   Do your best to choose the most nutritious foods you can manage - for some people this means going bland, for others it means more flavour - try to understand what tastes appeal to you most and make the best choices you are able to in that spectrum.  There is some evidence that morning sickness could be associated with the extra stress placed on the liver at this time - supplementing with vitamin B6 in its active form (P5P) can sometimes be helpful at a dose of 25-50mg 3x a day.  And water, drink water….

With all this talk of food and eating more many women wonder just how much weight they should gain during pregnancy.  Like all questions surrounding weight gain, this is a complicated one to answer.  For a woman who is underweight the target is anywhere from 28-40 lbs, women at a healthy weight should aim for 25-35 lbs and for women who are significantly overweight the target is a bit lower, between 15-25 lbs.  Before you run off and decide what category you fall in (us girls are notoriously challenged in this area), do yourself a favour and consult with a health professional to decide what is right for you.  One thing that is almost never the right idea is to decide to go on a diet during pregnancy unless you are being closely monitored by your doctor or health professional - and even then, there’s a reasonable chance that improving your diet will get the job done without restricting calories or major food groups. 

Aside from all this….enjoy your pregnancy, take this time to take care of yourself, get extra rest, appropriate exercise, get lots of fresh air and, if you have other little ones around try to get some help from friends and family when you need a break.