Labour of love

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Aileen Hunt, at nine months pregnant, teaches an exercise class to pregnant women last August. (DAVID LIPNOWSKI / WINNIPEG FREE PRESS ARCHIVES) Photo Store

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Aileen Hunt, at nine months pregnant, teaches an exercise class to pregnant women last August. (DAVID LIPNOWSKI / WINNIPEG FREE PRESS ARCHIVES) Photo Store

People glared rudely as Tammy Gies finished up her jog a few years ago, her baby bump visible through her workout clothes.

"I was doing a cool-down and walking down my street. I did get a couple of hairy looks from two women that I passed. I didn't appreciate that," says the Wolseley resident, who exercised to make labour easier.

Gies, a teacher, is set to give birth to her second child in April. As with her first, she has exercised throughout this pregnancy -- focusing mostly on prenatal aquafitness classes, the elliptical machine and the treadmill.

She hasn't received any stares this time around, but she understands why people might be confused, shocked and even angry when they see a mother-to-be jog, run or even briskly walk.

"There's a misconception out there," says Gies, explaining that some people don't realize it's safe to exercise while you're pregnant.

The reality, according the latest data? Not only is exercise safe for most pregnant women, it's what Canadian obstetricians recommend in their official statement regarding exercise and pregnancy.

June marks 10 years since the Society of Obstetricians and Gynecologists of Canada and the Canadian Society for Exercise Physiology established their guidelines on exercise during pregnancy.

They encourage all women with "uncomplicated" pregnancies to exercise whether or not they were sedentary before they conceived.

This goes against traditional -- and now outdated -- advice that pregnant women were to exercise only if they were active before pregnancy.

Kingston, Ont., obstetrician Dr. Gregory Davies says the 2003 guidelines "may not sound like much," but they are actually groundbreaking.

"Our starting point was generations of advice to (pregnant) women that they should take it easy and put their feet up," says Davies, Queen's University chair of maternal-fetal medicine and one of the principal authors of the SOGC guidelines.

Davies says he suspected for years that exercise in pregnancy was beneficial based on casually observing pregnant patients with the fewest aches and pains and least fatigue.

"Those who were heavy exercisers didn't have as much of that stuff in my personal practice. And when you saw those people in labour, they were much stronger and fitter and able to tolerate more."

With such compelling anecdotal evidence, why did Canadian doctors wait until 2003 to officially recommend exercise to their pregnant patients?

They needed conclusive scientific proof, says Davies, who, along with the other guideline authors, has studied pregnant women in a lab setting, which included measuring their physiological response when exercising at 80 per cent of their maximum aerobic capacity.

The verdict? Cardio and resistance exercise during pregnancy -- at moderate intensity -- is safe for mother and fetus. Even better, it can prevent conditions such as high blood pressure and gestational diabetes, which is often brought on when the mother is overweight.

The consequences of gestational diabetes can be serious, says Davies.

He says half of babies born to mothers with the metabolic condition will suffer from very low blood sugar. "They might have to have an IV. They might have to stay in the hospital longer," says Davies, noting that 50 per cent of the mothers who have gestational diabetes develop type 2 diabetes later in life.

How much exercise is too much?

In 2011, Amber Miller made headlines when she reportedly ran/walked the Chicago Marathon shortly before going into labour.

Even though she slowed down her pace and completed the run in six hours -- much longer than most marathoners would take to finish -- people wondered if she was Superwoman or just stupid.

While Davies advocates modifying your running pace when you're pregnant, he doesn't advocate training for or participating in a gruelling sporting event, even at a slowed pace.

"As a researcher, I don't know. Six hours of exercise is still a long time. Even though you're not going at your highest capacity, your muscles are still demanding a lot," says the professor, noting that he would be concerned about diverting blood flow away from the uterus and the brain when working out for that long.

"Again, there is that theoretical concern. We just don't have that evidence to support whether it's good or not good.

"I think they can run. They're probably going to find they are going to get to a point where it's no longer comfortable if their tummy gets too big."

As well, Davies notes that pregnant women often have balance issues and should keep that in mind when exercising.

As for abdominal exercises, those are also safe, though some pregnant woman may need to modify them, since lying flat can cut off blood supply and make some pregnant women dizzy.

"There really are no negatives as long as you're being smart. You need to tailor the exercise you're doing to your physical condition."

Aileen Hunt, who owns Fit 4 Two, Winnipeg West, says she doesn't have to convince pregnant Winnipeggers that exercise is safe for them.

The certified prenatal exercise leader, who has a university degree in dance, says business has been booming since starting her franchise in 2009, with 100 women a week taking her classes.

"I started with one class a week and now we have seven classes a week... just for prenatal," says the Crescentwood resident, who gave birth to her third child only five months ago.

Why the surge in post-natal fitness? Hunt says women are realizing the benefits of exercising while pregnant while their family members and doctors are encouraging them.

She says she focuses on getting their deep abdominal muscles and legs ready and strong for labour. Each potential student must get permission from her doctor before taking Hunt's classes.

As in the obstetricians and gynecologists' guidelines, Hunt tells her students to measure their exercise intensity using the Borg Rating of Perceived Exertion, a scale that uses subjective numbers to gauge exercise intensity.

Measuring perceived exertion is less complicated than calculating heart rates, she says.

The goal: To go at a pace that, according to the scale, is "somewhat hard."

"You can push yourself as far as you feel comfortable -- the feeling of a light jog," says Hunt, who exercised regularly when she carried her four-year-old sons and even more prior to giving birth to her five-month old daughter.

Leslie Adrian also teaches fitness classes at Fit 4 Two. The mother of two was inspired to become an instructor after her two vastly different pregnancies.

She says her first pregnancy 13 years ago was difficult since she didn't exercise.

"I gained 40 pounds, totally indulged myself, sat around and ate whatever and was considered high-risk," says Adrian, who spent 20 hours in labour, during which doctors had to use forceps to pry her baby out.

She decided to change her ways during her second pregnancy seven years later.

"I really, really watched the way I was eating, but I was exercising. I did a lot of walking almost everywhere -- a couple of hours a day. I attended some aqua classes. It made such a huge difference. I had such a comfortable pregnancy," says the Winnipegger, noting that her blood sugar and weight stayed normal and her labour took less than three hours.

She wasn't shocked when her physician encouraged exercise for her last pregnancy, but, in retrospect, wonders why her doctors didn't mention working out when she was pregnant the first time.

"There didn't seem to be a lot of emphasis on exercise. And I had gone to two different doctors."

Have an interesting story idea you'd like Shamona to write about? Contact her at shamona.harnett@freepress.mb.ca.

Republished from the Winnipeg Free Press print edition March 4, 2013 D1