Exercise and Weight Gain during Pregnancy (Nursing)

00:00 Let's think about exercise. Exercise is good for us when we're not pregnant, exercise is great for us when we are. If you've ever seen someone in labor, that is an intense form of working out. And the more we can do to prepare the body for that, the easier that experience will be.

00:17 So exercise is something we encourage that patients do to help prepare for labor. But we want to do it safely. So when we think about heart rate during exercise, during pregnancy, the recommendation is that the heart rate does not exceed 140 beats a minute. That if we're going to engage in strenuous exercise unless this is part of the client's normal activity, it should be less than 15 minutes of strenuous exercise. If it's moderate exercise, we can do that for more than 30 minutes. So we want to differentiate between strenuous and moderate and typically that has to do with the heart rate. So if the heart rate is getting above 140 beats per minute, then that's going to be strenuous. And when do we do this exercise? Most days of the week. So, 6 days a week would be perfect, 7 days a week is even better, but any amount is just fine. Now there are some precautions that we need to take during exercise to make sure that we don't put the patient at risk or the fetus. We want to think about positioning. So, after 20 weeks, we think about that great big uterus and the idea of lying flat on your back actually can compress the vena cava and make you short of breath. So, we want to think about not doing anything flat on your back after 20 weeks. We want to think about the hormonal influence on the joints. So, if we think about weightlifting or doing a lot of walking if that's not our normal routine, the patient might complain about an increase in soreness in the joints just because they're loose as a result of the hormones. We want to think about overexertion. So we just talked about thinking about heart rate and strenuous exercises versus moderate exercises. We don't want to get into a situation where the patient is overheated or overexhausted because that can take much longer for them to recover. And we want to think about balance. So, if you can imagine having a very large belly and having to walk and you may have seen pregnant patients waddle and they do that as a way to sort of stay upright with this change in weight. So we want to make sure that whatever exercise that we're doing, that we're doing it in a way maybe with our legs spread further apart or holding on to something so that we don't tip over. So those are going to be some important considerations for exercise. Now let's look at weight gain. Now I want to be very sensitive when we talk about weight. That weight means different things to different people and some people really struggle with weight. And so we have to be really careful about how we talk about weight with our patients and so we want to know if they have had a history of any sort of eating difference or eating intolerance before we get in to conversations about this and how much they should gain. And how much weight someone should gain is really determined individually. So I'm going to give you some parameters, but make sure that this is a conversation that you have with individual patients. So, the recommendation is somewhere between 25 and 35 pounds is the amount of weight that someone should gain during pregnancy. Now that someone who is at a healthy weight. If a client is a little bit overweight, then 25 to 35 pounds maybe too much and the recommendation maybe 15 to 25 pounds instead. If we have a patient who's experiencing obesity, then that weight recommendation is going to go down even further so will be between 11 and 20 pounds or you may find that the patient experienced obesity doesn't gain any weight and they're perfectly healthy or because of changes in their diet during pregnancy, they may actually lose weight. But this is going to be something that is going to be discussed with the provider. For a client on the other end of the spectrum who is underweight, they may need to gain a lot more weight to support that pregnancy and so they may find gaining 40 pounds, 50 pounds, 60 pounds is still considered normal depending on where they started. Okay? So 25 to 35 pounds is normal and there are all kinds of variances in between accounting for all the different types of patients that may come in to see us. When do we gain that weight? We tend to gain less of it during the first trimester, which makes sense if you think about the nausea and vomiting that someone might be experiencing. They may not really feel like eating very well.

04:21 So, they may not gain almost any weight during the first trimester and that's okay. But as we get past the first trimester and that ends, then we're going to expect to see about a pound a week or so after that all the way up until the end of pregnancy and that gets us to that 25 to 35 pounds.