addition, when you get up from lying down, take care not to strain the abdominal muscles. Roll over on to your side, push yourself up with your arms, then get into a kneeling position and stand up, one leg at a time while keeping your back straight.
Another reason not to exercise while lying on your back in pregnancy is to avoid feeling faint. When you are pregnant and lie on your back, the weight of the pregnancy can obstruct the large blood vessels in your abdomen that are pumping the blood back to the heart. The heart therefore has less blood to pump out and so you can feel faint.
If you feel any strain during exercise, stop at once to prevent damage to your ligaments. Your ligaments are very strong fibrous bands of tissue that hold bones together, including those of the pelvis and they soften in pregnancy to allow more room in the pelvis to help ease the passage of the baby through the birth canal. However, this softening also makes them more likely to be strained if you stretch too far.
Jogging
From 20 weeks onwards, it is thought best by some doctors to avoid exercises that cause the womb and the baby to bounce up and down on your pelvic floor (such as jogging and jumping) because this might lead to weakening of your pelvic floor. However, other doctors believe that moderate amounts of jogging are not harmful.
Jogging can stress your joints and your breasts, so if you do jog, wear a supportive sport’s bra and running shoes that absorb some of the shock. If you are a serious runner and jog frequently, it is probably best to reduce the number of kilometres you do after 28 weeks of pregnancy, and further reduce it after 36 weeks. This is because there is some concern that strenuous prolonged exercise at this stage of pregnancy could reduce the blood supply to the baby. You can, of course, replace jogging with less strenuous forms of exercise in later pregnancy.
When exercise is best avoided
You should avoid vigorous or strenuous exercise in certain situations, and in other conditions more care and supervision may be required. If you have a medical problem, talk to your doctor about exercise before you embark on a routine before or during pregnancy. It is sometimes best to restrict yourself to stretching-type exercises only.
Using a sauna or hot tub after exercise
watch out!
Other activities that are best to avoid when pregnant include:
• any activity like horseriding that might be associated with loss of balance or trauma to the developing baby
• any exercising at high altitudes, such as skiing in the mountains, as there is less oxygen at high altitudes, which in turn might lead to a reduced oxygen supply for the baby
• scuba diving, because of the possible effects of decompression sickness on the baby, which are potentially dangerous
It is best to avoid a sauna or hot tub as the risk of getting overheated is more likely in pregnancy, especially after exercise, which can make you faint. If you do have a sauna, limit the time to no longer than five minutes and also limit the temperature to less than 82 °C (179.6 °F). If you have a hot tub, limit the time to a maximum of 15 minutes at a temperature of less than 39 °C (102.2 °F). If you feel uncomfortable or faint, get out immediately. You should also make sure that you maintain your fluid intake as the heat can be very dehydrating.
Pelvic floor exercises
The pelvic floor is a sheet of muscle and fibrous tissue lying across the bottom of the pelvis. It supports the pelvic organs, including the bladder, part of the bowel and the womb, while the vagina, bowel and urethra (the tube that takes urine from the bladder to the outside) pass through it. The pelvic floor therefore helps you keep control of your bladder and bowel function. When you want to stop passing urine mid-stream, it is the pelvic floor muscles that you contract to do so.
These muscles can be stretched and damaged by the stress of pregnancy and delivery, which can lead to problems such as stress incontinence, where increased pressure on the pelvic floor, such as with coughing, leads to a small leak of urine from the bladder. It thus makes sense to strengthen the pelvic floor before and during pregnancy to minimize the risk of problems later on. Pelvic floor exercises are designed to do this and should be performed both during and after pregnancy.
Raising the pelvic floor
First, pull up and tense the muscles around your urethra, vagina and rectum as if you are interrupting the flow of urine. Hold for several seconds, then release and relax. Repeat four to five times and then repeat this set ten times and thereafter several times a day. You may want to try fitting these exercises into your daily routine, so try practising them each time you pass urine.
Avoiding back strain
The increased load on your body from the growing pregnancy often leads to backache. You need to think about your posture and avoid stooping or slumping forward as this stresses your back more. When you are sitting, tuck a cushion behind the lower part of your back to help you sit up straight. You should avoid exercises and activities that might strain your back. Do not do any heavy lifting or load bearing as this can also strain your back. If you have to lift something heavy, like a young child, bend your legs to get down, keep your back straight and lift by straightening your legs. Keep the child close to your body as lifting something at arms’ length can add to the strain on your back.
3. Fertility problems and treatment
Fertility problems are common: 1:6 couples are affected. However, the last 25 years has seen an explosion in our knowledge of male and female fertility and our technical ability to treat a whole range of fertility problems. So it is important to know that if you do have a problem, there is now a great deal that can be done to help you conceive.
Conception difficulties
When a couple have difficulty conceiving, it is often thought to be the woman’s problem. This is a misconception and so it is important to take the couple into consideration rather than the man or the woman individually.
Potential reasons for conception difficulties
• In a third of cases, there is a problem with sperm quantity or quality.
• In around a quarter of cases, there may be a problem in producing eggs.
• In a fifth of cases, problems with the fallopian tubes prevent transport of the eggs to the womb.
Furthermore, it is not uncommon for more than one factor to be present and in almost 1:5 couples, both partners contribute to the problem. However, in about a quarter of cases, no cause can be found in either partner. This is called unexplained infertility. In addition, the problem can be something that you might not consider to be a medical issue, like being underweight or overweight, experiencing rapid weight loss or smoking.
What is ‘infertility’?
Humans are not highly efficient when it comes to fertility. About 20 per cent of couples will conceive within a month of beginning to try, rising to 70 per cent within six months. After a year of regular unprotected intercourse only around 84 per cent of normal fertile couples will have conceived. In those couples who have not conceived after a year, around
must know
Conception facts
• Around 16 per cent of couples have some difficulty conceiving.
•