BY JANE SEYMOUR
The first time I met
Birgitta, it was at the request of my doctor, Sheryl Ross, MD
I was three and a half months pregnant with twins, and Sheryl
told me that I needed to exercise to counteract the effects
that this pregnancy would have on my body. My show, Dr. Quinn,
Medicine Woman, was on hiatus, so it was a good time to start
an exercise program. This pregnancy at this stage in my life
was very different from my previous pregnancies, which I also
exercised through. Back then I was pregnant with only one child
and I did floor exercises at Jane Fonda's Workout Center. Now,
with twins, I was a "high risk" pregnancy, and I wasn't
sure what I would be able to do.
Birgitta assessed me and
conferred with Dr. Ross about everything we were to do. We started
out with some light toning exercises that she gradually made
more difficult. In the beginning we would alternate indoor workouts
with pool workouts. We did a lot of squats, outer thigh exercises,
abdominals, upper body movements on the Pilates machine, breathing
exercises, and those eternal Kegels. She would throw in Kegels
everywhere, at the bottom of a squat, in the middle of a stomach
contraction, and even during stretching. Working in the pool
was a lot of fun. Birgitta had all kinds of pool toys that we
used for resistance. Sometimes my time was so constrained that
Birgitta had to come to the set to work me out. It must have
been quite a sight-me exercising in a big crinoline dress, hat
She always encouraged me
to work to my capacity, but also to listen to my body and slow
down and rest when I needed to. She kept it fun and varied and
modified the workout according to my advancing condition. Toward
the end I was put on bed-rest just to be on the safe side. I
was supposed to remain in bed for most of the day, but about
the only time that I did was during our workouts. Birgitta somehow
managed to modify and redesign my whole workout to be done in
bed. Being pregnant with twins became a gruesome experience,
but she kept my spirits and strengths up. It was always about
staying strong and healthy, never about vanity-and I'm proud
to say, I never waddled once.
a pregnancy is like a metaphor for life. It can be difficult,
at times when you feel like giving up, when you're aching and
tired and overwhelmed. But you keep going. Finally, when those
boys were born, the purpose was clear. I did it for them as
much as for me, but postpartum it was all for me. Three days
later, Birgitta came to the hospital handing me a sheet of three
"little" exercises to do until I saw her in two weeks.
I got no break at all. I was back in shape in no time. With
a Golden Globe nomination, it was a good thing. Hollywood can
be very cruel, especially at awards-we have to look fabulous.
We continued working
out, gradually making me stronger, and by the time my boys were
six months old, I felt and was back to normal.
As you read on, you'll
be impressed with Birgitta's dedicated and thorough research
and incredible knowledge on pre- and postnatal fitness. This
book is full of useful information that you won't find anywhere
Thank you Birgitta.
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We are living in very
exciting times. Gone are the days of submissively accepting
the idea that pregnancy is a disease that requires total confinement
and inactivity, and the fear that the pregnant body can't be
trusted. The outmoded Western belief that a pregnant woman should
be sedentary is cultural and not based on physiological need.
New studies show that exercise and pregnancy actually complement
each other to be "feto-protective." There is actually
more that a pregnant woman can do than can't do, but if you
haven't exercised before you will need to begin slowly.
I designed this book to be as comprehensive as possible, covering
everything you need to know to enjoy a healthy pregnancy, including
exercise and nutritional guidelines, information on the changes
the pregnant body goes through, answers to many pregnancy-related
questions, and much more. Although some of this information
has been published, a lot has never before been made available
to the public. It is all based on the latest research from medical
journals (primarily the groundbreaking work of Drs. Raul Artal
and James F. Clapp III) and institutions including the American
College of Obstetricians and Gynecologists and the American
College of Sports Medicine, as well as my years of personal
experience working with pregnant moms. You may find some sections
to be a bit technical, but it's not necessary for you to study
and learn every detail. Even if you just skim through some of
the medical chapters, you will still gain an understanding of
the whys, hows, dos, and don'ts of pre- and postnatal fitness.
Birgitta Gallo's (now
Lauren) Expecting Fitness is the first book to offer recommendations
on how to modify specific sports and fitness activities during
pregnancy. It covers practically every sport and fitness activity,
with instructions on how to adapt each one. There are some activities
that should be avoided altogether during pregnancy, but you'll
be surprised how much you can do, with some modifications. In
addition to teaching you to adapt your current activities, I'll
also lead you through exercises to tone, stretch, and strengthen
every part of your body.
You should consult your OB/GYN prior to beginning any fitness
program or participating in any sport or activity. You know
your body best, however, and if you feel your doctor's guidelines
are too restrictive, you should consider getting a second opinion.
Unfortunately, there are some doctors out there who don't keep
up with the latest scientific data on exercise and pregnancy,
and some who cling to outmoded fitness recommendations. Make
sure you choose a doctor you feel comfortable with. For advice
on how to find the right doctor, I recommend the book Doctor
Shopping: How to Choose the Right Doctor for You and Your Family
by Hal Apiar. The
benefits of exercise during pregnancy are tremendous. These
benefits include increased energy levels, reduced pregnancy
discomfort, fewer delivery complications, decreased labor time,
and speedier recovery time. Exercise will give you better control
of your pregnant body, because a strong and fit body can better
support the growth and changes in a pregnant woman. Exercising
when pregnant also helps your circulation, relieves tension,
and helps with balance and coordination. You will gain less
weight and regain your pre-pregnancy shape sooner. Most importantly,
recent research has proven my personal theory to be correct-your
baby will derive substantial health benefits.
Realizing that your
pregnant body is beautiful, strong, and healthy will do wonders
for your self-esteem, confidence, and emotional well-being.
With an educated and positive outlook on the changes of pregnancy,
you will move and enjoy your body much more. With a better understanding
of your pregnant body, knowing how to minimize discomfort and
prevent complications, your mind will be more at ease throughout
your pregnancy and as you anticipate motherhood.
Being able to motivate and inspire women to confidently go through
their pregnancies strong, fit, and healthy, and to educate them
about their pregnant bodies is extremely fulfilling and exciting.
Part of my goal in writing this book was to answer your questions
about prenatal fitness, so that you can confidently exercise
your right to a healthy pregnancy by staying as fit and strong
as you can. Just by picking up this book you are demonstrating
an interest in giving your baby the best possible start in life.
Being pregnant is definitely not the time to stop moving-stay
active and enjoy the nine months of quiet before the storm.
Also look for Jane Seymour's upcoming book on having twins,
released in the spring of 2001.
E-mail me with any questions at firstname.lastname@example.org
or look for my newsletter at www.expecting-fitness.com.
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BY RAUL ARTAL MD
is the best kind of exercise. Most women who are pregnant find
that a two to three mile walk daily is all they enjoy, and very
few are inclined to indulge in six miles, which is generally
accepted as the upper limit. Very few outdoor sports can be
unconditionally recommended to the prospective mother. Because
athletic exercise is either too violent or else jolts the body
a great deal, it is especially dangerous in the early months
of pregnancy. All kinds of violent exertion should be avoided-a
rule which at once excludes sweeping, scrubbing, laundry work,
lifting anything that is heavy, and going up and down stairs
hurriedly or frequently. The use of a sewing machine is also
It is well recognized
that 40 percent of all medical conditions in our urbanized society
are behavior related, that is, they arise because of sedentary
lifestyle and poor nutritional habits that result in obesity,
cardiovascular disease, diabetes, and hypertension.
Pregnancy provides a unique
opportunity for behavioral modification. The increased awareness
for well-being in pregnancy provides a strong impetus for lifestyle
changes. Pregnancy-acquired lifestyle changes ultimately impact
on the well-being of the entire family. It is laudable that
prominent individuals in the entertainment industry such as
Jane Seymour have taken upon themselves to promote a healthy
lifestyle for the public at large. These initiatives have a
significant influence on behavior modification.
Today's women are better informed and usually assume the key
role in issues that relate to family health. Most of the women
in today's society combine a career with pregnancy and motherhood
and wish to remain physically active. We as health-care providers
should promote these trends.
Contrary to the beliefs and practices of previous generations,
we should change the perception that pregnancy is a state of
confinement. It is not! Women can and should continue to derive
health benefits from an active lifestyle during their pregnancy.
The immediate benefits
of exercise and fitness in pregnancy include the ability to
better cope with the rapid anatomical changes of pregnancy:
to maintain better posture, ambulate more easily, experience
less back pain, and maintain a better overall psychological
outlook. Fit women also appear to cope better with labor and
attitudes toward pregnancy and fitness have changed dramatically,
although misconceptions and misinformation persist to this day.
To the Victorian lady, pregnancy was a state of confinement
and it was considered unseemly for pregnant women to engage
in active recreational or social activities. It was even inappropriate
to be seen outside her family setting.
The same attitude toward pregnant women persisted in the beginning
of the century in the United States. In 1913, a handbook for
pregnant women advised:
moderate amount of exercise is good for anyone, and this is
particularly true for pregnant women. Unless you have been ill
or unless there is some complication, you can continue your
housework, gardening, daily walks ... and even swim occasionally.
These attitudes have gradually and slowly changed. By 1949, the
U.S. Children's Bureau recommended:
Dich-Read, a South African obstetrician practicing in London,
emphasized knowledge, relaxation, and some specific prenatal
exercises to reduce the need for pain medication in labor. A
Russian physician named Velvovsky developed a psychoprophylaxis
regimen for "painless" childbirth, which was introduced
to the West in the 1950s by Dr. Fernand Lamaze and brought to
the United States by one of his patients, Marjorie Karmel.
Most childbirth preparation
classes thereafter focused on relaxation techniques intended
to ease the perception of pain and minimize the administration
of pain medication. Some called this technique natural labor,
a term that was utilized earlier in the century to describe
home deliveries. At that time, hospital deliveries were associated
with a high incidence of maternal mortality, primarily due to
infections. The hospital environment was considered dangerous,
unnatural, and a last resort. Realities
and perceptions have changed. Modern hospitals and facilities
are certainly the safest locations for labor and deliveries;
prospective mothers are educated, inquisitive, in control of
their bodies, eager to stay fit and derive health benefits from
a healthy lifestyle. In the past ten years, significant research
has demonstrated that exercise during pregnancy is not only
safe, it is also desirable.
Safe guidelines for exercise in pregnancy have been developed
and published by the American College of Obstetricians and Gynecologists.
Pregnant women are well-advised to participate in programs that
incorporate these guidelines; however, it's always wise to also
consult your obstetrician.
Birgitta Gallo has authored with Dr. Sheryl Ross this very practical
book on fitness and pregnancy. This book is an excellent, balanced
source of information that should find its way to each pregnant
woman who desires to remain active in pregnancy!
-Raul Artal, MD
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PREGNANCY/EXERCISE CONNECTION Pregnancy
is a nine-month physical and emotional roller-coaster adventure
to motherhood. There is so much information on pregnancy, but
do we really understand it? Myths and unsubstantiated theories
are perpetually thrown at us. New books come out all the time
without updating their information or researching all of the
new medical studies on the subject, many of which have been
published in just the last five years. Many books dispense facts
about pregnancy but leave out the all-important why.
This chapter begins by detailing the benefits of prenatal exercise
and dispelling the myths that had earlier generations of women
afraid to leave their rocking chairs during pregnancy. Next,
it describes the basics of the pregnancy/exercise connection,
helping you to understand why exercise is not just okay but
important during a pregnancy, benefiting both mother and child,
and how and why pregnancy will affect the way you can exercise.
why you need to exercise Let's
begin with the reasons why you should exercise during all stages
of your pregnancy. Most of these will be discussed in greater
detail elsewhere in this book, but I wanted to start off by
listing the many benefits-to you and your baby-of a good pre-
and postnatal fitness program:
• improves your fertility
• reduces the unpleasant effects of the biomechanical changes
• eliminates or reduces pregnancy-related discomforts
• prevents and treats pregnancy-induced diabetes
• improves calcium absorption, preventing hypertension,
preeclampsia, and future osteoporosis
• relieves tension, stress, and possible depression
• increases your general strength, improving your ability
your larger belly
• reduces the strain on your upper back
• reduces the strain and pressure on your lower back and
• prevents "round shoulders" and improper posture
• increases energy, particularly in the last trimester
• improves your immunity
• less excess weight gain
• a better looking pregnant body
• increases your self-esteem and improves your self-image
• gives you a sense of achievement
• gives you a more positive outlook on your pregnancy and
• strengthens, tones, and gives you better control of your
muscles during labor
• improves your endurance, fitness level, and muscle control,
a faster, easier, and less painful labor
• prevents or reduces the risk of labor complications
• reduces your chance of needing a C-section
• reduces the chance of birth defects
• increases the chance of delivering a child with higher
scores (tests taken at one and five minutes after birth-low
usually indicate a problem with the baby's health)
• minimizes stretch marks
• minimizes postpartum blues or depression
• minimizes present and future incontinence (urinary leaking)
and organ prolapse problems
• allows faster recovery from pregnancy and labor
• helps you get back into shape easier, faster, and more
• reduces back strain from carrying and nursing your newborn
• increases energy and allows you to keep up with your
• gives you time for yourself
• reduces birth defects and need for medical intervention
• child is born healthier, leaner and calmer
• minimizes your child's chances of having a weight problem
• improves your child's neurological, mental, and physical
let's get some of those pesky myths out of the way. There have
been so many misconceptions about what pregnant women should
or should not be allowed to do. There have been even bigger
misconceptions about the entire concept of "prenatal exercise;"
perpetuated by both the fitness industry and the medical community,
mainly due to the lack of knowledge on how exercise can and
should be modified during pregnancy. Many of these myths grew
out of fear or ignorance, and they have been disproved by modern
Following is a list of things regular exercise during pregnancy
was thought to cause:
• hormonal imbalance
• overstressing of the joints, increasing risk of injury
• redirecting blood flow away from the fetus to the muscles,
reducing oxygen and nutrient supply for the fetus
• overheating the fetus in the womb
• uterine bleeding
• displacement or rupture of the placenta (the placenta
moving to cover the opening of the cervix, preventing the baby
from coming out during labor)
sessions to fifteen minutes and keeping your heart rate under
140 bpm (beats per minute). When you're pregnant, your resting
heart rate increases by about ten to twenty bpm, so just walking
around could bring it up that high. Most prenatal fitness research
done in the past was performed on animals. Not surprisingly,
scientists have discovered that those findings often do not
quite correlate to human pregnancies.
performed over the last ten to fifteen years, has proven that
exercise is not just okay for a healthy pregnant woman, it is
actually beneficial, and not just to the mother but to the baby
as well. We can thank two American gynecologists-Raul Artal,
MD, and James F. Clapp III, MD, for most of this research. Dr.
Clapp, professor of the Department of Obstetrics and Gynecology
at Metro Health and Medical Center in Cleveland, states, "Pregnancy
is a normal physiological state, not a disease, and the benefits
of exercise appear to be substantial for both the woman and
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When you exercise, the primary targets for your blood to flow
to are your muscles. Pregnancy itself increases your blood volume
by 40 to 45 percent-it increases the amount of red cells that
carry oxygen, and allows blood vessels to carry more blood at
once. Exercise increases your blood volume another 10 percent.
Put all of this together, and you have an abundance of blood,
ensuring that there is always plenty to go around, protecting
the fetus and serving the needs of your other organs. With more
hemoglobin in the blood transporting oxygen during exercise,
the fetus draws more blood and oxygen than usual through the
placenta, and more blood is being pumped with each beat of the
mother's heart. A sufficient oxygen supply to the fetus is thus
This safety mechanism
might have something to do with the fact that pregnancy improves
your metabolism to compensate for your weight gain. Therefore,
you won't need as much oxygen to do the same amount of exercise.
This faster metabolism, combined with extra blood and increased
oxygen intake, gives pregnancy a "training effect,"
making you more fit.
With all this extra
blood, your body may at times have trouble moving it around.
If you lie on your back or sit in the same position for a long
time, the circulation slows down, and blood pools in your legs,
preventing it from returning to the heart or flowing to the
fetus. This makes you tired and dizzy. This is called "supine
hypotension," and is another safety mechanism of the pregnant
body. If this happens when you are in a standing position and
the blood doesn't get back to the heart, your blood pressure
falls and you need to lay down to enable the blood to rapidly
return to the heart-so you faint and fall. Amazing how it all
works-who knew fainting could, in a way, be "good for you."
Exercising and moving
your body will keep your blood circulating properly. When exercising,
keep your legs moving as much as you can. If you are doing certain
seated, standing, or lying exercises, make sure to walk around
a little between sets, to prevent blood pooling in your legs.
It is probably this blood pooling that accentuates varicose
veins, which is why exercise helps to alleviate them. Sitting
for a long time can also add to pressure in the pelvis, so you're
not going to be comfortable in any position for very long. In
order to keep your blood circulating efficiently, it is almost
as if pregnancy makes your body say, "Get up and move."
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YOUR CHANGING BIOMECHANICS
The mechanical workings of your body (how your joints move and
which muscles are doing what work during a movement), are definitely
affected by both your pregnancy and any physical training you
The physical changes
that you will experience from pregnancy increased size, weight,
changing shape and center of gravity, swelling tissues, and
softer joints-affect the way you walk and perform everyday tasks.
You are carrying more weight around, on top of softer, less
stable joints, which makes you more susceptible to injuries,
sprains, and lower back pain. Exercise, when done properly,
strengthens your body, reducing this risk of injury and strain.
After the fifth month,
your hips won't move as well and your range of motion will be
restricted. A simple movement such as getting up from a chair
becomes not so simple. Leg strengthening exercises for the outer
and front thighs (quadriceps), and front lower legs (tibia),
will help, and thereby reduce the risk of injury to your knees.
Pressing yourself up with the help of your arms will also alleviate
the strain on your legs, which means that you should strengthen
your arms and upper body, too. It's hard to imagine that just
getting out of a chair could get so complicated, but when you
are pregnant and your body doesn't move as well, you have to
become more aware of your posture, body position, situation,
and surroundings. You need to come up with ways to reduce the
stress on your body. Instead of sitting on a low chair or sofa,
try sitting on a higher chair or bar stool.