Expecting Parent Resource Guide – Section 3

• Eat foods rich in iron such as meat, chicken, fish, eggs, dried beans and fortified grains. The form of iron in meat products, called heme, is more easily absorbed than the iron found in vegetables. If you are anemic and you ordinarily eat meat, increasing the amount of meat you consume is the easiest way to increase the iron your body receives.
• Eat foods high in folic acid, such as dried beans, dark green leafy vegetables, wheat germ and orange juice.
• Eat foods high in vitamin C, such as citrus fruits and fresh raw vegetables.

While continuing to exercise or starting a new exercise routine during pregnancy can be intimidating, here are some helpful guidelines to help you be active.

• It is typically safe to continue with your pre-pregnancy exercise routine or begin a new routine during pregnancy, but first consult with your doctor if you have any questions.
• Aerobic and strength exercise are both beneficial during pregnancy. Aim to get 150 minutes of low to moderate intensity activity each week.
• Stay well hydrated during activity to help regulate your heart rate and blood pressure. Signs of dehydration include dizziness, rapid heart rate and dark urine/little urine.
• Be aware of your body temperature and exercise in an environment that allows your body to cool itself. Uncontrolled, elevated core body temperature (such as high fevers, hot water submersion or heat-related illness) can increase risks to you and your baby.
• Invest in supportive clothing, such as supportive bras and belly supports, to wear as needed during exercise.
• Avoid exercises or movements that increase your risk of losing your balance and falling, such as quick lateral movements and long-duration hold yoga poses or stretches. As pregnancy progresses, your center of gravity changes and joints become less stable, which increases your risk of falling.

Remember if at any time during your pregnancy you experience any of the below symptoms, contact your doctor and/or seek medical attention:

• Bleeding or excessive fluid flow from your vagina
• Feeling dizzy or faint
• Shortness of breath prior to beginning exercise
• Chest pain
• Calf pain or swelling
• Painful contractions in uterus

Monitoring the intensity of your workout is critical while exercising during pregnancy. Considering all the physiological changes happening in the body during pregnancy, monitor your exercise intensity using these two effective tests:

• Talk test: You should be able to carry a conversation throughout the duration of your workout.
• RPE scale: Based on the rate of perceived exertion, aim to stay in the light to moderate intensity range most of the time (2- 6). You may venture into vigorous activity/intensity (7-8) for a very short period of time, depending on your physical capacity.

Exercise guidelines

• Always allow for ample time to warm up.
• Focus on training your total body – strengthening your legs, arms, core and back – for your long-term health through pregnancy and beyond.
• Pay attention to special areas of interest that may become “problem” areas during pregnancy, like your lower back, pelvic floor, hips, upper back, abdominals and diaphragm.
• Focus on moving slowly and owning every degree of every exercise – remember what is happening to your musculoskeletal system during pregnancy.
• Abdominal training
  • Avoid oblique exercises. Instead, focus on abdominal work that tracks up and down the spine rather than across the body.
  • Avoid prolonged time laying on your back, for risk of compressing the vena cava. The vena cava is a large vein that carries blood to your heart from the other areas of the body. If it is compressed due to the weight of the baby and gravity, rolling over and relieving the pressure should eliminate feelings of lightheadedness or numbness.
  • When performing abdominal exercises, think about “hugging your baby” or holding your baby high and tight with your abdominal muscles, keeping them engaged throughout your entire workout.
  • As pregnancy progresses and your belly grows, performing abdominal exercises may become more challenging but are still important. There are modifications and alternatives to almost every abdominal exercise.
• Pelvic floor strengthening and Kegel exercises
  • The pelvic floor undergoes massive changes during and after pregnancy. Being aware of your pelvic floor and how to properly engage it can aid tremendously through all stages of pregnancy and postpartum.
  • Doing Kegel exercises is one of the most helpful things you can do to strengthen your pelvic floor and the muscles that support the bladder, uterus and bowels. Daily pelvic floor exercises may help to alleviate or even prevent problems during and after pregnancy, such as incontinence and poor bladder control.
• Low back and lower body training
  • Your low back muscles aid in maintaining good posture as your body changes and grows with pregnancy. Engaging your low back muscles will set you up for success as your posture and center of gravity changes throughout pregnancy.
  • Exercising your lower back through squats, lunges, wall sits and bridges will strengthen both your lower body and pelvic floor.
• Water-based training
  • Engaging in water-based training or activity is a great option during pregnancy, especially the third trimester.
  • At all stages of pregnancy, water-based training can allow you to stay active while alleviating many of the discomforts and limitations associated with exercise during pregnancy.
  • During water exercise, pregnant women only have to support roughly 50% of their body weight due to the water’s buoyancy. Water eases the pressure on all the joints caused by pregnancy and weight gain, as well as has been shown to relieve chronic low back pain.

Trimester 1

• In your first trimester, many of the noticeable physical changes that come with pregnancy may not yet be relevant. This is a great opportunity to focus on building strength throughout the whole body and becoming familiar with monitoring your exercise intensity.
• Engaging in exercise early in your pregnancy can also aid in managing common first trimester aliments, such as morning sickness and fatigue.

Trimester 2

• As your pregnancy progresses and you begin to notice more physical changes, like your growing belly and breasts, focus on giving yourself proper time to warm up before exercise. Because of the changes in your hormones, your body and joints will need more time to warm up and produce the protective fluid that acts as a cushion between your bones, helping lower your risk of injury during exercise.
• Start learning and practicing correct postural and exercise modifications now, in preparation for your body and the baby’s continued growth.

Trimester 3

• Your third trimester can bring all sorts of discomforts. Movements and workouts you had previously been doing may seem even more challenging.
• As swelling increases, more pressure is placed on your joints, which can result in carpal tunnel. Pregnant individuals will usually experience carpal tunnel of the wrists, causing swelling and numbness in the hands, wrists or even arms. Carpal tunnel typically will subside after the baby is born.

While it is a private topic for most, miscarriage is the most common complication during pregnancy. In fact, at least 15% of all pregnancies end in a miscarriage. There are several signs that can indicate a possible miscarriage. If you notice any of these signs, contact your doctor:

• Abdominal cramping or pain
• Back pain that can range from mild to severe
• Heavy spotting or bleeding
• Vaginal discharge that can include tissue, fluid or blood clots

Although miscarriage is common and does not necessarily indicate an underlying reproductive issue, multiple miscarriages may indicate that further attention is required.

Recurrent pregnancy loss (RPL) is the miscarriage of two or more consecutive pregnancies that were previously confirmed by a pregnancy test or an ultrasound. There are many possible causes of RPL, including genetics, anatomic issues, immune system, blood clotting, hormonal imbalance and infection. RPL impacts up to 5% of all couples.

The health system offers the TLC program to help individuals and couples navigate RPL. The diagnosis, evaluation and treatment of multiple miscarriages can be an overwhelming process emotionally and physically. The health system’s team of experts will support you through this complex process, providing individualized care and treatment in a supportive environment. Click here to learn about the full range of TLC program services, including egg and sperm donation, fertility evaluation, genetic testing, intrauterine insemination (IUI) and in vitro fertilization (IVF).

Coping with and recovering from a loss can be challenging. Talk to your doctor about how you are feeling and be open and honest with your concerns. If you would like additional support, talk to your OBGYN about referring you to a counselor or other professional who can help with anxiety, depression or other mental health struggles.

You also have access to free professional counseling services provided by our Employee Assistance Program partner, ComPsych. All health system employees, regardless of benefits eligibility, and members of their household have access to eight free counseling sessions per topic. Sessions are 100% confidential and available in person, by telephone, via video or through private chat. Click here to get connected.

For University of Kansas Physicians, The Standard, which is the Employee Assistance Program provider for UKP, offers confidential services and counseling as well, available 24/7. Click here to get started or call 888-293-6948.