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Busting Myths for a Healthy Pregnancy

Staying active and enjoying the second trimester! 

Staying active and enjoying the second trimester! 

Over the course of pregnancy, it seems like we have so much to worry about. Between vastly differing opinions, old wives’ tales and pregnancy books dishing out contradictory information, it really can send your head into a spin! 

Many of these anxieties are centered around what we should be eating and how we should be exercising. The thought that your behavior could potentially be harming your baby is a mother’s nightmare. So, when it comes to fitness and nutrition, just what is considered safe? How do we know if we’re pushing too much and will that slice of cake really make it all better?

As a Pre and Postnatal Specialist, ACSM-certified trainer and expectant mom, I’m here to put your mind at ease regarding a few of these pregnancy myths: 
 

Myth 1: Pregnancy is a time to put your feet up.

It’s important to give your body adequate rest, especially since pregnancy fatigue can be so debilitating. However, resist keeping your feet up throughout your pregnancy unless it’s doctor’s orders- it’s so important to get up off that couch and get moving!

According to American College of Sports Medicine guidelines, we should aim for 20-30 minutes of exercise most days of the week during pregnancy.

Exercise not only prepares you for labour and delivery, but helps keep you in shape, increases mood and energy levels, relieves constipation, swelling, and muscle aches and can reduce the risk of gestational diabetes. Remember, each woman and each pregnancy is different and there are contraindications to exercising for some people, so please consult your doctor if you’re embarking on a new exercise program, especially if you are having complications.
 

Myth 2: Exercising too hard will harm your baby.

It's a common belief that too much exercise will pull nutrients away from your baby. Don’t worry, your baby will be fine! Our bodies are great regulators and it’s you who will experience a dip in energy if nutrient stores are low. To avoid this, keep blood sugar levels balanced, eat small frequent meals and ensure you’re not exercising on an empty stomach.

Another similar concern is that exercising too strenuously will deprive your baby of oxygen. Again, it’s you who will feel the effects of this first. The blood containing oxygen will be shunted to baby before mom. If you’re pushing it too hard and feeling exhausted, then it’s time to stop and your body will tell you so. 

So how do you know if you’re overstepping the limits? This usually equates to gasping for breath or unable to talk.

 Health professionals recommend using RPE (Rate of Perceived Exertion) to measure intensity during pregnancy. This is a scale that corresponds with how hard you’re working based on how you are feeling. For example, are you able to hold a conversation? If not, it’s time to stop!

Try to avoid being fixated on target heart rate zones; there is no true fixed target heart rate for pregnant women as our exercising and resting heart rates are effected so much by the demands of a growing baby. 
 

Myth 3: Running during pregnancy is bad.

So many moms, myself included, love to run. The health benefits from running are immense and the release of endorphins can be addictive. The thought of giving this up for 9 months is depressing!

But, is all that jarring movement really ok for baby?

Yes! You can carry on running throughout pregnancy if you were a runner before, and some marathon runners maintain their sport all the way through pregnancy. However, if you did not run prior to pregnancy, now is not the time to take it up.

As always, listen to your body and take into account the many changes that you’re physically going through. Some women find it uncomfortable to run as they gain weight and the pressure of the growing uterus on the pelvic floor muscles can create some undesirable situations, including incontinence! Also, be aware of the added pressure on joints- knee and ankle injuries are not uncommon during this time. Keep hydrated and monitor exhaustion levels carefully. Now is not the time to press for that PB!
 

Myth 4: You should avoid all abdominal exercises during pregnancy.

Core training is SO important during pregnancy and will help with a speedier labour, delivery and recovery postpartum. You just need to be mindful of the type of abdominal work you partake in.

The muscles we need to strengthen during pregnancy are the deep inner core muscles, which comprise of your pelvic floor, transverse abdominals, diaphragm and multifidus. These muscles form a unit which work together to stabilize the spine and pelvis ahead of movement.

The main abdominal exercises we need to avoid are the abdominal crunch and front loaded plank. Both exercises can cause intra-abdominal pressure leading to a splitting of the recti muscles (Diastasis Recti). 

For more information on how to safely train your core muscles through each trimester, please see my blog:

http://tangramwellness.com/blog/2016/11/15/strong-mama-solid-core-a-trimester-by-trimester-core-training-guide
 

Myth 5: Pregnancy is a time to eat for two.

You’ve probably heard this expression a zillion times! While you do need extra nutrients during pregnancy- particularly additional protein and calcium- piling on the calories is not the way to go.

During the first trimester, your baby does not require additional fuel. Trimester two is a period of growth but nothing to get excited about- an extra 300 calories daily will suffice. Your intake should increase to an added 500 calories during trimester three to accommodate for your baby’s growth. 

The real issue here is how worthwhile those additional 300-500 calories are towards feeding your baby, so aim to choose your food sources wisely. As I mentioned, protein and calcium are essential for the growth of your baby. Try incorporating the following in your diet: Greek yogurt, lentils, beans, nuts, sweet potato, lean meat, eggs and salmon.

Pregnancy should be a time to think about eating smarter rather than just eating more.
 

Myth 6: It’s fine to indulge in sugary, fatty foods throughout pregnancy.

Unfortunately, like any time in your life, a diet high in fat and sugar can have disastrous health consequences, as well as contributing to unwanted weight gain. 

Remember, you don’t have to put on a ton of weight in order to have a healthy baby. If you’re starting out at an average weight and body fat percentage for your height and frame, a weight gain of between 25-35 pounds over the course of nine months is what’s generally recommended.

Putting on too much weight during pregnancy can make you more susceptible to gestational diabetes, high blood pressure, and varicose veins while making natural labour much more difficult.

And, before you reach for a bag of chips, some researchers have found that what happens in the womb doesn’t just stay in the womb. Women on high fat, high sugar diets throughout pregnancy are more likely to give birth to larger babies who are at increased risk of diabetes and childhood obesity.

 My bottom line advice: Be sensible during pregnancy and listen to your body. Try to maintain a healthy, nutritious diet and continue to enjoy any exercise which your body is already used to. Avoid sports by which you have an increased risk of falling or abdominal injury- for example, horseback riding, skiing, gymnastics or rollerblading. And, please consult a health professional if you’re concerned about any aspect of exercise in pregnancy.

Thanks for reading! If you're ready to embark on a pre- or postnatal exercise program or have any questions, email me at Anna@tangramwellness.com . I offer weekly small group classes and private sessions for both expectant and new moms.

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Five Things No One Tells You About Strength Training in Pregnancy

Seven months ago, in the midst of training for physique and powerlifting competitions, I discovered that I was pregnant with my first child. As an athlete and wellness business owner who credits exercise in transforming my life, I wasn’t about to let morning sickness keep me away from my sanctuary- the weight room. Strength training in pregnancy has many potential benefits for both baby and mom, including a shorter and easier labor, a lower risk of pre-term birth, and less physical discomfort throughout pregnancy. However, what I’d anticipated on my journey as a flexing mama-to-be has turned out to be quite different from the reality of lifting weights with a growing baby bump! Here are five things you should know about strength training while pregnant: 

1. No matter how closely you stick to your training plan, your body is going to do what it wants to do. 
So, you think you’re going to remain a shredded mama-to-be, maintaining your fitness level and lean physique throughout your pregnancy, save for a cute little belly? You may want to rethink that! Expanding hips, bigger breasts, growing glutes and thicker thighs tend to be the norm in the second and third trimesters of pregnancy no matter what your fitness level is. Athletes especially tend to see pretty dramatic changes, due to the fact that many are starting out with lower body fat percentages and can no longer follow the near daily strenuous training routines that they're used to. Instead of focusing on your changing body composition and inevitable weight gain, celebrate completing workouts, practicing self-care and being able to pull your pants up all by yourself. Strength train for your overall health and to prepare for the birth of your baby, not because you want to look a certain way when you’re pregnant. 

2. Weight training regularly in pregnancy will really rev up your appetite.

If you strength train regularly throughout your pregnancy, your appetite is bound to skyrocket beyond the hunger pangs of your less fit counterparts. Women with higher muscle mass tend to have better blood sugar level control and increased metabolic rates, making it easier for them to manage body fat. Add in pregnancy, which naturally boosts the metabolism while increasing daily caloric requirements in order to support baby's growth, and you may suddenly find yourself justifying those pre-workout donuts as “carb loading.” Proceed with caution, and plan accordingly! Excessive sugar intake during pregnancy can increase your chance of developing gestational diabetes, pre-eclampsia, or unnecessary weight gain. Eat several well-balanced meals throughout the day and pack a few healthy goodies in your gym bag like mixed nuts, peanut butter and natural energy bars to avoid gorging on empty calories.

3. Drop it like it’s squat, but be sure to train your pelvic floor as well.

Final weighted squat session at 33 weeks. My alignment was off, my pelvis ached and I no longer felt stable and secure, so I knew that was a wrap! If you continue with the big lifts in pregnancy, be sure to listen to your body closely. 

Final weighted squat session at 33 weeks. My alignment was off, my pelvis ached and I no longer felt stable and secure, so I knew that was a wrap! If you continue with the big lifts in pregnancy, be sure to listen to your body closely. 

Weighted squats are possibly the best exercise to prepare for a natural delivery, strengthening the muscles required to open up the pelvic outlet and help baby descend during labor while getting you used to holding that position in a relaxed manner when the time comes to give birth. Squatting (or using a birthing stool) is also a preferred position to assume when delivering a baby naturally, lessening the chance for a C-section and easing contractions. 
However, when you’re under the squat rack at the gym, your chance of accidentally peeing in your training pants increases thanks to added pressure on the bladder from both baby and body mechanics. You'll also want to maintain a narrower stance during squat sessions as your pregnancy progresses to avoid pelvic girdle pain and instability (more on that in a bit). Be sure to practice those kegels regularly, wear a panty liner and bring along an extra pair of cotton briefs (not thongs, unless you’re gunning for a urinary tract infection)! I highly recommend investing in an Epi-No for pelvic floor and childbirth training.

4. Relax- no really. It’s the relaxin!

Image via: Pregmed.org

Image via: Pregmed.org

As pregnancy progresses, a hormone called relaxin increases its production in preparation for childbirth, softening and widening the cervix while relaxing the ligaments. If you’re weightlifting regularly, this can spell big trouble for your pelvic girdle, causing a painful and potentially debilitating condition, symphysis pubis dysfunction. If you continue to push through the pain in order to maintain your fitness level, you may soon find yourself in the physiotherapist’s office, or even in a wheelchair for a while. If you’re feeling increased pain and pressure in the pubic region or shooting pains throughout your hips and legs, you’ll need to bag the lower body weight exercises, including squats, deadlifts and even leg extensions. This is particularly true when it comes to single leg exercises, like lunges. Unfortunately, this condition is quite common, and has benched many a weightlifter in the third trimester, including myself. Listen to your body, relax, and know that if you take care of yourself now, you’ll likely be back in the gym in no time flat once baby arrives.

5. Just by showing up, you’re inspiring someone.
When your bump really begins to show, you may find yourself engaged more frequently in locker room conversations with random women who just happen to be mesmerized by the fact that you’re pumping iron while pregnant. The truth is, despite all we know about the many benefits of strength training throughout pregnancy, it’s still rare to see a woman working out with a protruding baby bump. In fact, fewer than 1 in 4 pregnant women meet recommended physical activity guidelines, and far less even consider lifting weights due to myths around bulking up, largely unwarranted safety concerns, and ignorant naysayers. So, indulge in some gym gab, keep it real (none of this, “I feel so glowing and gorgeous!” crap) and know that- even if you’re not feeling like your fittest and strongest self- you’re inspiring someone just by being there!

Thanks for reading! Do you have any tips for strength training in pregnancy, or any questions on exercise during this special time? If so, we'd love to hear from you- leave your thoughts in the comments section.

If you'd like some assistance in maintaining your fitness throughout your pre- and postnatal period, give us a shout at hello@tangramwellness.com !
Our pre- and postnatal exercise specialist, Anna, is taking on clients for private sessions and small group classes.



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Strong Mama, Solid Core: A Trimester-by-Trimester Core Training Guide

TrimesterCore.jpg

Core strengthening during pregnancy is quite often an area of concern. We’ve heard about how a stronger core will help us throughout our pregnancy, but is it really safe to work the muscles of your midsection during this time of immense physical change?

The answer to this is, “Yes, absolutely!"

It’s actually beneficial to incorporate core strengthening exercises into your pregnancy fitness program. In fact, this is one of the most important ways of ensuring a healthy pregnancy, labour, delivery and recovery.

There are, however, certain moves we should avoid, including:

Deep closed twists, in which the abdominal area is compressed. We see this a lot in yoga poses and certain exercises recruiting the obliques, for example the supine bicycle twist. You'll want to avoid twisting your core too much during pregnancy, as your uterus is working hard to make optimal conditions for your growing baby and twisting motions can disturb this process. 

Abdominal crunches, which involve deep flexion of the spine should also be avoided, especially after trimester one. This movement can cause abdominal separation (Diastasis Recti) as the uterus grows in size. Another negative of the abdominal crunch, like any exercise which involves lying on your back, is that the weight of the uterus can compress the vena cava blood vessels leading to your heart. This can cause lightheadedness and may also reduce oxygen supply to the fetus.

There are certain core exercises by which the safety can vary from person to person depending on one's ability to be able to activate smaller and usually forgotten stabilizing muscles ahead of the move. 

A great example of what I'm referring to is the front plank. It's essential to engage the pelvic floor muscles and transverse abdominal muscles ahead of performing the plank. Failure to do so can put too much pressure on the abdominal wall and again, contribute to that dreaded Diastasis Recti. If you're unsure of how to engage these deep core muscles ahead of planking, then this move should be avoided.

We're all built differently, with different levels of experience- our training plans should reflect this!

Ok, so which core exercises should you be performing as a mama-to-be?

Below are 3 examples of exercises which will keep your core strong during each trimester of pregnancy and are generally quite safe to perform:

TRIMESTER 1: OBLIQUE SIDE PLANKS

Oblique Side Plank, with modified version at the bottom

Oblique Side Plank, with modified version at the bottom

Your obliques are often neglected, but these muscles are such important stabilizers throughout pregnancy and strengthening them will help you eventually push your baby out! What could be better than added strength on delivery day?

 Teaching points:

·      Remember to breathe throughout the hold; aim for 30 seconds and try 3 rounds.

·      Imagine a zipper running from your pelvic floor muscles to your ribs. Activate and squeeze your core tight as you zip up.

·      If this move is too difficult, then drop your bottom leg to a bent knee position, as shown in the bottom photo.

TRIMESTER 2: SUPINE LEG EXTENSIONS

Supine Alternating Leg Extensions with Elbow Support

Supine Alternating Leg Extensions with Elbow Support

This exercise activates your transverse abdominal muscle, which is a key player in preventing Diastasis Recti.

Teaching points:

·      This exercise should be performed on your elbows especially after trimester 1 to prevent pressure on the vena cava vein.

·      Try three sets of 10 slow reps and exhale deeply on each extension.

·      Push your lower spine downward and pull your knees closer to your body to avoid lower back pain.

TRIMESTER 3: SITTING WALL SUPPORTED SQUAT

Wall Supported Squat

Wall Supported Squat

You may not think of this a great core strengthener but remember that your core includes your glutes, hips and lower back muscles too. Performing this move will not only help strengthen all the muscles of your core during pregnancy but will also help with your labour. This squatting position can be one of the easiest delivery positions and practice will help a speedy delivery!

Teaching points:

·      Try and hold the squat for 30 seconds at a time and breathe throughout.

·      Aim to keep your knees at a 90-degree angle.

·      Remember to engage your lower back muscles against the wall and squeeze your pelvic floor muscles to help activate your transverse abdominals too.

Ok strong mamas-to-be, happy core training!  

If you would like further information on how to exercise safely during your pregnancy and postpartum period, please contact Pre and Postnatal exercise specialist Anna Kwan: anna@tangramwellness.com for both private and small group tuition. Thanks for reading!   

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PREGNANCY, DEPRESSION & EMOTIONAL RELAPSE: HERE’S HOW I’M DEALING WITH IT

Exposure therapy at work? Or, a good friend who coaxed a belly pic and smile out of me? A bit of both... Week 25, 12kg's gained so far, and today was a good day. 

Exposure therapy at work? Or, a good friend who coaxed a belly pic and smile out of me? A bit of both... Week 25, 12kg's gained so far, and today was a good day. 

As I type this, I’m now 25 weeks into marching alongside my scary monster, a once-imagined situation that I’d framed in my mind as “the most frightening thing in the world.” I’m not talking about public speaking or spiders or failure or the dark. I’m referring to a condition that many millions of women welcome and yearn for: pregnancy. Please don’t misread this- I’m elated to become a mom, and I consider my good fortune at conceiving naturally at this point in my life nothing short of a miracle. However, the concept of being pregnant has always terrified me. Whenever my husband and I discussed our options for potentially starting a family, including fertility treatment, I usually came to the somewhat illogical conclusion that I’d been dealt my hand of cards- which included a history of depression and less than fabulous hormonal wiring- for good reason, and one of those reasons was that I simply wasn’t meant to be a parent. As I mentioned in my last blog post, that line of thinking was never a huge deal for me, and I knew that I could be fulfilled as a person with or without children.

Since week 8, my “scary monster of pregnancy” has been all too real, beginning with a solid two months of morning sickness that rekindled some of my worst hangover memories and made me question my own inner strength. Regularly hugging the toilet bowl at 3am was hard; harder still was feeling like I was constantly letting people down because I couldn’t get out of bed some days, or worrying that my own physical and mental state might be causing harm to my baby. While the millions of pregnancy blogs all seem to view the second trimester as a golden and bliss-filled time, around week 14 I slammed into a steel wall of what appears to be antenatal depression, marked by persistent insomnia, obsessive thinking, and extreme irritability. Although an estimated 20 percent of pregnant women contend with antenatal depression, I didn’t even know it was a “thing” until I began investigating what the heck was going on with me- we only seem to talk about the postnatal kind. To compound matters, I became unable to look at myself in the mirror without feeling repulsed, which unfortunately continues to this day- quite an interesting conundrum for someone who regularly preaches self-love and works with women on their own journeys through body dysmorphia.

Yep. All the feels in the world for this. 

Yep. All the feels in the world for this. 

But, it’s not only my own head that’s been doing me in. The public commentary is also surprising.

“You’re pregnant!” some random guy exclaimed to me at the gym last week, as if I hadn’t noticed.  “Shouldn’t you be sitting down? Can’t exercise like that hurt the baby?” He openly and persistently doubted the expertise of both me and my doctor.

“A 10kg weight gain at this point in your pregnancy is a bit high. We’ll monitor it and do a test for diabetes later on,” the nurse said to me during a routine check. This is definitely not something a health fanatic wants to hear.

And, let’s not forget the various folks who decided to take a guess on the baby’s gender, based entirely on an old wives tale that a woman who’s become ugly must be having a boy…. or a girl... depending on your cultural lens. Yes, a few people actually said this to me.

In the parallel pink cloud universe that seems to have a particularly strong presence in Singapore, pregnancy is touted as a lady’s time to magically float and glow from one high tea luncheon to another- in luxurious silk kaftans, of course. “Cherish every moment!” they say. “Enjoy your pregnancy!” I don’t think it serves anyone to pretend that we all blossom beautifully in our ripening when the reality is often anything but. 

Thankfully, I tend to hang around some seriously awesome and refreshingly honest women who, rather than shaming me for expressing this unpopular narrative, were willing to open up about their own conflicted pregnancy experiences, doubts and fears, or at least just listen to mine without judgement.

As a coach and behavioral health professional and with their moral support, I can confidently (albeit very self-consciously) admit that after seven years of feeling mentally rock solid the majority of the time, I am no longer at that place since becoming pregnant, thanks in part to some pretty major hormonal shifts. What was beyond a doubt some of the happiest news of my life has also morphed into an anxiety-riddled roller coaster ride, and I’ve not yet figured out a way to quell the resulting cognitive cacophany. From a recovery perspective, I recognize this as an “emotional relapse.” In other words, I’m not thinking about drinking or restricting food again to deal with an uncomfortable state of being, but some of my emotions and behaviors are in line with what led me into addiction in the first place. No matter how long someone has abstained from their destructive behavior(s) of choice, whether it’s binge eating, pill popping or excessive drinking, most people in recovery will experience emotional relapses at various points in their lives, particularly during high stress situations or periods of great change. The signs of an emotional relapse include:

  • Anxiety
  • Intolerance
  • Rigidity and inflexibility
  • Isolating oneself
  • Insomnia
  • Rejecting intimacy and love
  • Poor eating habits
  • Shame and blame
  • Black and white thinking
  • Mood swings
  • Ruminating and living in the past
  • Refusing to seek help

Whether simply the side effects of a rough pregnancy or something more, I know that for myself and the people I work with, this potent psychological cocktail is nothing to mess around with. So, as I prepare for the third trimester, I’m assessing what I’ve been doing to support myself through this emotional relapse and life challenge. Here’s how I’m getting through my first big emotional relapse in nearly a decade while tackling antenatal depression head on:                                          

And, once in a while radical self-care means sitting on a beach when you're supposed to be at a conference.

And, once in a while radical self-care means sitting on a beach when you're supposed to be at a conference.

  • I’m not hiding. As hard as it’s been to be honest about my own experience of pregnancy in the face of so many myths and expectations, I’ve committed to speaking my truth. When I’m not ok, I say so. When I’m feeling really down, I do my very best to reach out to someone I trust. And, although it’s exceptionally tough for a person who works in the behavioral health sector to admit to their own weaknesses and rough patches, the fact of the matter is that coaches, counsellors, psychologists and other “helping” professionals can be particularly prone to depression, anxiety and addiction-related issues. The related sensitivity and experience is what brings so many of us into the field in the first place. Consider this- nearly 50% of practicing NHS psychologists in the UK currently have depression. We’re all human, bottom line.
     
  • I’m practicing RADICAL self-care. Radical self-care means saying “no” to anything and everything that totally stresses me out. It means making a pampering date with myself at least a few times a week, whether for a manicure, massage, physiotherapy or shopping for new bras. It means journaling and drawing and curling up with a good novel instead of focusing on an achievement-based “to do” list. It means forgiving myself for engaging in harsh self-talk and negative thoughts, instead of identifying with them. And, it means staying away from people who may be toxic for me at this time.
     
  • I’m fighting the urge to isolate by keeping the lines of communication open and asking for help when I need it. I knew the importance of being honest with my obstetric doctor about my personal history, and as a result I’ve been seeing a therapist every few weeks who specializes in pregnancy and fertility-related issues, including anxiety and antenatal depression. I also have a small yet strong support network of friends who I can trust and I’ve been making it a point to reach out to some of them, whether it’s just a text, a brunch, or a tea date at my place.

  • I’m making exercise and good nutrition a top priority. While I actually don’t feel like working out or eating much, I’ve been getting in at least 30 minutes of exercise most days of the week and I also eat between 2,200 and 2,400 calories daily consisting of healthy fats, complex carbohydrates and lean proteins. Despite the urge, I’m not bingeing on junk food because I know that the sugar crash won’t help my mood. When the cravings come, I’ve got some good snacks on hand, like sliced banana drizzled with honey and nut butter. Having a workout buddy I can lean on- usually my husband or Roz- has helped immensely during this time.
     
  • I’m taking a long sabbatical from social media. Uploading this blog will be the first time I’ve logged onto social media in over two weeks, and after it’s been published I’ll unplug again until the end of October. I’ve been using HootSuite to pre-upload posts for Tangram Wellness, and have it set up so that I’m not able to view anyone else’s feeds- it’s a fantastic tool! Social media can easily bring up a slew of negative emotions for people, as well as serving as a crutch or addiction when the going gets tough, which only compounds the problem. I advise many of my clients to curb their social media use, particularly if they find themselves comparing their own experience to that of others, and I’m taking my own advice here.

    I share this blog post in part for every woman who has experienced a less than stellar pregnancy, and for the millions in recovery who will go through an emotional relapse at some point in their lives. As the saying goes, "we are only as sick as our secrets." We free ourselves and others when we each speak our truth as women, as parents, as individuals in recovery, and as helping professionals. 

Thanks for reading! If you feel like this post would help someone you know, please share it. If you have a question or comment, leave it below or email me directly at aimee@tangramwellness.com

- Aimee

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