Pregnancy a green not red light for workouts


LAS VEGAS, Nev. — Early in the morning, at a Las Vegas public park, you may find Kerry Geyser engaged in what appears to be the start of a human wheelbarrow race. Some would say it’s the last thing Geyser, co-founder of the outdoor fitness program Las Vegas Bootcamp, should be doing.

She’s pregnant and due in October, but isn’t afraid to demonstrate an exercise she refers to as the “Death Cart.” In the move, she has her feet, toes down, propped on a dolly while her arms are in the “high plank” position (the up position of a push-up). She then makes her way across a basketball court, to the surprise of more than a few bootcamp participants.

While it may seem Geyser is toeing a dangerous line, the soon-to-be mom says, for now, her body with its 15 extra pounds isn’t objecting to too many exercises.

“I’m very grateful for the fact that I was in very good condition before I got pregnant,” she said.

Geyser still teaches two bootcamp classes a day, and packs six to eight training clients into her busy schedule. But she says she isn’t trying to be a supermom-to-be.

“At the moment, some of my (exercise) demonstrations aren’t as thorough as I’d like. But I have people in each class that are pretty advanced and they’ll help out,” she said.

Geyser is also a trainer for pregnant clients. She does a thorough evaluation of pre-pregnancy exercise routines before working with them. Keeping resistance training weights to less than 10 pounds and keeping an eye on heart rate are two things she monitors closely with herself and clients.

“There used to be a lot of exercise restrictions (for pregnant women) based on heart rates, but not as much now,” said Dr. Edmond Pack, an obstetrician-gynecologist and partner with Women’s Health Associates of Southern Nevada. Pack recommends not exceeding 80 percent of a person’s maximum heart rate. Online target heart-rate calculators can help better understand an appropriate range.

A triathlete, Geyser has toned down her workouts; she didn’t run in her first trimester, but resumed three- to four-mile runs in her second trimester, cross training with biking as well. She has done eight-mile runs while pregnant.

“It (running) didn’t feel like it was working for my body at first. … I talked to my doctor about it and he said if it doesn’t feel right, don’t do it,” she said. “If anything, this has really taught me to listen to my body.”

Even while maintaining an impressive workout schedule, she admitted fatigue catches up with her at times.

“I’ve never needed a nap in the middle of the day,” she added with a laugh. “But now I know it’s not just about me. In the past I would’ve just pushed through. I try not to do that now.”

Shift in thinking

Geyser probably represents the exception when it comes to staying in shape while pregnant. But the exercise and medical communities have been more on the same page when it comes to exercise recommendations in the past decade or so than ever.

“I think the public perception of the delicate pregnant woman is finally starting to go by the wayside,” Pack said. “When you’re pregnant you’re not broken. It’s not a disease. It’s a physiologic change.”

Pack and other doctors point to the recommendations set forth by the American Congress of Obstetricians and Gynecologists 10 years ago that were simply reaffirmed and not changed by the organization in 2009. The organization recommends 30 minutes of exercise a day, for “most, if not all, days of the week” to help reduce backaches, constipation and swelling as well as increase energy, improve mood, posture and sleep.

There are obvious no-no’s such as scuba diving, which brings pressure changes that could harm the baby, and activities and sports such as skiing that could involve a fall and potential trauma to the abdomen.

But as long as a woman is listening to her body, Pack said, there are few exercise limitations. Even most abdominal and core area exercises aren’t the threat to the baby some may think.

“No matter how hard you try you’re not going to crush a baby doing a crunch. The body just won’t allow it to happen,” Pack added.

Dr. Jessica Zarndt, a board certified family medicine physician and assistant professor at Touro University Nevada College of Osteopathic Medicine, likes how exercise has evolved into more of a necessity for pregnant women than a suggestion.

“I believe exercise and some light resistance training can even help with postpartum depression,” she said.

The nonathlete

For some who didn’t prioritize exercise before, getting pregnant is a fitness wake-up call.

Pack has seen situations where an obese mom-to-be even loses weight during pregnancy by exercising and following a proper nutrition plan, not a restrictive diet.

“Really, if you’re overweight to start your pregnancy, but lose a little during it, it’s not a bad thing,” Pack added. “It’s refreshing to see.”

Even with the 30-minute recommendation, those who haven’t exercised much before their pregnancy may start with 15- to 20-minute walks, Zarndt said. But she emphasizes that women should not get too zealous about exercise to the point where they are trying something new and strenuous.

“You don’t want to be going from couch potato to triathlete,” she added.

Dialing back exercise is more important in the second half of pregnancy, Pack said, largely because of physiological changes.

Lying on your back and stomach for long periods of time is not suggested at this time.

Understanding that one’s balance may be compromised is also important. Geyser’s “Death Cart” demonstrations are probably finished as she approaches her third trimester.

For those with diabetes, exercise helps to maintain blood glucose levels, Pack said. Diabetic or obese women who are pregnant bring a greater risk for a C-section, Zarndt said.

Other factors like an oversized newborn or one with low blood sugar at birth and a greater risk of first-trimester miscarriage are also in play.

High-risk pregnancies that require close fetal monitoring may not allow for much exercise. And there are more serious signs to watch for that could indicate you’re overdoing it, according to the American Congress of Obstetricians and Gynecologists.

The organization gives the following symptoms to watch for: vaginal bleeding, dizziness, headache, shortness of breath before exertion, chest pain, muscle weakness, decreased fetal movement and amniotic fluid leakage.

Nutrition, postpartum

For the typical pregnancy, the recommended weight-gain range is 25 to 35 pounds, experts say. Pregnancy often becomes an excuse to overeat, when in reality the body needs only between 300 and 500 more calories a day.

“It never fails. I’ll have a patient come in whose weight gain is book-perfect and everyone says she’s so small and she’s asking if what she’s doing is OK. It’s a perception problem we have in terms of what is a healthy pregnancy and what is normal weight gain,” Pack said.

Molly Michelman, a lecturer in the nutrition sciences program at the University of Nevada, Las Vegas, said there is no evidence linking food cravings to nutritional deficiencies, a common justification heard.

She encourages moms, and anyone who is interested in healthy eating to follow the recommendations of a well-rounded diet found at www.myplate.com.

But while she is a strong advocate of getting nutrients directly from food and not supplements, she makes exceptions for pregnant women.

“Some foods might just seem disgusting to you. You may be battling morning sickness and not wanting to eat much. That’s when I say (supplements are) better than nothing,” she said.

Hydration is equally important, Zarndt said. During pregnancy, dehydration could cause Braxton-Hicks contractions. Most doctors recommend at least a gallon of water a day, and for the practice to continue after childbirth, especially if nursing.

Andrea Behrens, an executive with a Las Vegas collections agency, admitted to overeating when pregnant, but she still maintained a light exercise schedule during her pregnancy.

“I used to say, ‘Baby wants french fries. Baby wants a quart of ice cream.’ I would walk around the block (for exercise), but I wasn’t hard-core about it. It wasn’t so much laziness, it was more that I knew I could get away with it,” she said.

After having two children 18 months apart in her late 30s, she eventually lost the 50 pounds gained from the experience. She’s now grateful she had an exercise routine before getting pregnant, but also recognizes her diet and lifestyle choices now are a model for her children, too.

“I feel great. I feel really healthy. Before I would watch what I ate but now I know about healthy fats and things like that. I don’t look at it as a diet. It’s a way of life. I want my kids to be healthy, too. We take them out for walks at night. I let them have a cookie, but they have to eat the cucumber first,” she said.

Zarndt said simply creating the exercise habit during or before pregnancy can go a long way with helping to continue it after the child is born.

“It only gets harder the longer you wait,” she added.