Chapter 1

An Introduction

Are You Ready to Run a Marathon?

You have just learned, to your inexpressible delight, that you're pregnant. You've been to the obstetrician, gotten a clean bill of health for you and your still-peanut-sized growing baby, lined up a series of once-a-month checkups for the next seven or eight months. You have armed yourself with the latest information and best advice about vitamin supplements, eating for two, and everything else you should know about what to put and what not to put in your body.

You've marked on your calendar the date, five months hence, when you and your partner will appear, pillows in hand, for the first of four childbirth education classes at the hospital or the nurse's office. You've canvassed friends who have been through childbirth to come up with a list of pregnancy exercise classes, and you're planning to sign up for the mothers-to-be workout group that meets once a week at the Y. You're ready. You've got your bases covered. So why do you need this book?

First, all that other stuff is great. Of course you should keep regular appointments with your doctor and learn as much as you can about the birth process and join an exercise group. But consider this: you should spend perhaps twenty minutes a month with your obstetrician, at least until the very end of your pregnancy, and he or she will be interested mainly in monitoring vital signs and making sure all systems are go.

Childbirth education sessions will teach you some techniques, mostly about breathing, that you may or may not find useful when the time comes (just ask a friend who's had a baby). Group exercise classes are designed to provide general workouts for a roomful of women. Not one of these supports, essential or helpful though it may be, will show you how to prepare your body for your pregnancy and your labor. That's what we'll do. In particular and most important, the Maternal Fitness routine will show you how to strengthen the most important pregnancy muscles of all, the abdominals.

Decades ago my neighbor gave birth to her oldest child, and recently I asked this healthy, strong, charming, articulate, feisty seventy-five-year-old, "How did it go? What was it like?" Here's some of what she told me: "Everybody -- my doctor, my mother, my aunt -- said, 'Don't move around too much. Don't raise your arms over your head to get things down from a top shelf; you'll shift the baby and maybe start contractions. Don't lift anything heavy; you'll strain your muscles and maybe start contractions. Don't stand on your feet too long. Don't run unless the house is burning down.'

"Labor pains started, and my husband took me to the hospital," she continued. "A gas cone was put over my mouth and nose, and I woke up -- who knows when? -- the mother of a son. Then I stayed in the hospital for two weeks. I felt perfectly fine, but that's what new mothers did in those days. Flat on my back for one week. Then I was allowed to sit on the edge of the bed and dangle my legs over the side. Then, finally, walking!"

Not an unusual story. That's what having a baby was like for many women in our grandmothers' and even our mothers' time: Something that other people, the experts, took charge of. Something of a medical "problem," like coming down with a bad case of the flu or dropping a bowling ball on your foot. Something that brought down on the poor pregnant woman's head a flurry of old wives' tales about what she had to do or must never do with her body if she wanted to end up with a baby.

Some of that stuff might apply if you're an old wife, a really old wife -- say, seventy or eighty -- and pregnant. Fortunately, over the last several decades there's been a sea change, nothing short of a revolution, really, in attitudes about pregnancy and childbirth. It's a revolution that we -- the women having the kids -- have played a big part in, because we started saying, "Hey! I'm strong, I'm healthy, I want to have a baby, I am having a baby, and I don't need a lot of people telling me how to do it." We said, "I'm proud of my big, beautiful, bulging body. I want to be awake and alert and fully engaged in giving birth. I want my partner with me in the delivery room and my baby in my arms right away, not whisked off to a nursery down the hall. I want to get up and out and back to my life, my family, my job, my clothes, my workouts.

The medical profession has changed along with us. Obstetricians and family practice doctors are saying it's good for a pregnant woman to keep fit and strong, keep with an exercise regimen if that's what she's been accustomed to. Indeed, more and more, exercise is being promoted as an essential part of good prenatal care -- just as important for feeling good and producing a healthy baby as eating the right foods, avoiding the bad stuff, getting enough sleep, and going for checkups. A report by Dr. James F. Clapp even suggests that exercising during pregnancy makes for a better delivery. According to one study, almost nine out of ten who exercised had their babies without obstetric interventions -- no forceps, no cesareans -- while among the non-exercisers, that figure was only about 50 percent. To my way of thinking, it's common sense: the better shape you're in, the better you'll handle those nine months while you're growing a new life inside you and on that spectacular day when you welcome your new son or daughter to join you in the world outside. One thing is for sure: having a baby is the most phenomenal thing your body will ever do.

Over the past five years I have led hundreds of pregnant women through an exercise routine that I have developed and refined with three goals in mind.

The first goal is prevention. You don't need me or anybody else to point out this basic fact: from the day of conception through the next nine months your body undergoes dramatic changes and unusual stresses. Your breasts get bigger, pulling your shoulders and head forward, shortening your chest muscles, and lengthening your upper back muscles. Your belly gets bigger, compelling you to compensate for this startling change in your center of gravity by curving in your spine in ways it never did before. Your hormones run riot, causing your joints to loosen, and you to feel oddly unstable on your feet. Your growing uterus presses on lungs and bladder and anything else in its way, creating surprising difficulties when you try to do normal things, like breathe. The result: backaches, shoulder aches, neck aches, urinary incontinence, and all the other non-serious but unattractive and sometimes painful problems that so many pregnant women know so well.

In this book you'll learn how to prevent most of these discomforts. My exercises will show you how to align and balance the different parts of your changing body, how to lengthen muscles that keep getting shorter, and how to shorten muscles getting longer.

The second goal is preparation. I tell a particularly fitness-minded client to think of preparing for childbirth as she would for running a twenty-mile race. Think of it as the marathon of labor. Not to scare her but to help her get in a mind-set that says delivering a baby is -- among many other glorious things, of course -- an athletic event, one she can and should prepare for by understanding what is involved, what a truly bodily business it is. The analogy to the long-distance run is apt. Preparing for childbirth is a grind! Labor and birth take the same kind of focus, strength, and stamina, which means that before the main event, you need to do some training. That's something you don't hear a lot about in prenatal classes.

Here's what you do typically learn in the traditional childbirth class: during contractions you should breathe in various ways and combinations of ways; during delivery you should hold your breath and bear down.

I say, before your baby is ready to be born, breathe in any way that works to help you through contractions. And when it's time to deliver, keep right on breathing, and work your strong abdominal muscles to push that baby out like toothpaste out of a tube! That's what the most critical exercises in this book will show you -- how to strengthen your transverse muscle gradually over nine months (the transverse is your innermost abdominal muscle; it circles your waist like a wide belt and goes forward and backward when you breathe) and how to use it to push back on the uterus when the time comes to push. I call this "the Tupler Technique," because it's unique to my pregnancy workout program.

The abdominals aren't the only muscles that need preparation. For one thing, childbirth, for the majority of women in this country, happens while a woman is lying supine. That's a strain on the legs, especially the long muscles of the inner and outer thighs. I'll show you how to strengthen those muscles so you'll avoid the kind of leg fatigue that's a distraction you don't need when you're concentrating on getting that baby out.

You'll learn here, too, how to control the muscles of the pelvic floor so that you will be able to relax and open them while your abdominals are doing that tightening and pushing back against the uterus.

Relaxation is an overlooked, misunderstood, and most critical component of fitness, by the way. Maybe it's not talked about much because it sounds like something that should come naturally. Nurses or doctors will tell you, when you're in a lot of pain, "Just relax!" The fact is that it's hard to just relax, and you need to learn how to do it!

And the third goal is restoration. Childbirth is the end of pregnancy, of course, and the beginning of everything else. During the postpartum weeks, your body will be adjusting once again -- to another change in the center of gravity, stretched muscles, and more -- and all that is going on while you're feeding, carrying, and generally doing everything else for your new baby. The difficulties of this period of adjustment should not be underestimated! The more you work the critical muscles while you're pregnant, the lesser your chances of developing backaches, shoulder pain, and other aches after you're pregnant.

Again I think it's just common sense that the more thoughtfully you exercise your body during pregnancy, the faster and more easily it will recover, or restore itself to your pre-pregnancy shape and energy level.

Three Women, Three Stories

Carmen, thirty-eight years old when she became pregnant with her first child, was in the pink of health and very fit. Carmen doesn't exercise because she thinks she should or because she knows it makes her look better. She does it because she loves every sweating, huffing, grinding minute of it! A naturally talented athlete with a long, agile body, she's always been a serious skier and a serious tennis player, and she's a recent convert to in-line skating. She hits the gym two or three times a week for step classes and workouts with the weight machines. "I'm an addict, what can I tell you?" says Carmen about her fitness fanaticism.

Claudia, pregnant with twins, her second and third children, at age twenty-five, said that "running around like a crazy woman" -- mainly on the trail of her three-year-old-son -- was her major form of physical workout. (In fact, she does have powerful leg muscles.) The only time Claudia "officially" exercised was in an aerobics class at the Y when she first got out of college. She describes herself as "a little on the pudgy side" and "the original klutz of the Western world."

Frances, age thirty, had her first baby by cesarean section and was eager to deliver his new brother or sister vaginally. Because she was never much of an exerciser to begin with, her upper and lower body strength was weak and she tired fairly easily. Although her pregnancy was normal and proceeded smoothly, the sciatic nerve in her right leg was irritated by the way she carried her baby, and Frances experienced a fair degree of pain when walking or lying down.

Carmen, Claudia, and Frances were all clients of mine. All followed the exercise routine you'll find in this book, and they say they felt better and stronger each day. All had uncomplicated births and robust babies. Frances surprised her obstetrician and delighted herself by a vaginal delivery that she reports was "almost a piece of cake!" Carmen pushed her daughter out in eight minutes, was up and walking around one hour later, and went back to wearing her prenatal skirts three weeks after that. Claudia says she feels "amazingly lean and mean, after a much more comfortable pregnancy than I had the first time around."

My point is this: exercising during pregnancy is good for you, you can do it, and you will learn some new and most useful techniques from this book. My program works for everyone, and it will work for you if you're over thirty-five and having your first child, if you've been letting your muscles just lie there for years, if you're a fitness fiend already, if you've had an earlier cesarean, or if your body is playing tricks on you and throwing in some discomforts you weren't told to expect. Of course, there are some movements you should avoid, some signals that tell you to slow down or stop. You'll learn here what those are, and you'll feel confident in your own ability to listen to your body.

Adjust the routine to your own fitness level and preferences -- it's simple and I'll show you how. I want this book to feel and function as if you have invited me or one of my trainers into your home for a personal, one-on-one workout designed to meet your one-of-a-kind needs. Will it be fun? I hope so -- or at least a feeling-good way to work your body during these amazing months.

Copyright © 1996 by Maternal Fitness, Inc. and Andrea Thompson