Pregnancy & Exercise Interview of Kurt R. Wharton, M.D. This is a transcript of the Audio: Pregnancy & Exercise (http://38.111.154.172/SutterEastBay/wharton.wma). To listen you may download Windows Media Player (http://windows.microsoft.com/en-US/windows/download-windows-media-player). Dr. Kurt Wharton: My name is Kurt Wharton. I'm an obstetrician and gynecologist. I'm in solo practice. My office is in Lafayette, California. For 19 years I've been an obstetrician and gynecologist on the staff at Alta Bates Summit Hospital in Berkeley. The most important thing that women should know about pregnancy and exercise is that it's safe, helpful and encouraged. There are no exercises women should specifically consider before becoming pregnant. The Center for Disease Control and the American College of Sports Medicine suggests that every person, male or female, pregnant or not should participate in 30 minutes of exercise each and every day. But more seriously, scuba diving is a specific exercise/sport, that people cannot participate in when they become pregnant because of the changes in pressure, the use of nitrogen gas in the scuba tanks; we feel that this is a hazard to the fetus. But women can run and swim. We encourage them to stretch and relax after exercise as well. The one activity I have always personally encouraged women to try and abstain from is using hot tubs. In pregnancy many people like to relax after working out at the gym or at home and soak in their hot tub for awhile. What we have to remember is that as soon as a woman becomes pregnant, her body rapidly goes through significant physiological changes. By the seventh week of pregnancy, her blood volume has increased by 40 percent. This is anticipation of the changes in pregnancy and the blood loss which occurs even in the most easy of deliveries. With an increase of 40 percent in blood volume, the heart rate increases. The heart enlarges in size. It changes in its position, the diaphragm rises as the baby enlarges and this compromises some of the pulmonary functions, some of the function of the lungs. In the latter parts of pregnancy there are a number of body changes that occur. the center of gravity is thrown forward by the large, heavy, pregnant uterus. There is a change in the lower spine so that women are more prone to back injury. I certainly encourage women to avoid wearing high heels and wear more of an athletic shoe and flats while they're pregnant. Running becomes much more difficult in the latter part of pregnancy. Your balance is off. Your hips, knees, insteps of the feet become more uncomfortable. Interestingly, swimming becomes much more attractive. Most pregnant women love getting in the swimming pool at the end of pregnancy. The extra pounds seem to just float away as you become buoyant in the pool. One thing I should mention is that there are several contraindications to exercise and pregnancy. Most patients when they're pregnant, should they develop these conditions; their healthcare provider would point this out to them, but it's women who are experiencing premature labor. People who are having vaginal bleeding that has not been diagnosed should refrain from exercise. Women who have twins, triplets or other multiple gestations are at increased risk and should avoid exercise. Women who smoke, of course we strongly encourage them to stop smoking while they're pregnant. We certainly encourage them to not smoke immediately before or after exercise, as their pulmonary function is compromised. One personal story I would like to share regards a patient of mine who had been an athlete in high school and really had not participated in any type of exercise until she became pregnant in her late thirties and began exercising, decided to take up jogging, started very slowly at home on the treadmill, starting running on the streets and continued through the course of her pregnancy. She found that she enjoyed it so much she began pushing her baby in a jogging stroller and she recently completed her fifth marathon. She encouraged her husband to take up running as well and now they're a running family and she feels she's in better shape than she's ever been in her life. And she never thought, now that she's in her early forties and a mother, that she would be so fortunate. (Recording Ends) - INTERVIEW CONCLUDED - Go to the Women's Health Audio Web Page (http://www.altabatessummit.org/health/audio_womenshealthtips.html)