Exercise builds stamina for delivery

Program focuses on endurance, exercise

Most people wouldn't think of running a marathon without training, because the 26-mile-plus race is too grueling. Yet many women go into labor - also a grueling experience - without first building their physical stamina. That's one reason The Ohio State University Center for Wellness and Prevention in Columbus launched a fitness program for pregnant women called Great Beginnings.

"If you think about the word labor, it is exactly that," says Christa Schindler, exercise physiologist and program coordinator. "If a woman is going to do hard work like labor, she ought to get as physically prepared as she can."

While the fitness program's main goal is to prepare women for labor and delivery, the exercise and stretching also help alleviate some of the physical discomfort typically experienced during pregnancy, such as swollen legs and lower back pain. Women who keep their fitness level up during pregnancy have a higher energy level, and they get back into shape more quickly after the birth of their baby, says Schindler.

There are two categories of exercise. On Tuesday evenings, women can participate in a low-impact dance aerobics class. On Monday and Thursday evenings, they can follow a personal workout regimen designed specifically for them. During the personal workout, the women do 30 to 40 minutes of aerobic exercise on the treadmills, bicycles, and stair-stepping machines available at the fitness center. They also work with some of the weight equipment. The exercise classes are followed by group stretching and toning.

On Monday evenings, a short education component is included during the stretching and toning. For example, one week Schindler discussed how to find a health care provider for an infant. The educational topics are selected to foster conversation. "We want to get them talking about things that are going on in their pregnancy and share their experiences with one another," says Schindler.

Women can start the class at any time during their pregnancy, but they must have a note from their physician allowing them to participate in an exercise program. Most join the program in their second trimester, although some start as late as eight months or even postpartum. Women can continue to participate in the program for one year after the birth of their child. "Once a woman delivers, she can come back to the program after her four- to six-week follow-up visit with the obstetrician. She has to have permission to go back to her normal routine," says Schindler.

Women learn about Great Beginnings in three ways. It is listed in a quarterly catalog on health classes offered by the institution. A flier on the program is inserted in the birthing packet given to women who deliver at University Hospital. Physicians also tell women about the program.

"The biggest problem we have encountered is getting the physicians to encourage their patients to come to the program," says Schindler. It seems that when women ask about exercise during pregnancy, physicians give them guidelines, but physicians don't give them information on the classes unless patients specifically ask for an exercise program. About a year ago, Schindler personally visited each physician office and spoke to the nurse managers about the program. Currently, she is planning a luncheon for the managers and/or physicians to explain more about the program.

When a woman starts the exercise program, Schindler sends a letter to her physician. In the letter, she tells the physician that his or her patient has enrolled and encourages the physician to ask questions about the program. "I want them to learn more about the program and hear some positive feedback, as well," she explains.

To determine the program's success, Schindler distributes a survey to women participating in it following their delivery. "Most of the women felt that staying in shape helped them recover much faster after giving birth and made it easier for them to get up and do things," says Schindler.