Pregnancy is an adventure – a time to nurture oneself and begin nesting and a time of excitement and change. It is also an opportunity to indulge a little – hey you are going to gain weight anyway! But, pregnancy can also come hand in hand with a few unwelcome side effects. Here are a few tips to help you recognize and avoid some of the less desirable, but not uncommon, aspects of pregnancy.

Problem 1: Low Back Pain is probably the most typical complaint of women during pregnancy (besides excessive weight gain that is).

Contributing Factors: Ligaments are more lax (loose) during pregnancy, which can contribute to instability and also increase the stress to the spine and its supporting muscles. An increase and re-distribution of body weight as well as the resultant change in center of gravity also create more stress to the lower back.

Low Back Solutions: Prevent low back pain with attentiveness to posture – stand erectly and engage your abdominal muscles to avoid excessive arching of your low back. Bend and lift with care and with attentiveness to form – bending from your hips and knees rather than your back. Sleep on your side and, consider positioning a pillow between your knees or try cuddling up to a body pillow, resting your top arm and leg forward. If you experience low back symptoms, ask your doctor about a lumbo-sacral belt to provide additional support and avoid activities that reproduce symptoms. Consult with a physical therapist if your pain is debilitating – there are treatments and exercises that can help!

After the big day: Even once the baby is born, take care to continue the good habits outlined above.

A few more helpful hints: When lifting the baby from the crib, first move him/her close to where you are standing to avoid lifting while reaching forward. To lift a toddler from the floor, bend into a squat and lift from your legs or, if you have pain, have your young child climb onto a sofa and lift him up from that higher position. Switch off from one hip to the other when carrying a baby for a longer period and opt for one of the great carriers on the market if you will be holding the baby for an extended time (or better yet, use a stroller). To rise from bed, when lying on your back, roll to your side and push from your hands to reach a sitting position to avoid rising using an old-fashioned sit-up motion. Most importantly, get back on track with your fitness program once you’ve received your OB’s OK.

Problem 2: Abdominal Diastasis. Not every pregnant woman winds up with this problem and it is essentially impossible to prevent.

Contributing Factor: The abdominal diastasis is essentially a separation of the right and left sides of the front abdominal muscle (rectus abdominus) from their central attachment (the linea alba). Most often noted in the third trimester, the separation is a result of weakened connective tissue (from hormonal changes) coupled with the uterus pushing against the abdominal wall. This separation can be felt as you do a partial crunch, lifting your head and shoulders while you palpate.

Solutions: There are no solutions during pregnancy except not to let the diastasis worry you. In most cases it will resolve after the baby is born.

After the big day: Brace your abdominal muscles with your hands, pushing both the right and left sides toward the center if you have to cough. This will keep the sides of the muscle from pulling apart while it contracts more violently. When resuming your exercise program, begin by strengthening the more interior abdominal muscles (transverse abdominus) before focusing on the weakened rectus abdominus, avoiding crunches at the outset. Consult a resource on pregnancy and exercise for specific instructions.

Problem 3: Fatigue. Most women experience fatigue, especially during the first trimester.

Easy solution, sleep! Enjoy it too because down the road, sleep may be harder to come by!

Contributing Factor: Your body is undergoing significant hormone adjustments.

Solution: Don’t fight it! And it may seem counterintuitive, but consider beginning a low-level exercise program; a good walk, may help you to sleep better. As long as you don’t push your limits, there’s no time like the present…

After the big day: Once the baby is born sleep may really be at a premium. Try to rest when the baby naps and listen to your body. You are also burning a lot of energy/calories, particularly if you are nursing. The weight will come off if you eat sensibly – avoid going overboard counting calories – be sure to eat a sufficient amount and eat healthy calories to address your own nutritional needs.

Problem 4: General Fitness Concerns. The general rule is that if you’ve already been doing it, you can continue to do it – that goes for weight training, running, sports and sex. However, there are a few notable exceptions and rules to follow:

• Avoid exercises on your back after the first trimester (continue to work your abdominals in safer/recommended ways rather than crunches or the like).
• Lighten up! Pregnancy is not a time to set personal bests. Go easier on yourself.
• Don’t worry too much about your heart rate, but monitor your perceived exertion (RPE). If you feel like an activity is too strenuous, it is. STOP! If you experience light-headedness or dizziness, discuss it with your physician.
• Work to strengthen your pelvic floor muscles (the famous Kegel exercises).
• Avoid sports and activities that challenge your balance after the fourth month because during pregnancy balance tends to be more of an issue. You don’t want to fall.
• Listen to your body – even if you are doing an activity you’ve been doing all along, if it begins to feel awkward or uncomfortable, stop.

Enjoy your pregnancy and all that will follow. The time, as they all say, will go by so fast.