Should I keep my heart rate no higher than 140 beats per minute when exercising? 

One of my pregnant patients recently asked me if she should keep her heart rate no higher than 140 beats per minute when exercising?

Answer:
There is presently no scientific basis and no official recommendation to keep the heart rate during pregnancy below certain levels.

Physical activity during pregnancy has benefits beyond maintaining or improving physical fitness, including helping with weight management, reducing the risk of gestational diabetes and preeclampsia, making it easier to cope with labor pain and easing recovery from childbirth.

ACOG, the American College of Obstetrics and Gynecology encourages pregnant women to engage in moderate-intensity exercise for at least 20 to 30 minutes a day most days of the week, as long as there are no medical or obstetric complications.  No upper level of safe exercise intensity has been established. Women who exercised regularly before pregnancy and have no pregnancy-related complications can engage in high-intensity exercise programs, such as jogging and aerobics, with no adverse effects.

Some modification of exercise routines may be necessary to accommodate physiologic and anatomic changes that occur during pregnancy, such as changes in the center of gravity, laxity of joints and ligaments and respiratory changes. Activities that involve a high risk of injury, such as downhill skiing and horseback riding, should be avoided, as should contact sports, scuba diving, skydiving and hot yoga.

What forms of exercise are safe during pregnancy?
Certain sports are safe during pregnancy, even for beginners:

  • Walking is a good exercise for anyone.
  • Swimming is great for your body because it works so many muscles.
  • Cycling provides a good aerobic workout.
  • Aerobics is a good way to keep your heart and lungs strong.
  • If you were a runner before you became pregnant, you often can keep running during pregnancy, although you may have to modify your routine.

The Fourth Trimester – Post Birth

The postpartum or postbirth period after delivery lasts for many months. The postbirth period is usually a happy time for most women, but it can also be stressful, and possibly dangerous. There are many potential complications for a new mom which may even be life-threatening. You have to care for your new baby and at the same time, your body has undergone many changes that need to be addressed. And because you are focusing on the baby, you may ignore serious issues with you and your body.

You need to be aware of the signs and symptoms that may happen in the postpartum period which can be dangerous and need to be addressed quickly before they threaten your health or life.

Unfortunately, many women don’t know the signs of potentially life-threatening complications that could occur after you give birth. Specific signs you should watch for during the first year after birth include pain, shortness of breath, thoughts of hurting yourself or your baby, and various others.

Read HERE more about this from the American College of Obstetricians and Gynecologists (ACOG).

 

You need to be aware of signs and symptoms that may happen in the postpartum period which can be dangerous and need to be addressed quickly before they threaten your health or life.

Unfortunately, many women don’t know the signs of potentially life-threatening complications that could occur after you give birth. Specific signs you should watch for during the first year after birth include pain, shortness of breath, thoughts of hurting yourself or your baby, and various others.

In this educational quiz, Dr. Amos will guide you through potential symptoms and complications, and explain when it is essential to call your doctor. Your answers are scored according to the severity of the issues.

Postpartum or Postbirth is a time period after delivery that officially lasts 6 weeks but it can also last up to a year. This time period is usually a happy time for most women but it also can be stressful and even dangerous and life-threatening with many potential complications for the mother. You need to care for your baby and and the same time you realize that your body has undergone many changes that need to be addressed. Many women often ignore dangerous signs because they are taking care of their baby and they are unaware of serious signals of potential problems. 

Every woman needs to be aware of these possibly serious signs and symptoms that happen postpartum which can be dangerous and need to be addressed quickly before they threaten your health or life. 

Unfortunately, many women don’t know the signs of potentially life-threatening complications that could affect you after you give birth.

Twelve signs and symptoms you should watch for during the first year after birth: 

  1. Headache that does not improve, even after taking medicine, bad headache with vision changes, and “thunderclap” headache 
  2. Sadness, depression, and especially thoughts of hurting yourself or your baby
  3. Vaginal bleeeding that is soaking through one pad/hour, or blood clots the size of an egg or bigger 
  4. Vaginal discharge, pain or redness that is not improving
  5. Pain in your chest
  6. Pain in other body parts such as an incision that is too painful or  not healing 
  7. Breathing issues such as shortness of breath
  8. Seizures
  9. Red or swollen legs that are painful or warm to touch 
  10. Temperature of 100.4° F or higher
  11. Breast pain or excessive swelling
  12. Pain or blood in the urine when you urinate

If you have any of these issues, call your doctor or midwife, call 911, or go to the nearest hospital to be checked. Delaying these issues may make them worse. The sooner your doctor or midwife can make a diagnosis and provide the necessary care, the safer you are. 

Perinatal depression can be prevented

Mental health is essential for everyone including pregnant women. Perinatal or pregnancy depression affects about 1 in 8 new mothers annually in the United States. It can have a devastating effect on the mother as well as the infant.

Risk factors that can be used to identify individuals at risk for perinatal depression include:

  • a history of depression
  • history of physical or sexual abuse
  • unplanned or unwanted pregnancy
  • stressful life events
  • intimate partner violence
  • complications during pregnancy

Additionally, low socioeconomic status, lack of social support, and bearing children during adolescence have been associated with a greater risk of developing perinatal depression after delivery.

The Edinburgh postpartum depression test can screen effectively for your risk of having postpartum depression.

In addition, the interactive Zhung Self-Rating Depression Scale Quiz checks the level of depression to help decide how severe it could be.

Coronavirus 2019-COVID & Pregnancy

Pregnancy and Coronavirus COVID-19

UPDATE AS OF February 2020

There is still much unknown about 2019-COVID and pregnancy. Probably for now the best and most recent answers on 2019-COVID and pregnancy can be found on the CDC website.

On 2/3/2020 it was reported that a pregnant woman with Coronavirus infection was delivered by cesarean section in China at 37 weeks. Both mother and baby are doing well.

On 2/12/2020 The Lancet reported on 9 cases of COVID-19 in the third trimester pregnant women. All were delivered by cesarean section. Symptoms of COVID-19 infections in pregnant women were similar to non-pregnant individuals. There was no evidence for intrauterine infection in these 9 cases caused by transmission from the women to the baby. Also, there is no evidence that a cesarean delivery is needed to protect the mother or the fetus.

In February 2020, most information we have on pregnancy and coronavirus derives from information on MERS and SARS coronaviruses.

One was a report of 5 pregnant women from Saudi Arabia which concluded that MERS-CoV may pose serious health risks to both mothers and infants during pregnancy. Two of the 5 mothers infected with the virus died.

Pregnant women with severe acute respiratory syndrome (SARS) appear to have a worse clinical outcome and a higher mortality rate compared to non-pregnant women.

Though there were a limited number of pregnant women among these cases, it seems pregnant women are more likely to become infected and those who became infected with SARS were more likely to get sick.

Pregnancy is a time of low immune function which generally includes:

  • older people
  • diabetics
  • people with HIV infection
  • people with long-term use of immunosuppressive agents
  • pregnant women