Oh, baby

Staying fit during pregnancy can make delivery easier, but some doctors are cautious

Ashley Gurbal, agurbal@altoonamirror.com
When Paula Radcliffe, 33, won the New York City mara-thon 9 1/2 months after giving birth, some mothers looked at the images of the sinewy British runner in bewilderment, thinking of their hips that haven’t been the same since childbirth.

Others, like Amy Dantos of Altoona, know firsthand what it’s like to quickly bounce back to their pre-pregnancy shape.

Dantos, an aerobics instructor, taught a class five days after giving birth to her son Dillan, now 3.

When she consulted her doctors, Dantos said they told her ‘‘to continue to do what you do — just be smart about it.’’

Dantos, 32, exercised throughout her pregnancy, teaching classes up until the night she went into labor.

A woman’s fitness level is the biggest factor in determining how active she should be during pregnancy — and how quickly she gets back in shape, a local obstetrician said.

‘‘Be fit before you get pregnant,’’ said Dr. Liang Bartkowiak, chairwoman of the obstetrics and gynecology department at Altoona Regional Health System, Altoona Hospital Campus. ‘‘And still stay fit during pregnancy ... with exercise.’’

Dantos and her husband, Michael, are expecting a baby girl Dec. 8 — and she’s still teaching classes. She said she’s modified her routine — using two risers instead of four during step aerobics, for instance, and keeping tabs on her heart rate. Bartkowiak said expectant mothers shouldn’t raise their heart rate above 120.

For Jody Black, 34, of Altoona, staying active meant an easy labor and delivery.

On Nov. 10, she gave birth to a healthy baby boy, Jace Eric, after 11 minutes of pushing.

‘‘(Active pregnant women) are more limber,’’ Bartkowiak said. ‘‘Their joints are more limber and more stretched out. And they have more strength to push.’’

A former gymnast, Black was also fit before she got pregnant. She and her husband, Eric, have two older sons, Graham, 3, and Cade, 4, and she exercised throughout all three pregnancies — all of which ended in smooth, easy deliveries.

When she was pregnant with Jace, she went running through her eighth month and continued to lift weights during the last weeks.

‘‘I’d wrap my belly with an Ace wrap (for support) and go,’’ she said.

Dantos is planning to resume her aerobics classes as quickly as she did after the birth of her son, and Black said she would probably wait about two weeks before exercising again.

For less active women, it takes about one year after giving birth to get back into their pre-pregnancy shape, Bartkowiak said, and most can resume physical activity within two weeks.

‘‘It depends on whether there were complications,’’ Bartkowiak said. ‘‘It would depend on whether she had a normal, spontaneous, vaginal delivery, and whether she had an episiotomy (a surgical cut in the perineum to enlarge the vagina during childbirth).’’

Still, when a woman does resume her fitness routine post-partum, she should begin slowly, to lower the risk of injury.

‘‘If you’re too fast, too aggressive, your body will fight you,’’ Bartkowiak said.

Bartkowiak and others are in favor of exercise during pregnancy, at least for physically fit women. But other doctors are ‘‘pretty nervous about women exercising during pregnancy’’ and advise against, said Dr. Linda Szymanski, a Johns Hopkins obstetrician and exercise specialist.

The problem is, guidelines are vague and there’s not much research, she said.

Most medical advice on the topic is based on ‘‘pretty poor evidence,’’ and there’s even less data on the effects in highly trained athletes, Szymanski said. ‘‘It’s a really tough area.’’

Women in childbirth classes at Altoona Regional are advised to ‘‘use common sense’’ when it comes to exercise.

‘‘We tell them to make adjustments as needed,’’ said Sherry Turchetta, community education specialist, who teaches the classes. ‘‘They wouldn’t want to be doing anything where they’re overheated or dehydrated.’’

Pregnant women should also avoid exercises that place them flat on their backs or in a reclined position, because pregnancy increases the blood pressure on vessels in the back, and resting on the back could lead to decreased blood flow to the heart and uterus.

Water aerobics are recommended for prenatal fitness at the Hollidaysburg YMCA, said LeeAnn Aurandt, aquatic program director.

‘‘In water aerobics, there’s no stress on the body,’’ Aurandt said. ‘‘You’re not hitting the pavement. In the water, you’re only 10 percent of your body weight.’’

Some seek out personal training. Mike Schultz, fitness director at The Summit, said his staff sees about 10 pregnant women per year for personal training.

‘‘A lot want to be in the best shape they can be, healthwise, for ease during delivery,’’ Schultz said. ‘‘And others, once they have the baby and start working out again, don’t want to be at a point where it’s like they’re starting over.’’

Exercise, however, is only one part of fitness during pregnancy. Though some may use the baby’s needs as an excuse to ‘‘eat for two,’’ Bartkowiak said, they’re ‘‘really only eating for one and a half.’’

‘‘A lot of women overcompensate,’’ she said. ‘‘In reality, only 300 to 500 extra calories are needed to maintain a pregnancy.’’

Women should gain around 25 pounds during pregnancy, though thin women may gain around 30, and overweight women should gain 10 to 15 pounds, Bartkowiak said. And no matter what fitness routine is kept or how little weight is gained, some women’s bodies may never be the same post-pregnancy.

For example, Bartkowiak said, some women may notice they have to buy bras with a larger band size, as the chest wall increases in diameter, and ribs that splayed up and out to make room for a growing fetus may never fully close.

Shoe size may change, as pregnancy can weaken the arch of the foot, and hips ‘‘may be a little wider,’’ Bartkowiak said.

‘‘There’ll always be a little bit of difference,’’ she said.

The Associated Press contributed to this story.

Mirror Staff Writer Ashley Gurbal is at 946-7435.