Maternity Fitness Complements Women's Programs

**by Bonnie Berk, RN, BS, CES, CPFT, President, MOTHERWELL,Carlisle, PA
Article provided courtesy of NAPWH. For more information on NAWHP call 312-786-1468.

Interest in exercise classes for expectant and new mothers is at an all-time high. However, being active during pregnancy is not a new idea. Even Egyptian slaves had easier deliveries than their noble sedentary counterparts. In fact, did you know that belly-dancing was originally developed to help prepare the Arab woman's pelvis for childbirth? Today, we call the exercise "hip circles."

Research Shows Beneficial Effect
Research on exercise and pregnancy prior to the 1980's was mainly performed on animals. Pregnant ewes were the research subjects of choice since their physiology closely resembles that of the pregnant woman. However, animals, in general, react differently to exercise than humans. Animals pant instead of sweat to get rid of excess body heat. Also, the hemodynamics are different in quadrupeds than in humans who stand upright. Applying animal research to the human pregnancy condition has been very limiting. As a result, for many years, obstetricians told pregnant women to continue doing what they were used to, but to avoid anything new.

Recently, however, research supports the wisdom of our ancestors. We now know that exercise during pregnancy is not only safe, but extremely effective at relieving the common discomforts of pregnancy, such as low back pain, ankle swelling, fatigue, leg cramps and depression. Maternity exercise classes also offer a means of social support which positively impacts on pregnancy outcome.

Many health care providers recognize the benefits of staying active throughout pregnancy. The American College of Obstetricians and Gynecologists (ACOG) published guidelines for exercise and pregnancy in 1985 and then revised them in 1993. ACOG states that pregnant women who do not have any risk factors for adverse maternal or prenatal outcomes benefit from starting a mild to moderate intensity exercise program during pregnancy. Women's health centers and services can reap many benefits by offering maternity fitness classes to their communities.

Six Elements for Success
As you plan to incorporate maternity exercise classes into your program offerings, keep in mind that the success of any health promotion program depends on the quality of the program, instructor credentials and ongoing promotional efforts. Following are six tips on how to offer a successful maternity fitness program at your facility:

1. Exercises need to be designed with the pregnant woman in mind and should include a warmup, cardiovascular conditioning, strengthening an toning of all major muscle groups, and exercises that increase flexibility, balance and coordination. Kegel and relaxation exercises should be incorporated into the program as well. All exercises need to follow ACOG's safety guidelines. It is important that each participant is able to self-pace the exercises according to her own individual fitness level and the stage of her pregnancy.

2. Unlike childbirth education programs, teaching exercise requires specific psychomotor skills. Instructors should be health and/or fitness professionals with a special certification in pre and post-natal fitness. When asked about what they look for in an exercise class, pregnant women repeatedly respond that they want an instructor that is empathetic to pregnant women and shares information in classes about issues surrounding the childbirth experience, ie. weight gain, common discomforts, baby tips, ante-natal testing, etc.

3. Your instructor will either make or break the program. Exercises instruction is a performing art. Therefore, instructors need to possess certain attributes to make the classes exciting and fun. Instructors should be able to project their voices easily, suitably perform exercises, and easily follow a musical beat. Instructors need to espouse your facility's philosophy. Remember, the sale begins after the sale. If you are not sure whether to hire a certain person, ask yourself, "Would I want this person teaching me?" If you have to think about it, then find someone else.

4. There is a normal attrition that occurs with maternity fitness classes. Pregnant women eventually deliver their babies and move on to other activities. For this reason, it is important to promote your classes on a continuous basis. An important source of referrals is obstetrical health care providers and their staff. Every month, send all obstetrical offices in your service area reminders of class start dates. Include "free class" coupons for providers to distribute to their pregnant clients. Offer to give inservices (on site classes) on pregnancy and exercise to obstetrical staff as well as discounts to all office employees and their spouses. Studies show that satisfied customers are your best advertisement.

5. In order to ensure high attendance and positive outcomes, maternity fitness classes need to be offered on an ongoing basis. The benefits from exercising are derived by exercising at least two days a week for muscle strengthening and toning and three days a week for cardiovascular fitness. ACOG recommends that pregnant women exercise on a regular basis rather than intermittently. Most facilities will offer classes twice a week and then encourage participants to find another day during the week to exercise aerobically.

6. Remember to cross market your services. Maternity fitness classes are a great marketing too l for other programs and services you offer at your facility. Pregnant women are brand loyal. Be sure that everyone in your maternity exercise class knows about the other programs and services you offer to pregnant women and new mothers and vice versa. Everyone in your facility should be aware of your programs, especially people answering the telephones. Include information about your maternity exercise program in all brochures and notices about other women's health education programs you offer to your community.

With proper planning, selection of instructors and an ongoing commitment to a program of excellence, your facility will gain a reputation for offering the state-of-the-art in maternity fitness.
For More Information
For more information about starting a maternity fitness program, call Bonnie Berk, RN using the MOTHERWELL toll-free number: 1-800-MOMWELL.

Bonnie Berk, a member of NAPWH, is a registered nurse, childbirth education specialist and certified personal fitness trainer with a degree in health education. She has been working with pregnant women and hew mothers for eighteen years. Berk is president and founder of the medically-proven MOTHERWELL Maternity Health & Fitness Programs. MOTHERWELL is currently offered through over 100 hospitals and health care facilities nationwide including various U.S. Army bases. Berk also offers the award-winning MOTHERWELL Home Exercise Video. Berk is a speaker, author and consultant to a broad range of institutions addressing the special health and fitness needs of pregnant women and new mothers.

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