Pregnancy encyclopedia: Depression during pregnancy to Exercises

Depression during pregnancy

The stress of pregnancy can lead to or can worsen depression. About 10 percent of all pregnant women become depressed for various reasons. If you're depressed, there is help available. Ask your partner to help you contact mental health support in your community. Talk to your health care provider.

Dilate

This means to widen, which is exactly what your cervix must do during labor. Your cervix widens to about 10 centimeters -- large enough for your baby's head to pass through.

Doula

This ancient Greek word means "woman who serves." A doula is:

• a trained professional who acts as a labor and birth companion and/or assists you at home after you give birth
• a woman who is experienced in childbirth and parenting and can help you go through labor and birth, care for your baby, begin breastfeeding, and more

Postpartum doulas also may help with home chores after your baby is born. Doulas are often familiar with birth center staffs and attend many births each year.

Ectopic pregnancy

A pregnancy in which the fertilized egg begins to grow in a place other than inside the uterus, usually in the Fallopian tubes. Because the egg cannot attach to the uterine wall, the baby cannot survive.

Edema

Swelling from water retention (especially common during pregnancy) that often affects the feet, ankles, lower legs and hands. Swelling in your ankles is common, but swelling in your hands or face should be reported to your health care provider. Putting your feet up should help. If, after resting overnight, the swelling is still present, call your health care provider.

Efface

This means to thin out, which is what your cervix does during labor. Your cervix becomes thinner and shorter, pulling over your baby's head like pulling on a turtleneck sweater. Your health care provider will measure effacement in percentages, telling you that you are 30 percent effaced or 70 percent effaced, for example. At 100 percent effacement, your labor will begin to progress faster.

Effleurage

Gentle "butterfly" strokes of circular massage done with the fingertips, to be used on your abdomen, hips, thighs, or anywhere on your body where it feels good.

Electronic fetal monitoring

The use of external or internal instruments to record your baby's heartbeat and your contractions.

Endometriosis

A condition in which tissue similar to the lining of the uterus is found outside the uterus, usually on the ovaries, tubes, and other pelvic structures.

Episiotomy

An incision in the tissues between the vagina and the anus, made as your baby's head is being born. It enlarges the vaginal opening and prevents tearing.

Exercises -- postpartum

You may begin these exercises the first day after your baby is born, or as your health care provider directs. Start with doing each exercise two times a day. Increase by one repetition each day until you are doing 10 of each exercise two times a day. Or follow the schedule your health care provider gives you.

Deep breathing with abdominal wall tightening
Position: Lying on your back or side with knees bent.

• Take a deep breath through your nose. Let your abdominal wall expand upward.
• With your lips slightly parted, blow air out through your mouth while tightening your abdominal wall.
• Keep blowing until you have emptied your lungs.
• Don't take too many deep breaths in a row or you might get dizzy.

Toe pointing
Position: Sitting or lying.

• Pull your toes toward you as far as you can.
• Then point your foot downward.
• Repeat.
• Rest before continuing.

If pointing your toes downward causes cramps: pull up your toes, relax, pull up your toes, relax.

Foot and ankle circles
Position: Sitting or lying.
Make large, slow circles with each foot, first to the right, then to the left. This is an excellent exercise to improve the circulation in your legs.

Pelvic tilt
Position: Lying flat on your back with knees bent and feet flat on the floor.

• Tilt your pelvis back by flattening your lower back against the floor.
• Tighten your abdominal muscles and your bottom. This strengthens the abdominal muscles.

Exercises -- pregnancy, labor, and birth

Ask your health care provider if it is safe for you to exercise while pregnant. The following exercises are for pregnancy, but their benefits will last into your labor, birth and recovery. These exercises were chosen because they strengthen and stretch muscles and ligaments that especially pertain to pregnancy and birth.

Pick and choose from this list to fashion your own workout. Work up to doing each exercise 10 times a day. Choose an aerobic activity, too, like walking or swimming, and do that 3 to 5 times a week. Or follow your health care provider's guidelines for exercise.

Note: exercises that are performed on your back should not be done after the first trimester.

The first five exercises promote full, pain-free upper back and neck motion, relieve tension, and strengthen upper back and arms -- areas where you may be storing tension.

Neck circle stretch

• Sit up straight and close your eyes.
• Let your head fall gently forward with your chin near your chest
• Keeping your shoulders still, slowly move your chin until it is directly above your right shoulder.
• Lower your head, making a half circle toward your chest until you reach your right shoulder again.
• Repeat, starting at your left shoulder.

Chin tuck stretch
Pull your chin straight back until you feel a stretch at the base of your skull.

Shoulder circle stretch

• With your arms at your sides, slowly make big circles with your shoulders going forward. Reverse the circles.
• Take a deep breath, lifting your shoulders as you inhale and lowering them as you exhale.

Shoulder squeeze stretch

• While sitting or standing with proper posture, squeeze your shoulder blades together with your elbows and arms at your sides.
• Clasp your hands behind your back and gently lift them up and back, stretching the front chest muscles.

Wall pushup strengthening

• While standing about 2 feet from the wall with feet hip distance apart and back straight, slowly lean toward the wall, allowing your elbows to bend.
• Slowly straighten your elbows as you push out from the wall.
• You can also do traditional pushups on the floor -- just make sure your back is straight.

Pelvic tilt
This exercise strengthens abdominal muscles, which support the growing uterus. Do it on your back during your first trimester, but do it on all fours after the third month of pregnancy.

• Lie on your back with your knees bent.
• Tighten your tummy and buttocks until your back flattens toward the floor. Hold for 5 seconds.
• Relax and repeat 10 times.

Once you've mastered the pelvic tilt while lying on your back, try it standing, sitting, and on all fours. This exercise should not be done on your back after the first trimester.

Cat stretch and strengthening
This limbers and strengthens lower back and abdominal muscles, and helps relieve low back discomfort.

• Get on your hands and knees, with your abdominal muscles slightly contracted to prevent swaying of the lower back.
• Do a pelvic tilt, and then slowly arch your back like a cat does when it's afraid.
• If there is a place in your back that feels especially good during this stretch, stay in that position for a longer amount of time.
• Then bring your bottom down toward the floor and take several slow, deep, cleansing breaths, letting your lower back relax.
• Slowly move back into the starting position and bend at the waist, bringing your right shoulder and right hip toward each other until you feel a gentle stretch on the left side.
• Repeat on the opposite side.

Abdominal muscle exercise and strengthening
This exercise helps strengthen the abdominal muscles and helps reduce the separation between them that sometimes occurs during pregnancy.

Before you try this exercise, see if your muscles are separating:

• Lie on your back with your knees bent.
• Reach one arm toward your knees as you tighten your abdominal muscles and lift your head and shoulders.
• Put the fingers of your other hand just below your navel. You will feel the bundles of muscles tighten.
• If you have a separation of three or more finger widths between the two halves of your abdominal muscles, do not do this exercise or any other abdominal strengthening exercise until after your baby is born. Talk to your health care provider about this separation.

If your separation is less, doing this exercise can help reduce it.

• Lying on your back, knees 12 to 16 inches apart, cross your hands over your abdomen so that as you raise your head you will be able to support your abdominal muscles.
• Breathe in deeply, exhale, and raise your head forward to your chest, gently pushing the separated abdominal muscles toward each other.

Half curl-up strengthening
Ask your health care provider if you should perform this beyond your fourth month of pregnancy. It strengthens the abdominal muscles and helps prevent back injury.

• Lying on your back with your knees up, do a pelvic tilt.
• Slowly lift your head and shoulders from the floor, reaching toward your knees.
• Raise yourself just enough so your shoulder blades clear the floor.
• Slowly lower yourself to the floor and release the pelvic tilt.
• You can also do the curl-up bringing one shoulder toward your opposite knee to strengthen your oblique abdominal muscles.
• Roll to the side to sit up when you are finished.

Spinal twist stretch
This increases your back flexibility and relieves tension and discomfort in your lower back.

• Sit up straight with crossed legs or with legs straight out in a "V."
• Place right arm on left knee and extend your left arm out straight behind you until you feel a gentle stretch.
• Relax your shoulders and take a deep cleansing breath.
• Repeat toward the right side.

Inner thigh stretch
This exercise builds flexible thigh muscles which help in labor and birth.

• Sit on the floor.
• Bend your knees and put the soles of your feet together. Pull them in as close as possible without causing discomfort.
• Hold your ankles with your hands and slowly push your knees toward the floor, using your elbows for gentle leverage.
• Hold for 10 seconds.
• Repeat 10 times.
• If you have trouble sitting up straight while doing this, use the palm of your hands, rather than your elbows, to gently apply the stretch.

Squatting strengthening
This strengthens and limbers your legs in preparation for pushing during birth

• Stand, holding onto a table or chair with your legs wide apart.
• Slowly squat down, keeping your back straight and your abdominal muscles tight.
• Hold this position for 1 to 2 minutes, or as long as comfortable.
• When you straighten up, keep your buttocks tight, contract your abdominal muscles, and keep your back straight.
• You can also do this holding onto your partner's hands.

Hip flexor stretch
This increases the flexibility in your hip muscles, which will help during birth. It also helps promote posture and prevent low back injury.

• Stand with one leg in front of the other or kneel on one knee, holding onto a chair.
• Move your trunk forward, keeping your buttocks tightened and your back in an upright position until you feel a gentle pull in the front of your hip (of back leg).

Heelcord stretch
This stretch helps relieve and prevent cramps in your calf. Doing it before bed can help prevent cramping at night.

• Stand and hold onto a chair or wall.
• Place one leg in front of the other.
• Keep the back leg straight and your heel on the floor.
• Keeping your toes pointing forward, slowly lean forward over the front leg until you feel a gentle pull in the calf of your back leg. Hold for 10 seconds.
• Repeat five times on each side.

First published: 10/04/2002
Last updated: 10/04/2002

Reviewed by: Allina Patient Education, experts