It has been decades since being pregnant meant being treated like an invalid. But just this year, the American College of Obstetricians and Gynecologists, the guiding force of prenatal care in the United States, published a landmark opinion that, “In the absence of either medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.”

        One way to follow this recommendation is a program called Fit to Deliver, developed in Canada in 1996 and available in Greater Cincinnati through a company called Fitness for Women.

        “We offer the program through group classes or in personal training appointments,” says Renee Jeffreys, an exercise physiologist who owns Fitness for Women and runs the Fit to Deliver program at New Body's Personal Training Fitness Center in Blue Ash.

        “For habitual exercisers, I will set up a (individualized) program and act as a resource as they need it (usually over the phone or by e-mail).” she says.

        The program also includes a manual that outlines stretching and strength training routines and gives exercise guidelines for the first, second and third trimesters of pregnancy.

        One of Ms. Jeffreys' Fit to Deliver participants is 32-year-old Tamara Cline of Hamilton, who is seven months pregnant.

        “Remember your transverse,” Ms. Jeffreys reminds Ms. Cline, who was warming up on the treadmill.

        “The transverse is that muscle you suck in when you see a good-looking guy walk by,” Ms. Jeffrey says. “But a lot of times, people contract it and hold their breath. And that's what we don't want you to do.”

        One way that Fit to Deliver is different from many other prenatal programs is that it focuses on the core muscles, such as the transverse abdominals and muscles in the back. This helps strengthen the back to reduce discomfort and strengthen the muscles that carry the baby's weight.

        Also, Fit to Deliver uses a team approach. A physician, physical therapist and exercise physiologist advise each client.

        “When we design a program or add or make modifications to exercises we are looking at it from those three disciplines,” Ms. Jeffreys says.

        Ms. Cline joined the program early in her pregnancy, hoping for a shorter and more energetic labor, and a quicker rebound after the baby is born.

        “I did not do this with my first (child),” she says. “I wasn't as self-aware body wise. I had a really long labor . . . I was aiming for natural childbirth, but I couldn't do it.”

        Ms. Cline feels the Fit to Deliver program has made a difference.

        “It's helping boost my energy, self-esteem and self awareness,” she says. “I did not expect that at all.”

        Daniel Bowen, an OB-GYN with a practice in Springdale, says exercise during pregnancy is nothing new for his patients.

        “I have a fairly high percentage of patients who are either already in an established exercise program or want to be because they got pregnant and want to do what's best for the baby,” Dr. Bowen says.

        Although there are no scientific studies documenting the benefits of exercise on delivery, he says his patients who exercise report “they sleep better, eat better and generally have a better sense of well being (throughout their pregnancy).”

        Studies have indicated that continuing exercise after pregnancy can minimize post-partum depression in patients who may have a greater risk for that condition.

        But what if you weren't exercising before you became pregnant? Is now a good time to start?

        Ms. Jeffreys believes it is.

        “When women are pregnant, they are more likely to do positive things for themselves,” she says. “So if you can get a woman to exercise during pregnancy and she can maintain that after pregnancy, she is going to have a much healthier life over the long term.”

Exercise tips

        Dr. Daniel Bowen, a Springdale OB-GYN, offers these tips for exercise during pregnancy:

        • Due to increased blood volume, your heart is working harder at rest and with every (movement). For cardiovascular exercise, you will reach your target heart rate faster and should maintain it only for 20 minutes.

        • Keep muscles stretched and do a good warm-up and cool down every time you exercise.

        • Your physical space changes during pregnancy as your belly gets bigger. There is some higher risk of falling, especially on stairs, or of turning the wrong way. Pay attention and be attentive to the mechanics of what you do.

        • The hormone relaxin is released early in pregnancy to soften the joints and allow easier delivery of the baby's head. It affects ankles, knees, hips and the lower back as muscles work harder to maintain posture. Look for less jarring exercises that will give cardiovascular benefit without causing joint or back pain.

        • If you were not an exerciser before pregnancy, start slowly. Try swimming or walking rather than running. The frequent changes in your center of gravity makes it difficult to recognize and keep a proper running form if you were not a runner before pregnancy.

About Fit to Deliver

        Location: New Body's Personal Training Fitness Center, 11142 Luschek Drive, Blue Ash.

        Group classes: Meet three times per week, for cardiovascular and conditioning work. Fitness testing and individual exercise prescription included. Cost: $150-$400 (based on weeks pregnant when registering).

        Personal training: Individual one-hour sessions with a personal trainer who specializes in prenatal clients. Includes fitness testing, individual exercise prescription, Fit to Deliver book, two one-hour sessions. Basic package: $170.

        Exercise prescription for pregnancy: Designed for the experienced exerciser and includes fitness testing, personalized exercise prescription,one-hour personal training sessions, access to trainer to answer questions throughout the pregnancy. Cost: $200.

        Information, registration: Contact: Renee Jeffreys of Fitness for Women, (859) 291-4354; e-mail renee@fittodeliver.com. The Fit to Deliver manual is available separately from Ms. Jeffreys.

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