Eating Well With Gestational Diabetes

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Eating Well with Gestational Diabetes 

Guest post by Melissa Gosser, RD

Melissa is a registered dietitian, mommy to two beautiful girls and the woman behind Fit Fab Mommy

eating well with gestational diabetesGestational diabetes is a type of diabetes that women get while pregnant (during gestation).  In simple terms, diabetes occurs when you have high levels of sugar (glucose) in your blood, either because your pancreas doesn’t produce enough insulin or can’t use it properly, therefore sugar remains in your blood stream instead of moving into cells or converting to energy, as it should. While some women are considered higher risk for gestational diabetes, anyone can get it.  Hormonal changes during pregnancy can make a mother insulin resistant, which means your body is not able to make enough insulin or use it efficiently, causing glucose to build up in the blood (also known as hyperglycemia).  While most women with gestational diabetes don’t remain diabetic once the baby is born they are at higher risk of developing it in subsequent pregnancies and becoming diabetic later in life.

Expectant mothers are screened for gestational diabetes around 24-28 weeks (or sooner if you are considered high risk for diabetes) with a glucose-screening test.  This is that sickeningly sweet drink you have to chug down in five minutes (hopefully the morning sickness has subsided by now) that can identify if you have a problem.  If you test positive it doesn’t necessarily mean you have gestational diabetes (it is just a screening test, not a diagnostic test), it means you need to take another test called the glucose tolerance test, which is much longer (3 hours) and will diagnose if you in fact have gestational diabetes.  You are considered high risk for gestational diabetes if you are obese, had gestational diabetes with a previous pregnancy, have sugar in your urine, or have a strong family history of diabetes and will be tested early on.  However, some women don’t have any of these risk factors and still may develop gestational diabetes, this is why it is important that all pregnant women get tested.

If you test positive for gestational diabetes, don’t panic.  Most women with gestational diabetes have perfectly, healthy babies.  However, you must take action immediately to control your gestational diabetes as it can have serious short and long-term effects for both you and your baby.  If uncontrolled, complications for the fetus and baby may include: birth defects (digestive tract, brain and spine abnormalities, heart and connecting blood vessels), stillbirth, macrosomia (a baby that is considerably larger than normal), birth injury (due to large size of baby), hypoglycemia (low blood sugar in the baby upon delivery), or difficulty breathing.   For a mother with uncontrolled gestational diabetes, complications may include: early delivery, preeclampsia (high blood pressure with possible protein in the urine, or liver or kidney abnormalities), C-section, and having a large baby, which can lead to delivery complications.

By following a healthy meal plan, getting regular physical activity and keeping track of blood glucose levels most women with gestational diabetes can control their blood sugar levels.  However, some women may also need insulin to keep blood glucose levels under control. Below are some general guidelines to follow as preventative measures for gestational diabetes.  They are also good guidelines to follow if you do in fact have gestational diabetes, however everyone is different so it is important to meet with a healthcare provider to come up with a plan that is best for you.

Make healthy food choices:

  • Carbohydrates are one of the three main energy sources in food; the other two are protein and fat.
  • Carbs include: Starchy vegetables (corn, peas, potatoes, winter squash, sweet potatoes), sugars, fruits, milk, yogurt, grains (pasta, bread, cereal), sweets (candy, cookies, cakes, ice cream etc.), snacks (popcorn, chips, pretzels, rice cakes, etc.).
  • Don’t skip meals and definitely don’t eliminate carbs all together. Carbs are our bodies’ main source of energy and are important in making our body function properly.
  • Make your carbs count. “Healthy” carbs are carbs that are unrefined, which means they haven’t been processed so they are full of nutrition.  Unrefined carbs contain fiber, which does not raise blood glucose levels because it is not broken down by the body.  So eating an apple or a slice of whole grain bread, while they still contain carbohydrates, are better for you than say refined or processed carbs (such as candy, white breads and pastas) because they contain fiber.  So eat more unrefined carb products (whole grain, fruit) instead of refined or processed carbs.
  • Balance your meals by including a healthy carb (whole grain, fruit), lean protein (lean chicken, fish, meat) and/or healthy fat (olive oil, avocado, almonds, walnuts) in each meal.
  • Eat regularly and space out your carbs evenly throughout the day to help maintain better glucose control. Think 3 meals and 2 snacks spaced out every three to four hours.
  • For breakfast, especially if you are a cereal eater, remember both the cereal and milk count as carbs. You need to add a protein or healthy fat.  Mix and match from the list below.  Pick one carb and one protein:

 

CARBOHYDRATE PROTEIN
Cereal & Milk Eggs (hardboiled or scrambled)
Oatmeal 0% Fat Greek Yogurt
1 slice whole grain toast Almonds & Walnuts
High Protein Waffle Peanut Butter
Fruit Cream Cheese

 

  • For snacks always combine a carb with a protein or healthy fat. Some examples of good snacks include:
    • A piece of fruit (apple, pear, orange) with low-fat string cheese
    • A piece of fruit with nuts (almonds, peanuts, walnuts)
    • A piece of fruit with peanut butter
    • Hummus with raw vegetables (celery, carrots, cucumber)
    • Hummus with whole grain pita
    • Greek yogurt with berries
  • For lunch and dinner, have equal portions carb (grain, bread or starchy vegetable) and protein (meat, chicken, fish) and as many non-starchy vegetables as you want (salad, dark green leafy veggies, etc.)
  • Pay attention to portion size.

Blood Glucose

The American Diabetes Association suggests the following targets for women who develop gestational diabetes during pregnancy.

  • Before a meal (pre-prandial): 95 mg/dl or less
  • 1-hour after a meal (postprandial): 140 mg/dl or less
  • 2-hours after a meal (postprandial): 120 mg/dl or less

For more information on gestational diabetes visit the American Diabetes Association.

 

Postpartum Core Strengthener – Mommy Moves

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This month’s postpartum Mommy Moves exercise is a fantastic postpartum core strengthener, well really a great core engaging exercise for anyone but particularly moms because our core needs a lot of TLC after having a baby. This exercise is a great example of small movements, when done correctly, making a big impact.

First time trying a Mommy Moves exercise? Mommy Moves is a monthly series that highlights a great prenatal and postpartum exercise for you to try. If you haven’t already, be sure to try the featured exercises from October and November. If you have any requests of issues or body parts that you’d like us to address, please email us.

December Postpartum Mommy Move: Postpartum Core Strengthener

Get into an all fours position, with hands beneath shoulders. Inhale and on the exhale contract your abdominals and slowly lift your knees slightly off the ground (shown below). Hold for a few seconds then lower. Perform 2-3 sets of 12-15 reps.

If you live in the Los Angeles/Pasadena area and need help with your postpartum recovery, we recently launched a great postpartum recovery exercise class at The Family Room.   

postpartum core strengthener

Labor Prep Exercise – Mommy Moves

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Labor Prep Exercise – Wall Sit

This month’s Mommy Moves exercise for pregnant mamas is a great way to mentally and physically prepare for labor. It will help you experiment with what works and doesn’t work for you to be able to mentally push yourself through labor contractions and it’s also a great exercise to build up strength and endurance in your lower body, which you’ll need during labor.

If you’re a new follower to our Mommy Moves series, be sure to check out last month’s exercise, which is a great prenatal hip opener. October’s featured exercise is also a good one because it will help baby get into an optimal position for birth. Our Mommy Moves series highlights a new prenatal and postpartum exercise each month. If you have any requests of issues or body parts that you’d like us to address in an upcoming  feature, please email us.

December Prenatal Mommy Move: Labor Prep Exercise – Wall Sit

Stand against a wall. Slowly lower yourself down as if you were sitting in a chair. Try to form a 90° angle with your legs but it’s okay if you can’t go that low. Hold this position for 30 seconds-1 minute. Once you build up your stamina, try to hold for 1 minute, rest for 1 minute and repeat 5 times. During this exercise, play around with techniques to push through the difficulty of holding the position. Experiment with your breathing, closing your eyes, focusing your eyes on an object across the room, listening to music, having your partner coach you through it. Knowing what works and doesn’t work for you before you go into labor will really help your labor experience.

*If you live in the Los Angeles/Pasadena area and need guidance on a safe and effective prenatal exercise program, join our prenatal exercise class at The Family Room

labor prep exercise

Prenatal Hip Opener – Mommy Moves

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Prenatal Hip Opener

This month’s Mommy Moves exercise for pregnant mamas is not only a great prenatal hip opener – it’s also fantastic for relieving lower body discomfort that many women experience during pregnancy. Hard to beat a multi-tasking move like this one!

If you’re a new follower to our Mommy Moves series, be sure to check out last month’s exercise, which will help baby get into an optimal position for birth. Our Mommy Moves series highlights a new prenatal and postpartum exercise each month. If you have any requests of issues or body parts that you’d like us to address in an upcoming  feature, please email us.

November Prenatal Mommy Move: Prenatal Hip Opener

Place your hands on a chair/stool in front of you and push your hips back. Feet wide and spine neutral (don’t round your back). Slowly shift your hips to one side. Pause then slowly shift to the other side. Repeat for 1 minute. (Feel free to play around with the width of your feet to see what feels good for you).

*If you live in the Los Angeles/Pasadena area and need guidance on a safe and effective prenatal exercise program, join our prenatal exercise class at The Family Room

prenatal hip opener

Postpartum Squat – Mommy Moves

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This month’s postpartum Mommy Moves exercise is what I’m calling the postpartum squat. This type of a squat is a great pelvic floor strengthener, making it ideal for postpartum moms. If this is your first introduction to our Mommy Moves series, I encourage you to try our featured exercise from last month before moving on to the postpartum squat. Last month’s exercise can also be done as a warm up to this squat.

Mommy Moves is a monthly series that highlights a great prenatal and postpartum exercise for you to try. If you have any requests of issues or body parts that you’d like us to address, please email us.

November Postpartum Mommy Move: Postpartum Squat

Stand with feet hip width apart, toes pointed forward. Holding onto something study, push your hips backward and lower yourself into a squat, only going as far down as you can keep lower back from rounding (no tucking pelvis under) and shins vertical. Return to standing. Perform  1-3 sets of 12 reps.

BTW – If you live in the Los Angeles/Pasadena area and need help with your postpartum recovery, we just launched a great postpartum recovery exercise class at The Family Room.   

postpartum squat

Strengthen Your Pelvic Floor – Mommy Moves

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This month’s postpartum Mommy Moves exercise is a great squat preparation exercise to learn how to properly use your glutes instead of your quads. Strong glutes are essential to strengthen your pelvic floor after pregnancy. No matter how you delivered your baby, your pelvic floor needs some TLC after pregnancy.

Mommy Moves is a new monthly series that will highlight a great prenatal and postpartum exercise for you to try. If you have any requests of issues or body parts that you’d like us to address, please email us.

October Postpartum Mommy Move: Hip Hinge

Stand with feet hip width apart, toes pointed forward. Engage the core, slowly bend forward pushing the hips backward. Be careful not to round the lower back. Return to standing. Perform 1-3 sets of 12 reps.

strengthen your pelvic floor

Help Baby Get Into Position – Mommy Moves

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Kicking off our new Mommy Moves series with an exercise for pregnant moms that can help baby get into position for birth. This exercise is great for releasing the psoas muscle which can get super tight (thanks in large part to all of the sitting we do). Releasing the psoas can help baby descend and get into an optimal position for birth.

If you have any requests of issues or body parts that you’d like us to address in an upcoming Mommy Moves feature, please email us.

October Prenatal Mommy Move: Lunging Hip Flexor Stretch

Assume a half kneeling lunge position. Slowly lunge forward, making sure to keep the shin of the front leg vertical and the pelvis neutral. Hold for one minute each side.

help baby get into position

What should I do for exercise during pregnancy?

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What should I do for exercise during pregnancy?

exercise during pregnancyIf you’re reading this, chances are you know that you SHOULD be exercising during your pregnancy, but you don’t know exactly what to do. I hope this post helps guide you in the right direction. My goal is to give you a general guideline that you can use to determine the specific types of exercise that are appropriate for you.

The sad reality is that the majority of pregnant women don’t get the amount or type of exercise that’s recommended. Most pregnant women fall into one of these categories: no exercise at all, prenatal yoga only, or sporadic exercise mostly during the second trimester. The recommendation is for pregnant women to exercise for at least 30 minutes on most, if not all, days of the week. Research tells us that weight-bearing aerobic and resistance exercise have the most impact on critical health factors for mom and baby.

Assuming you’ve been cleared to exercise (talk to your doctor or midwife to be sure you don’t have a medical or obstetric condition that contraindicates exercising during pregnancy), here’s what you’ll want to be sure to include in your exercise program:

1. Weight-Bearing Aerobic Exercise

Weight-bearing aerobic exercise includes activities such as: walking, jogging, stair climbing and dancing. Walking is one of the best forms of weight-bearing aerobic exercise for pregnant women because it’s safe and effective for women of many fitness levels. If you’re just starting out, try walking for 10-15 minutes and as your fitness level improves, increase the time and pace.  Hill walking is great for women at higher fitness levels that want more of a challenge. Jogging/running gets a bad rap, but the truth is that it’s safe for some pregnant women and unsafe for others. It really depends on your exercise history, fitness level and how your body feels. Some women are able to safely continue running throughout their entire pregnancies while others can’t because of pain or discomfort. Now’s a good time to mention that exercise during pregnancy should ALWAYS make you feel better, not worse. You should never exercise to the point of pain or discomfort. If something hurts or doesn’t feel right, that’s your body’s way of telling you to stop. Don’t ignore those signs. If before pregnancy you enjoyed higher intensity exercise such as running or spinning, stair climbing can be a good alternative for you. Just walking up and down stairs can give you a great cardio workout while still keeping you and baby safe. Dancing is also another great form of weight-bearing aerobic exercise that’s enjoyable and safe for women of many fitness levels.

Quick aside to talk about non weight-bearing aerobic exercise…

There are other forms of aerobic exercise that aren’t weight-bearing and feel great during pregnancy. Swimming is a great alternative form of aerobic exercise. It especially feels great as you get bigger and exercising on land becomes more difficult or in the heat of the summer. The recumbent bike is another alternative form of aerobic exercise that many pregnant women enjoy, however some report discomfort when using the recumbent bike at the end of pregnancy when the belly is bigger. Doing non weight-bearing aerobic exercise is fine, just be sure to also include some form of weight-bearing aerobic exercise in your program.

2. Resistance Exercise

Resistance exercise (strength training) isn’t just about lifting heavy weights to get huge muscles like body builders. Strength training is good for all of us, including pregnant women. And you don’t have to lift super heavy weights to get the benefits from strength training. Dumbbells (appropriate for your fitness level), resistance bands and even your own body weight are great tools to use when doing resistance exercise during pregnancy. One example of a great exercise to incorporate into your routine during pregnancy is the squat. Depending on your fitness level, you can do them just with your body weight or add external resistance like dumbbells. If you need more guidance about specific resistance exercises to do (and what not to do), seek out a qualified prenatal exercise specialist.

3. Relaxation/Breathing/Stretching Exercises

Relaxation, breathing and stretching exercises are a great supplement to your exercise program, but should not be the only type of exercise you do. Relaxation and breathing techniques come in very handy during labor and delivery. Taking a prenatal yoga class is great at any point during your pregnancy, but especially in the third trimester. Aside from prenatal yoga, incorporating stretching (tailored for your specific needs and workout) into your cool down is a great way to end your workouts.

That’s a general outline of the types of exercise you’ll want to include in your prenatal exercise program. If you need more help figuring out specifically what’s right for you, contact us. One of our specialties is creating exercise programs for pregnant and new moms, which are tailored specifically for you and tell you exactly what to do and when. We’d love to put one together for you. And the good news is, you don’t have to live in Los Angeles (where we’re based) to work with us. We put programs together for women all over the world (yes, the world).

Boot Camp Classes During and After Pregnancy

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Boot Camp Classes During and After Pregnancy

boot camp classes during and after pregnancy

This is the second post in a series on popular exercise classes and what to keep in mind if you’re pregnant or a new mom. Today we’re talking about boot camp classes during and after pregnancy. Click here to read the first post in the series about spin classes.

Before we get into the specifics of boot camp classes, here is some general info to keep in mind regarding exercise classes…

If you’re pregnant:

  • Number one rule – listen to your body. Do what feels right and don’t compete with others in the class. We know it’s tempting to want to do everything others are doing but resist the urge and instead tune into your own body and go at a pace that feels right for you.
  • When possible, take prenatal specific classes (that are taught by QUALIFIED instructors). Unfortunately, there aren’t that many prenatal specific classes out there. The most common prenatal class is yoga. Prenatal Pilates classes are popping up here and there but definitely not as widespread as prenatal yoga classes.
  • Tell the instructor before class that you’re expecting and ask for modifications. This is also important so the instructor doesn’t push you to do things you’re not comfortable doing (which they shouldn’t do in the first place but some classes and instructors are taught with a “tough love” philosophy).

If you’re a new mom:

  • If you’re just getting back into exercise, don’t be surprised if it’s more difficult then before you were pregnant or even when you were pregnant. Take it slow and do what you can. You might not be able to finish an entire class and that’s okay.
  • The same tip applies here as for pregnant moms – listen to your body. It’s tempting to be competitive and do what everyone else is doing, but that could lead to injury or overdoing it if you’re not careful.
  • If you have urine leakage, changes in bleeding or pain, these are all signs that your body isn’t ready for that intensity/type of workout. Don’t ignore these signs.

Many group exercise instructors (not all) aren’t educated about prenatal/postpartum women. They might know some modifications but they probably won’t know what’s going on with your body or how to address questions/concerns that come up. Again, this doesn’t apply to all instructors but quite often this is the case. This makes it even more important to listen to your body and only do what feels right. If you’re unsure, seek out a qualified pre/post natal exercise specialist.

Now for the specifics about boot camp classes during and after pregnancy…

Typically, boot camp classes are pretty intense, usually featuring intense intervals throughout the hour-long class. Boot camp instructors tend to be more “tough” on participants than instructors of other types of exercise classes. Participants are encouraged to push themselves to the limit and then some. Because of the intensity of the class, the format and exercises typically included, and the emphasis to push past your comfort zone, boot camp isn’t the ideal type of class for pregnant moms and moms just getting back into exercise after pregnancy. There are, of course, exceptions, and boot camp classes might work for some women. Here are some things to keep in mind:

During Pregnancy:

  • If you haven’t taken the specific boot camp class you’re interested in BEFORE getting pregnant, we wouldn’t recommend starting during pregnancy. If you have taken the class before, be sure you know the instructor and are comfortable with him/her as well as the format of the class. Also, be sure to let the instructor know that you’re pregnant before class and talk in detail about modifications.
  • Again, boot camp classes are not the type of classes you should start taking during pregnancy.
  • Listen to your body and don’t push yourself too hard. As we mentioned before, typically boot camp classes encourage participants to push past their comfort zone. This isn’t something you should do during pregnancy. You should never push yourself to the point of overexertion or fatigue when exercising during pregnancy. Stop before you get to that point. A good way to monitor the intensity of exercise is to use the talk test (you should be able to comfortably speak…if you can’t, decrease your intensity or take a break). As we’ve written about before, monitoring your heart rate isn’t the recommended way to monitor intensity during pregnancy. If you missed our post on the topic, click here to read it.
  • Don’t do everything the instructor says if it doesn’t feel right to you. Even if the exercise has been modified…if it doesn’t feel good, don’t do it. You know your body better than anyone else.
  • Keep your body at a comfortable temperature. Dress appropriately and stay hydrated. If the class is outdoors and it’s too hot on a particular day, it’s probably best to skip class.
  • If the class incorporates weights, be flexible and open to adjusting the weight you use. You might not be able to lift as much as you did before pregnancy, which is normal and something you need to respect about your changing body.

After Pregnancy:

  • Boot camp isn’t the type of class we’d recommend taking until you have built up a strong foundation and have done less intense forms of exercise first.
  • Many women feel a strong temptation after pregnancy to do the most intense exercise they can, hoping to lose baby weight quickly. As the saying goes, slow and steady wins the race. Take the time to ease into exercise and if/when you feel that your body is ready for a class like boot camp, take it slow. Don’t push yourself past your comfort zone if your body is giving you signs that it’s not ready. Signs include: pain, bleeding and urine leakage. Women often feel embarrassed about urine leakage and choose to ignore it and continue exercising. Urine leakage is not to be ignored. It’s a sign that your pelvic floor is not ready for that type of exercise. Get help from a physical therapist or perinatal exercise specialist.
  • If you have diastasis recti, an abdominal separation that can occur during pregnancy, you need to get it corrected BEFORE starting other forms of exercise, including boot camp classes. We offer a personalized diastasis recti correction program, so contact us if you need help. If you had diastasis recti and it’s been properly corrected and you are doing the proper maintenance/monitoring, you shouldn’t have a problem taking boot camp classes.  Again, if you need help or have questions, contact us.

Be sure to sign up to receive our blog posts so you can read about all of the classes we’ll write about in this series. If you’d like us to write about a specific type of class, let us know in the comments below.

Spin Classes During and After Pregnancy

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Spin Classes During and After Pregnancy

spin classes during and after pregnancy

This is the first in a series of posts on popular exercise classes and what to keep in mind if you’re pregnant or a new mom. Today we’re talking about spin classes during and after pregnancy. Be sure to sign up to receive our blog posts so you can read about all of the classes we’ll write about in this series. If you’d like us to write about a specific type of class, let us know in the comments below.

Before we get into the specifics of spin classes, here is some general info to keep in mind regarding exercise classes…

If you’re pregnant:

  • Number one rule – listen to your body. Do what feels right and don’t compete with others in the class. We know it’s tempting to want to do everything others are doing but resist the urge and instead tune into your own body and go at a pace that feels right for you.
  • When possible, take prenatal specific classes (that are taught by QUALIFIED instructors). Unfortunately, there aren’t that many prenatal specific classes out there. The most common prenatal class is yoga. Prenatal Pilates classes are popping up here and there but definitely not as widespread as prenatal yoga classes.
  • Tell the instructor before class that you’re expecting and ask for modifications. This is also important so the instructor doesn’t push you to do things you’re not comfortable doing (which they shouldn’t do in the first place but some classes and instructors are taught with a “tough love” philosophy).

If you’re a new mom:

  • If you’re just getting back into exercise, don’t be surprised if it’s more difficult then before you were pregnant or even when you were pregnant. Take it slow and do what you can. You might not be able to finish an entire class and that’s okay.
  • The same tip applies here as for pregnant moms – listen to your body. It’s tempting to be competitive and do what everyone else is doing, but that could lead to injury or overdoing it if you’re not careful.
  • If you have urine leakage, changes in bleeding or pain, these are all signs that your body isn’t ready for that intensity/type of workout. Don’t ignore these signs.

Many group exercise instructors (not all) aren’t educated about prenatal/postpartum women. They might know some modifications but they probably won’t know what’s going on with your body or how to address questions/concerns that come up. Again, this doesn’t apply to all instructors but quite often this is the case. This makes it even more important to listen to your body and only do what feels right. If you’re unsure, seek out a qualified pre/post natal exercise specialist.

Now for the specifics about spin classes during and after pregnancy…

During Pregnancy:

  • We’ve said it before but we’re going to say it again…listen to your body and don’t push yourself too hard. We mention this specifically in regards to spin classes because they are often pretty high intensity classes. You can definitely modify the intensity by how much or how little you turn the resistance, but it’s still a pretty high intensity class. Monitor your intensity by stopping before you feel overexerted or fatigued or use the talk test (you should be able to comfortably speak…if you can’t, decrease your intensity or take a break). As we’ve written about before, monitoring your heart rate isn’t the recommended way to monitor intensity during pregnancy. If you missed our post on the topic, click here to read it.
  • Don’t do everything the instructor says if it doesn’t feel right to you. For example, getting up off your seat often, as is usually done in spin classes, might be too intense.
  • Be careful not to get too hot. Dress appropriately, stay hydrated and make sure there is plenty of cool air in the room.
  • Spin isn’t the type of class you’d want to start during pregnancy if you haven’t done it frequently before pregnancy.
  • Be sure to adjust the seat and handles appropriately. Arrive to class early and ask the instructor to help you set up your bike if you need help.
  • Upright bikes are uncomfortable for many pregnant women. If that’s the case for you and you’d still like to ride an indoor bike (outside of class), try a recumbent bike.

After Pregnancy:

  • Spinning might be uncomfortable depending on your birth (for example, if you had an episiotomy, a tear or a c-section) and the healing process. As we said before, pain and bleeding are signs not to be ignored.
  • Be sure to adjust the seat and handles appropriately to prevent back pain, which you are at an increased risk for due to weakened abdominal muscles in the postpartum period.
  • Spin classes are usually pretty high intensity so we wouldn’t recommend this type of workout until you have built up a good foundation and have done other less intense forms of exercise first.
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