B.

Sc DEGREE COURSE IN NURSING (BASIC)

MIDWIFERY AND OBSTETRICAL NURSING
UNIT III : ASSESSMENT AND MANAGEMENT OF PREGNANCY
(ANTENATAL)

ANTENATAL EXERCISES
 OBJECTIVES

The student will be able to

• understand the purposes of antenatal exercises.
• Mention the types of antenatal exercises.
• Explain the benefits of antenatal exercises.
• Demonstrate the antenatal exercise to the mothers.
• List down the contra indications to exercises
• Discuss the Nursing guidance for exercise CONTENT
OVERVIEW

• Introduction
• Purposes of antenatal exercises.
• Benefits of antenatal exercises.
• Types of antenatal exercises.
• Contra indications to exercises
• Nursing guidance for exercise
INTRODUCTION

Exercise during child bearing year is not harmful to either

mother or baby. Antenatal exercise can relief back pain,
improving muscle strength and flexibility and improve energy
level. The aim of exercising in pregnancy should to maintain the
woman's level o fitness
 DEFINITION

• Exercise involves the physical and mental ability to participate

in carry out the better functions of the body throughout the

pregnancy
 AIM

Antenatal exercise aim to prevent low back pain and

enhancing physical and psychological preparation for delivery by

mean of joint stretching and muscle strengthening.

PURPOSES

• Improve posture and correct body mechanics

• Upper and lower extremities strengthening

• Improve circulatory compromise

• Control of pelvic floor musculature

• Maintain abdominal muscle function

• Improve relaxation

BENEFITS OF ANTENATAL EXERCISES

• It improve the circulation of mother and child

• It helps reduces pain during pregnancy like cramp and back ache

• It help to control weight gain

• It reduces stiffness in muscles swelling and pain

TYPES OF ANTENATAL EXERCISES

1. Breathing Exercises5. Foot &Leg Exercises

2. Abdominal Tightening ✓ Ankle rotation

✓ Calf stretching
3. Pelvic tilting or Rocking
6. Others
4. Pelvic floor Exercises ✓ Rib cage lifting
✓ Kegel’s Exercises ✓ Shoulder circling
✓ Walking
✓ Tailor Sitting
✓ Jogging
✓ The Squatting posture
 1. BREATHING EXERCISES
• Breathing exercise use to pain
relief during labour.
Steps
• Sit comfortably with eyes closed.
• ‘Listen in’ your breathing
,concentrating especially the
outward breath, recognizing the
short pause before the inward breath
naturally follows.
• A few deeper breaths now and again
will help the venous return and aid the
oxygen supply to both the pregnant
women and her baby but only 3 (or) 4
breaths at a time as hyperventilation
is more likely during pregnancy.
2. ABDOMINAL TIGHTENING
Steps
• Sit comfortably or kneel on all fours.
Breathe in and out.
• Pull in the lower part of part of the
abdomen below the umbilicus whilst
continuing to breathe normally. • Hold
for up to 10 seconds • Repeat up to
times.
Purpose
• it will help to prevent back ache in the
future.
 3. PELVIC TILTING OR ROCKING

• In a half- lying, well supported with

pillows, knees bent and feet flat.
• Place one hand under the small of the
back and other on top of the abdomen.
• Tighten the abdominals and buttocks,
and press the small of the back down
onto the underneath hand .Breath
normally, hold for up to 10 seconds and
Purpose: It plays important part in good future.
then relax. It helps to maintain the tone of the muscles to
• Repeat up to 10 times. retain their functions. They will also relax
during parturition and regain their former
strength quickly duringpuerperium
the .
 4.PELVIC FLOOR EXERCISES
✓Kegel’s Exercises
Steps
• Sit, Stand or half –lie with
legs slightly apart.
• Close and draw up around
the back passage as through
preventing a bowel action. 4.PELVIC FLOOR EXERCISES
Purpose (CONTD-)
Stretch the pelvic floor muscles for birth
 ✓Tailor Sitting Purpose
The beginner should remain in Stretch the pelvic floor muscles for
this position for about 5 minutes at a birth and to strengthen the thigh
time, gradually increasing to intervals muscles
of 15 mts to 30 mts .Since this
position significantly decreases the
circulation to the legs and feet ,the
women should “shake out her legs
every few minutes and then return to
the position.
 ✓The Squatting
posture
It is the preferred
method of lifting( or)
reaching for low objects

4.PELVIC FLOOR EXERCISES

(CONTD-)
during pregnancy in Stretch the pelvic floor
squatting position muscles for birth.
Purpose
 5. FOOT AND LEG EXERCISES

✓Ankle rotation
• Sit on chair with your back against
seatback.
• Start with one ankle and turn foot
upward and downward for 10 times.
• Repeat the same at the other ankle.
• Repeat the ankle to draw inward and
outward circle
• Repeat the same at the other ankle.
• It help to reduce leg swelling and
varicose vein
5. FOOT AND LEG EXERCISES(contd-)
 • These exercises should be performed
✓Calf stretching before getting up from resting, last thing
at night and several times during the
a.Stand with your feet slightly apart and
your hands on the back of chair (or) some
other objects that offers secure support.

b.Slide the foot of the cramped legs as for

as possible, without letting the head leave
the floor.

c.Bend the knees of the other leg. Return

to first position and relax performs several day.
times.
 6. OTHERS
✓Ribcage lifting • Initially the exercises can be
repeated 5 times with each arm
• Instruct the women to inhale while and gradually increased to ten
extending the right arm with elbow times Purpose
slightly flexed above her hand. Ribcage lifting to relieve shortness of
• With arm extended ,she should then breath
exhale ,extending then exhale,
extending the arm further as she feels
the muscles of her right side stretch.
She should stretch inhale again, return
to the starting position, and repeat the
exercise with left arm.
Other exercises (contd-)
 ✓ Shoulder circling
In this exercise she should inhale as the shoulders are rotated and
exhale as the circle is completed and the shoulders have return to the
starting position.

The exercises can be repeated 10 times, relaxing between each rotation.

Purpose:

Shoulder circling helps to strengthen the muscles of the upper back and
can be used to relieve upper back ache.
 ✓ Walking

• Walking is a good cardiovascular exercise and one of the best

exercise for pregnant women
 ✓ Jogging

• Jogging is best exercise to work body and heart

 ✓ Yoga

• Yoga help to maintain muscle tone and make body flexible

 7.BIRTHING BALL EXERCISES DURING
PREGNANCY

Importance
• Sitting on a birthing ball is also great
exercise. It can strengthen your
stomach and back muscles, improve
your posture, and prepare body for
delivery.
• Sitting in an upright position can
also change your baby from a
posterior position to an anterior
position, which may also relieve
back pain.
 Birthing ball safety tips

• Ball should be firm but have a little give, so can gently bounce or roll back
and forth while sitting.
• When it comes to ball size, go by according to height.
• According to Mayer:
Shorter women usually benefit from a 55 cm ball.
Medium size women from a 65 cm ball.
Tall women from a 75 cm ball.
SPECIAL EXERCISES

These Special
exercises mother
can accomplish
after consulting with
her obstetrician
 1. Squats
Steps want them to descend in this direction.
1. Stand straight with your feet a little
wider than shoulder-width apart, toes When to avoid?
pointing out (45 degrees), shoulders If the baby is not in a head-down position,
pinched back, and chest forward. ... avoid performing squats. Squatting might
2. Inhale, push your hips out and push the baby’s bottom further down to
squat down, and keep your body the pelvis into an awkward position. If the
weight on your heels. ... 3. Hold this baby turns into an optimal position (i.e.,
pose for 2 seconds.
head-down), then you can start squatting
4. Exhale and get back up to the starting again.
position.
When to do?
When baby is not in optimal birth position
after 30 weeks gestation – Squats help
baby to descend deeper down into the
pelvis. So, if baby's feet or bottom
(breech position) are presenting we don't
2.Butterfly Steps
1.Sit on the
exercises floor with
your back
erect and legs straightened before you.
2.Now bend your knees and bring your feet
towards your pelvic bone. Join the soles of your
feet together and bring them as close to your
groin as you can.
3.Now hold your feet together with your knees
pointing to the opposite sides.
4.Slowly press your knees towards the floor as low
as you can. Do not do jerky movements and press
softly. If you cannot touch the floor, it is okay; and
go as low as you can.
5.Now, press your knees up and then do it again.
6.Do these little pulses for as long as you feel
comfortable. Stop the exercise if you start feeling
any pain or discomfort.
Why to do?
1.It eases tired legs during
pregnancy. 2.It opens up the Pelvic
muscles which make standard
delivery easy.
3.It opens up the Thighs and Hips and
improves flexibility.
4.It helps in initiating faster delivery during
labour.
5.It also helps in enduring the pain during
labour.
3.CAT &CAMEL
EXERCISES

4.BRIDGING EXERCISES
SAFETY RULES FOR EXERCISE DURING
PREGNANCY
1. Check with your health care provider first
2. Take in Extra Kilocalories
3. Steer clear of dangerous sports
4. Wear the right cloths
5. Warm up
6. Drink plenty of water
7. Don’t lie flat on your back
8. Keep moving
9. Don’t over do it
10.Don’t get overheated
11.Get up from the floor slowly
 12. Cool down
13. Make it a habit
CONTRAINDICATIONS TO EXERCISE
• Pregnancy induced hypertension

• Preterm rupture of membrane

• Preterm labour

• Incompetent cervix

• Placenta praevia

• Intrauterine growth retardation

• Thyroid dysfunction
• Cardiac disease

• Vascular disease
 References
• Miles c Benjamin “text book of obstetric and
gynaecology” 2nd edition page no:249-254.
• Dutta dc “text book of obstetric and gynaecology”3 rd

edition page no 120-122.

• www.antenatal exercise. com
THANK YOU