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1. General Overview of Nine
Months of Pregnancy
FROM CONCEPTION TO
BIRTH

2. The First Trimester
Lasts from conception to the twelfth week of pregnancy
 3 periods during the first trimester:
 The Germinal Period
 Fertilized egg travels and implants in wall of uterus
 Implantation occurs 10-14 days after conception
 The Period of the Embryo
 Lasts from third through eighth week of pregnancy
 Major organs and anatomical structures begin to form
 The Period of the Fetus
 Lasts from ninth week of pregnancy until birth
 All major organs continue rapid growth and become
interconnected

3. The Second Trimester
Fetus assumes distinct human appearance
 The nails harden and skin thickens, as well as the
eye lashes, eye brows, and scalp hair appear during
fifth and sixth months
 Fetus’s visual and auditory senses are functional

4. The Third Trimester
All organ systems mature rapidly
 Fetus prepares for birth
 Fetus reaches „age of viability‟, the point at which
the fetus can survive outside of the uterus
 Fetus shows better-organized gross motor activity,
and sleepiness/ waking activity
 Towards end of ninth month, fetus is positioned
head-down with limbs curled up in „fetal position‟

5. Teratogens
 External agents such as viruses, drugs, chemicals
and radiation that can harm a developing embryo
or fetus.
 Time when organ system or body part is at highest
risk of effects from teratogens is known as
„sensitive period‟.
 Effects of teratogens on a body part or organ
system are worst during the period when that
structure is forming and growing most rapidly.

6. Teratogens
 The same defect can be caused by different
teratogens.
 A variety of defects can be caused by a single
teratogen.
 The longer the exposure or the higher the „dose‟ of
the teratogen, the more likely it is that serious
harm will be done.
 The long-term effects of a teratogen often depend
on the quality of the postnatal environment.

7. Subjective Assessment
 When pregnant female comes to you, the kinesiologist, you
should ask:
 Name
 Age
 Medical history
 Genetic history
 Previous surgeries
 Current/past medications
 If they have ever or are using “street drugs” or smoking
 Alcohol/caffeine use
 Occupation and current working status
 Marital status and children

8. Objective Assessment
 When observing the client, evaluate:
 Height
 Weight
 BMI
 Blood Pressure
 General alignment
 Range painful movement

9. Conditions During Pregnancy
 Constipation
 Affects half of pregnant women
 Causes:
 increase in progesterone
 the colon absorbing more water
 worse in first 13-14 weeks
 Treatment:
 Drink plenty of fluids
 Eat high fiber foods
 Take fiber supplements – psylium husks, Metamucil,
Ex-Lax
 EXERCISE!

10. Conditions During Pregnancy
 Fatigue
 Almost all women report increased fatigue in the 1st trimester.
 Causes:
 Body is working harder
 More levels of progesterone,
 Treatment:
 Take naps
 Drink plenty of fluids, but avoid fluids 2-3hr before bed. Lac
 Exercise
 Gentle stretches before bedtime can help prevent nighttime
cramping
 Eat foods rich in protein

11. Conditions During Pregnancy
 Back Ache
 Many women experience back aches during 2nd and 3rd trimesters
 Causes:
 Poor posture
 Extra weight
 Change in centre of gravity
 Hormones
 Treatment:
 Pay attention to posture
 Exercise
 Swimming
 Pillow support in bed
 Ask for assistance when lifting heavy objects
 Heat/cold
 Massage
 Support belt
 Wear supportive low heel shoes

12. Benefits of Exercise During
Pregnancy
 Maintenance/improvement of maternal fitness
 Control of excess weight gain
 Improved posture and appearance
 Increased energy
 Improved sleep
 Decreased incidence of back pain
 Improved self-esteem
 Decreased incidence of varicose veins
 Decreased water retention
 Decreased level of tension
 Possible decrease in complications during labour
 Shortened labour
 More rapid postpartum recovery

13. Disadvantages of Not Exercising
 Studies have shown that women who exercise do not
experience an increase in:
 Premature Rupture of Membranes (PROM)
 When the membranes that hold the amniotic fluid
break too early.
 Congenital Abnormalities

14. Risk Reduction
 Pre-Eclampsia (Toxemia)
 Occurs only during pregnancy and the postpartum period
 Affects 5-8% of all pregnancies
 Causes blood vessels to constrict resulting in high blood
pressure and a decrease in blood flow to organs and
uterus.
 Having high blood pressure before pregnancy puts you at
risk, also having a BMI of 30 or more
 Characterized by high blood pressure and presence of
protein in the urine
 Symptoms: excess swelling of hands and
feet, headaches, changes in visions, vomiting
blood, ringing in the ears
 Occurs in the 2nd or 3rd trimesters

15. Exercises During Pregnancy
 Low impact aerobics
 Water aerobics
 Walking
 Kegels
 Pilates
 Yoga
 Cycling
 Swimming

16. Kegels
 Help prepare body for labour
 Kegel exercises are easy to do - can be done
anywhere
 Kegels help strengthen the pelvic floor
muscles
 Many women do kegel exercises to prevent
incontinence

17. Yoga (prenatal)
 Help with breathing and relaxation
 Promote feelings of well-being
 Energizing
 Stress relief
 Improve posture
 Meet others who are facing the same challenges
 Note: Avoid positions lying on the back

18. Walking
 Vary the intensity
 Less impact on the knees and ankles
 Easy way to start exercising
 Supportive shoes
 Water bottle
 Spray bottle
 Maintain good posture

19. Exercises to Avoid During
Pregnancy
 Ball sports
 Contact sports: ultimate fighting, wrestling, football
 Sports that involve bouncing, leaping, a sudden change of
direction (increased joint laxity from hormones make joints
susceptible to sprains)
 Exercises that put you at risk for falls: rollerblading,
horseback ridding, skiing
 After 1st trimester avoid exercise in the supine position
 Lying in the prone position
 Lifting heavy free weights

20. Contraindications to Exercise
 Pregnancy induced hypertension
 Premature rupture of membranes
 Preterm labor during the prior or current pregnancy
 Persistent 2nd or 3rd trimester bleeding
 There should be an evaluation to determine whether an exercise
program is appropriate if the woman has conditions such as:
 Cardiac disease, constrictive lung disease
 Chronic hypertension
 Severe anemia
 Chronic bronchitis
 Extreme obesity
 Extreme underweight
 History of an extremely sedentary lifestyle
 Orthopedic limitations
 Heavy smoker

21. Recommendations for Exercise
 Beginners
 non weight bearing activities pose the least risk of injury
 20 – 30 minutes of activity a day at a comfortable pace
 Previously active women
 participation in aerobic activities are generally safe
 Exercise in high altitudes is not recommended
 Running
 can be continued late into pregnancy to maintain fitness, less than 45
min
 Weight training
 light weights and moderate reps will maintain flexibility and muscle
tone and reduce the risk of joint/ligament injury
 Should be able to converse while exercising – vigorous exercise offers
no benefits during pregnancy, only more complications
 Listen to your body – stop if you feel breathless, nausea, dizzy, tired
 Pulse should NEVER exceed 140 beats per minute!

22. Recommendations for Exercise
 Positions/Posture:
 Avoid lying on your back after 12th week of pregnancy
 Abdominal exercises
 Avoid standing for long periods
 Avoid back swaying (lordosis) – cat back stretch,
strengthen abdominals
 Rounded upper back (kyphosis) – chest stretches, upper
back strengthening
 Avoid valsalva maneuver – increase blood and intra-
abdominal pressure
 Avoid lying in the prone position after the 1st trimester