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Written by Mary Ann White, PTA

​Are you wondering how exercise can help you during pregnancy or what kinds of exercises are safe? Exercise is appropriate for most healthy women with uncomplicated pregnancies. ​

If you have gestational diabetes

• Exercise about an hour after a meal to keep your blood glucose level stable.
• If your blood glucose levels drop below 100 mg/dL during or after exercise, consume 15-20 grams of fast acting carbohydrate every 15 minutes until blood glucose is above 100 mg/dL
• Postpone exercise if your blood glucose level is above 240 mg/dL or you are sick
• Exercise at the same time each day, if possible
• Have a bedtime snack to keep blood glucose stable overnight
• If you are on insulin or medication, check with your physician about the proper timing of exercise and medication

Avoid activities that put you at risk for falling, injury or other complications

• Contact sports like ice hockey, boxing, soccer, basketball
• Activities with a high risk of falling like surfing, skiing, off-road cycling, gymnastics
• Hot yoga and hot Pilates
• Avoid exercising in a supine position (on your back) after the 1st trimester
• Avoid prolonged standing

Stop exercising and consult your physician if you experience:

• Vaginal bleeding or leakage of amniotic fluid
• Regular painful contractions
• Shortness of breath before physical activity
• Dizziness or sudden headache
• Chest pain
• Muscle weakness that affects your balance
• Calf pain or swelling

For more information, see:

• Physical Activity/Exercise and Diabetes:  A Position Statement of the American Diabetes Association (2016)
• The American College of Obstetricians and Gynecologists Committee Opinion:  Physical Activity and Exercise During Pregnancy and the Postpartum Period (number 650. December 2015)

“I am so fortunate to live in America,” Theresa continued. “My Irish in-laws call me ‘A spoiled Yank’. I used to love it when they referred to me that way. I have everything a person could want. Except that now I am terrified of being in public and have to wear adult diapers. I do not feel like a spoiled Yank anymore.”

I knew that Theresa was at the end of her tether. She had tried prescription medication, daily Imodium, altering her diet and kept her legs tightly crossed at all times to avoid what still happened. I explained to her what Pelvic Floor Physical Therapy was all about. That in this type of clinic, we would do an internal examination to discern if the muscles of her perineum might be driving the fecal incontinence.

“I have been through so much already. If you have to do an internal examination, so be it,” Theresa declared. After an exam of the musculature of Theresa’s pelvic floor, it felt as though her muscles were in moderate to severe spasm. These muscles control urination and defecation; they were firing so rapidly that she could not contain feces within her colon, and worked incessantly to force it out. The function of the large intestine is to pull water out of our foodstuffs and allow feces to become solid. This was not happening in Theresa’s case, because the food was not in her colon for enough time, and her stool was unformed and messy. This explained her chronic diarrhea.

The treatment plan for Theresa included deep breathing, relaxation of her pelvic floor muscles and some natural over-the-counter additives to bulk up her stool. “This sounds counter-intuitive to me,” Theresa said at first. “If I relax the muscles, then won’t more feces escape unplanned?” I smiled at her and explained that if she wanted to try something new, she would have to trust me.

It took almost three months of once-weekly treatment in our clinic, with a really good home program, for Theresa’s symptoms to subside. But subside, they did. She now has solid bowel movements twice daily and can control them wonderfully. Gone are the pull-ups and the fear of accidents. Her commute to work and social life have been restored to normalcy.

“I cannot believe how this treatment has helped me! I wonder if this would be available to my relatives in Ireland? I hope so. But at any rate, I feel like a ‘spoiled Yank’ once more,” Theresa remarked. Pelvic Floor Physical Therapy is gaining rank, accessibility and respect all over the world. It likely is available to her in-laws in Donegal, Ireland. The trick is to find ways to talk about these issues and overcome the embarrassment surrounding words like rectum, feces, and stool.

This is what we do, as pelvic floor physical therapists. One client at a time. For spoiled Yanks, people from Ireland and every other continent, men and women, young and older, there is help. We live in a time when anything is possible.