by James F. Clapp, III, MD.
This is the best book I've read on the subject of exercise and pregnancy.
Woven throughout is a review of the scientific studies about what we do and don't know about exercise and its effects on fertility, pregnancy, lactation, though written in layperson's terms. Clapp is a scientist who himself is the author of many of those studies. Given this focus, the book is not a light, "easy read" but it's not difficult, either. I highly recommend it to anyone looking for motivation to exercise during childbearing. Clapp makes a very compelling case for how exercise benefits both expectant moms and their babies.
The author goes into quite a bit of detail about the many adaptations the female body makes to handle the demands of pregnancy, and how these adaptations are often complemented by the adaptations brought about by regular exercise. He describes changes and challenges at every stage of pregnancy and postpartum. He is careful to make distinctions between women who exercise throughout their entire pregnancies, women who begin exercising during pregnancy, and women who are exercising early in pregnancy, then stop. In many cases, there are differences in the benefits that each group of women and their babies can gain from an exercise program.
Some of Clapp's findings were a pleasant surprise, and I hope that additional research will bear them out. Among other fascinating results, Clapp finds that exercising women are far less likely to require interventions during childbirth. Specifically, he says that women who exercise throughout pregnancy:
- deliver 7-8 days sooner, but are much more likely to carry to at least
37 weeks
- are 35% less likely to need pain relief during labor
- are 50% less likely have membranes ruptured artificially
- are 50% less likely to need labor induced w/ pitocin
- are 55% less likely to need an episiotomy
- are 75% less likely to need a c-section or forceps delivery
- have 1/3 shorter labors
- are much more likely to breastfeed (over 95% of their test subjects over
the years have)
Clapp also says that babies of exercising mothers are much better at
handling the stress of labor because the moderate stress of exercise
produces certain adaptations in the baby such as a bigger, healthier placenta, and increased ability to deal with short decreases in oxygen.
Clapp does not prescribe a specific exercise program, believing instead that most healthy, low-risk women can continue their pre-pregnancy activities and training programs during pregnancy. He does outline basic guidelines on designing an exercise program for pregnancy, and describes categories of women (such as competitive athletes) who should seek special advice from doctors and trainers to design a personalized program. He also lists situations where exercise is contraindicated, though his list is less conservative (based on his own research) than that of the American College of Obstetrics and Gynecology.
Clapp also provides comforting information for women who may fear that their activity level is affecting their fertility in some way. Though there are certainly cases where vigorous training programs result in a disruption in the menstrual cycle, Clapp explains how certain stereotypes and prejudices have affected opinions of the relative fertility of exercising women.
All in all, this book gave about a thousand good reasons to continue to
exercise throughout the duration of pregnancy, and it is serving to keep me motivated as I get bigger and more uncomfortable. I consider it a must-read for expectant moms who are serious about fitness or athletics. It may also help educate loved ones (or even doctors!) who are unsupportive of an active pregnancy.
Wendy Niemi Kremer
1/4/99
