Precautions for practicing while pregnant

From Aikido Today Magazine (Vol. 4, No. 1 Spring 1990)
The article is from the column 'Ask Mark', written by Dr. Mark Adachi.

The value of exercise in prenatal care has been a controversial topic for many years. In the past, it was standard medical practice to forbid any sports or vigorous exercise for the entire term of pregnancy. Recently, though, prenatal exercise has been recognized as an aid in controlling weight, reducing musculoskeletal pain, easing delivery, and speeding postnatal recovery. The prenatal exercise programs most often recommended include stretching, back and abdominal muscle strengthening, and mild aerobic conditioning.

While Aikido no doubt meets many of these requirements, there are some serious problems with Aikido practice during pregnancy.

The first and foremost of these problems has to do with ukemi. Ukemi should be recognized for what it is: a highly controlled method of preventing injury from falls. No matter how well ukemi is performed, uke's body still falls to the mat, the net force of the fall being directly related to the uke's body mass and acceleration. The traumatic force involved when uke's body hits the mat is considerable, and it must be dealt with in some safe way. This is usually not a problem, but, when uke is pregnant, even a fraction of this traumatic force may shock the fetus, possibly resulting in miscarriage -- especially in first pregnancies and in the first trimester of pregnancy, when the likelihood of miscarriage is increased. In the first trimester all falling, even forward and backward rolling, should be avoided.

In addition, much of the Aikido repertoire consists of pinning techniques, which result in uke landing in a prone (face-down) position. The direct shock of the abdomen hitting the mat in these techniques is not safe early in the pregnancy, and lying in this position is nearly impossible later in term due to the abdomen's increased size.

Pregnant women should also beware of kansetsu waza (joint locking techniques) such as ikkyo, nikyo, and sankyo. Among the many hormonal changes that occur during pregnancy is an increase in relaxin -- a polypeptide hormone that allows the opening of the pelvis during delivery. As its name suggests, this hormone relaxes the ligaments of the entire body. The relaxation may cause some minor joint instability, increasing the likelihood of sprains and strains. Pregnant women should therefore be especially careful with techniques that may put large amounts of torque on their joints.

If being uke is not a good idea during pregnancy, what about being nage? In general, practicing in the role of nage can be continued well into term if two considerations are kept in mind:

First, care must be taken to maintain an adequate oxygen supply for the fetus. If exercise becomes too strenuous, the mother's cardiovascular system, which must support both her and the fetus, will shunt blood away from the fetus. Also, exercise may put the fetus into oxygen debt if the mother's blood is not able to carry enough oxygen. It is therefore advisable for the expectant mother to limit her maximal heart rate to 140 beats per minute or less -- quite a bit lower than the usual limit, which is 220 minus one's age. It is also advisable for the expectant mother to limit periods of aerobic exercise to fifteen minutes.

Second, it is wise for pregnant Aikidoists to avoid certain common Aikido movements. As a fetus grows, a pregnant woman's center of gravity shifts, causing the swayback posture characteristic of the expectant mother. The condition of having the increased curve, called hyperlordosis, makes a woman's posture biomechanically weaker and predisposes her to chronic lower back pain. Unfortunately, the posture Aikidoists adopt when using the hara or koshi in many strong kokyu movements is also slightly hyperlordotic and stressful for the lower back muscles. So, pregnant women should avoid these movements -- or, at least, be very careful when attempting them.

A general rule of thumb regarding pregnancy and sports (Aikido included) is that usually, if a woman has been actively involved in an athletic activity before becoming pregnant, she can continue until the third trimester. So, if a woman has been actively involved in Aikido practice prior to pregnancy, and if she observes the precautions I have mentioned, she should be able to continue Aikido practice for quite a while into her term. But, if a woman has stopped training before becoming pregnant, she should not start up again during pregnancy. And even highly athletic women almost always restrict their activities drastically during the third trimester. There are women, of course, who continue right up to delevery -- but this is rare, and the wisdom of these womens' decisions is questionable.

Women vary tremendously in the problems associated with their pregnancies. So, pregnant women should consult with their obstetricians regarding their individual cases.

For more information on this topic, ask your doctor for the ACOG (American Colleges of Obstetricians and Gynecologists) guidelines for exercise and pregnancy. Much of the information in this article was drawn from these guidelines.