Gebelik ve Egzersiz Yapma

Genel olarak, kendini aşırı yoracak kadar olmadığında ve bebeğine ve kendine zarar verecek bir egzersiz yapmadığı durumlarda egzersiz kısıtlaması yapılmaz. Son günlerde pek çok gebe kadın jogging bile yapmaktadır. Gerçekte tıbbi kontrendikasyonlar olmadıkça gebeliğin geç dönemlerinde bile maraton koşan gebeler vardır.gebelik ve egzersiz

Clapp 1989’da yaptığı araştırmada gebe kadınlarda düzenli egzersiz yapıldığında oksijen ihtiyacının azaldığını göstermiştir. Pivarnik 1990 da yaptığı araştırmada yürüyüş ve bisiklet yapan sağlıklı gebe kadınlarda oksijen tüketiminin azaldığını, kalbin daha sağlıklı çalıştığını göstermiştir. Egzersiz yapan kadınlarda daha fazla kan hacmi oluştuğu gösterilmiştir.

Egzersizin gebelik sonuçları üzerine etkisi pek çok araştırmada benzer çıkmıştır.1990 ve 1995 yıllarında yapılan iki araştırmada (Clapp ve capeless, Clapp ve little) 47 koşucu ve 40 dansçı hamile kadın maximum kapasitelerinin %50-%85 i kadar aerobik egzersizleri gebelik sırasında düzenli olarak yaptıkları halde sonuçta düşük riski artmamıştır. Gebelik öncesi kondisyonu olan ve gebelikte aerobik ve koşu yapan ( düzenli olarak) kadınlarda ortalama doğum süresi daha kısa sürmüş, daha az sezaryen oranı bulunmuş ve bebeklerde fetal stres ve mekonyum yapma oranı daha az bulunmuştur.

Gebelik sırasında egzersizlere düzenli devam eden hamilelerin bebeklerde ortalama 310 gr daha az ağırlık tesbit edilmiş ancak bu azlığın bebeğin yağ dokusunun azlığı olduğu görülmüştür. Bu durum fazla kalori alan kadınlardaki daha iri bebek doğurma durumu ile uyum sağlamaktadır. Olasılıkla egzersiz yapan kadınların fazla kalori yaktıkları için bebekleri egzersiz yapmayan kadınların bebeklerine göre daha az kiloda doğmaktadır. Ancak daha az kilo demek zayıf ya da geri demek değildir. Asıl egzersiz yapmayan kadınların bebekleri gereksiz yağ dokusu ile 310 gr fazla doğmaktadır.

Amerikan Kadın Doğum ve Jinekoloji Koleji gebelik öncesi aerobik egzersizlere alışkın olan kadınların gebelik sırasında buna devam etmelerini önermektedir. Ancak yeni tip aerobik egzersizlere başlamak ya da daha zor aerobik egzersizlere geçmek önerilmemektedir. Örnek olarak gebelik öncesi hiç spor yapmayan bir kadına gebelik sırasında sadece yürüyüş önerilmektedir.

Bazı durumlarda egzersiz önerilmez. Bu durumlarda hastanın istirahati kendine ve bebeğine daha fazla yarar sağlar. Gebelik toksemisi (hipertansiyon), ikiz ve üçüz gebelikler, gelişme geriliği olan gebelikler ve kalp hastalığı olan gebelere fazla egzersiz önerilmemektedir.

Egzersiz sırasındaki 2 önemli değişiklik olur. Birincisi vücudunuz dalak, böbrek gibi organlara giden kan akımını azaltır. Egzersiz şiddeti arttıkça rahme (dolayısıyla bebeğe) giden kan akımı azalabilir. İkinci değişiklik egzersizde vücut ısısı artar. Vücudunuz bu artmış ısıyı cildinizdeki damarları genişleterek kanı buraya gönderir ve vücudunuzu soğutur. Bebeğiniz ise bunu yapamaz ve yüksek ısıya maruz kalabilir. Bu nedenlerden dolayı egzersiz yaparken maksimum kapasiteye ulaşmamak ve vücut ısısına dikkat etmek çok önemlidir.

Maksimum kapasite: Herkesin maksimum kapasitesi değişiktir. Gebelikte önerilen maksimum kapasitenize ulaşmamanızdır. Maksimum gücünüze ulaştığınızı iki şekilde anlayabilirsiniz. Birincisi eğer egzersiz yaparken konuşabiliyor, cümle kurabiliyorsanız (nefes almadan) hala maksimum kapasitenize ulaşmamışsınızdır. Konuşurken cümleyi kesip nefes almak ihtiyacı hissediyorsanız durmanızı tavsiye ediyoruz. İkinci yol nabız sayısına bakmaktır. Egzersiz yaparken nabzınızın 154- yaş sınırını geçmemesini isteriz. Örneğin; 30 yaşındaki kadın için 154-30=124 sınır değerdir. Nabız bu sınır değeri geçiyorsa maksimum kapasitenize dayandığınızı ve durmanız gerektiğini gösterir.

Genel öneriler

  • Riskli olmayan gebelere (kalpi hipertansiyon) hafif ve orta derecede egzersiz yapması önerilir.
  • Ağır egzersizler hiç bir gebeye önerilmez.
  • Gebelik öncesi egzersize başlamanız gebelikte egzersizleri daha kolay yapmanızı sağlar.
  • Egzersiz yaparken vücudunuzun aşırı ısınmamasına dikkat edin. Üstünüze bol, rahat kıyafetler giyin, bol su için.
  • Egzersiz yaparken rahat bir ayakkabı giyerek burkulma ve kaymalardan korunun.
  • Denge gerektiren kayak, paten, at binme gibi egzersizleri son 3 ayda yapmayın.
  • Egzersizi aşırı güneş altında veya soğukta yapmayın.
  • Egzersiz sırasında maksimum kapasitenizi zorlamayın, nabız testi ya da cümle testi ile kendinizi kontrol edin.
  • Egzersiz sonrası sauna düşük ısıda ve kısa süreli (10 dakikayı geçmeyecek) olmayacak ise kaçının. Aşırı sıcak-soğuk duş almayın.
  • Egzersizi düzenli yapıyor iseniz kan şekerinizin düşmemesi için aralıklı karbonhidrat alımınızı ayarlayın.
  • Lohusalık döneminde bu sınırlamalar pek olmaz. Genel kural: If it feels good and nothing hurts unreasonably, do it! (İyi hissediyor ve canınız nedensiz yanmıyor ise yapın!)
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