Essential Exercises for the Childbearing Years by Elizabeth Noble
Reviewed by Cristin Tighe
It is good a book like this exists, that provides a thorough overview for women about exercise and physical health during pregnancy and after. The tone is a bit crass and brusque at times, and it feels like it was written awhile ago. Although the book was revised (4th edition) in 1995, it is worth looking into additional, maybe more up-to-date research (e.g., Conscious Pregnancy Yoga and Healthy Moms Perinatal Fitness program). Mothers should note, like Elizabeth Noble says in the book: “… these are only guidelines – there’s no single right way, and what is best for one women is not necessarily best for another.” (p. 11). On the other hand, it is worth it to take her additional advice to heart: “Pregnant women are well-advised to participate in a sound program that incorporates regular, moderate exercise to aid circulation, increase muscle strength, improve posture, and enhance sleep and well-being.” (p. 11).
Elizabeth Noble does provide a good overview of why exercise matters for pregnancy and after. She does an excellent job in the chapters on the Pelvic Floor and the Abdominals giving an overview of anatomy, why they matter so much, and how to maintain strength. She also mentions “Pregnancy taxes the weakest parts of a women’s body and exposes the liabilities of a sedentary lifestyle.” (p. 25), and later says, “The weakest areas in women are the pelvic floor, abdominal muscles, shoulders, arms and wrists.” (p. 45). This is excellent to know, and it can provide incentive to work on overall body exercise consciously.
It is a confusing when she mentions “Physical preparation is important during pregnancy, but postpartum restoration is even more important.” (p. 19). It seems like all of the postpartum issues women face could be lessened if the mom is in shape before getting pregnant, or if she does regular exercises while pregnant. The chart on page 20 of all the health problems, which can be avoided by exercising during pregnancy, is excellent motivation for any pregnant women to start. Most women think that their abdominals are most impacted, but may not realize the posture, spine, low back and shoulders all suffer so much when the core (abdominals and perineum) are weak. It is also good for women to realize that postpartum healing, being tired, carry a baby, and breastfeeding can all have a kind of exponential negative impact on body health in many ways, which should provide even more incentive to do exercises regularly before and after baby.
Despite this, the book highlights and gives concrete things to do to improve the strength and health of the pelvic floor and the abdominals, both key during pregnancy, labor/birth and after birth. Elizabeth Noble provides not only concrete exercises that are specific to each woman’s needs, but also excellent explanation of the background and understanding of why these are useful. The Principles of Exercise (Chapter 2) can really empower women to take care from the start. The easy-to-use summary exercises are helpful; see Summary of Essential Prenatal Exercises on p. 227, Summary of Essential Postpartum Exercises on p. 229 and Summary of Essential Post-Cesarean Exercises on p.231. In addition to specific muscle groups to target and exercises to target, she highlights safety features (Posture, Position and Comfort in Chapter 5), as well as brings in some key things for pregnancy like Relaxation (Chapter 6), Breathing (Chapter 6), and Partner Exercises (Chapter 7) and specific needs like Cesarean Birth (Chapter 9) and Bed Rest (Chapter 10).
The book, although revised, is not the most modern educational tool. It is an excellent book for childbirth educators, doulas, fitness instructors, osteopaths, physical therapists and yoga teachers for a starting reference to begin to work with pregnant and post-partum women. It seems like the timing of this book was signifiant to help with the shift earlier in history that validates why and how pregnant women can exercise and to empower women around their own bodies and choices. But for now, it seems a bit out-dated with its tone and extensive descriptions. Now, we understand the safety precautions and positive benefits, so the significant thing is to provide information to new moms in an easy-to-use, time efficient way, so they have the incentive to exercise now. Many pregnant women in these modern times, especially those working, need accessible information to get to exercising quickly, and maybe less details and background. Basically, they need experience more than education. It would be great to see some pod casts that guided moms or DVDs that went through each of the Summary exercises, or an interactive website that teaches this information to women online. This sort of offering could really empower mothers around body awareness, connection to inner strength and power, and maybe help them connect within to their power to birth with less interventions and more instinctually.
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