Keeping it Real with Dr. Michelle Mele

Q: Welcome to Keeping It Real. Tell us about yourself.

A: I am currently practicing obstetrics and gynecology at Pennsylvania Hospital. I'm a graduate of Jefferson Medical College, and I did my residency in obstetrics and gynecology at Pennsylvania Hospital.

Q: What kind of patients do you see?

A: I see all types of obstetric and gynecologic patients. I take care of patients of all ages, from their teenage years through menopause.

Q: This week, we're discussing exercise during pregnancy. Is it wise to work out during pregnancy? Why or why not?

A: In the absence of either medical or obstetric complications, participation in a wide range of recreational activities is accepted as safe and is recommended during pregnancy.

Q: Are women limited in the kind, frequency or amount of exercise they can do during pregnancy?

A: I always encourage my patients to engage in regular physical activity throughout their pregnancies to continue to derive the same health benefits as they did prior to pregnancy. The kind, frequency and amount of exercise needs to be tailored to the individual woman. The American College of Obstetrics and Gynecology recommends 30 minutes or more a day of moderate-intensity activity as long as a woman has an uncomplicated pregnancy. There are some pregnant patients in which exercise can be harmful to mother and baby. Therefore, it is very important that women consult with their doctors early in pregnancy to discuss if exercise is safe for them.

Q: What are some good exercises for pregnant women? Which ones, if any, should definitely be avoided?

A: Most types of exercise are safe. The exercises my patients seem to enjoy include: swimming, walking, biking and yoga. There are, however, some exercises that should be avoided. Sports with high potential for contact like ice hockey, soccer and basketball may result in injury to the mother and fetus. Sports associated with an increased risk of falling like horseback riding and downhill skiing should generally be avoided during pregnancy. Activity that requires women to lie on their backs should be avoided. In addition, scuba diving should be avoided throughout pregnancy because the fetus is very susceptible to decompression sickness.

Q: Should exercise be discontinued after women reach a certain point in their pregnancies?

A: No, as long as the pregnancy remains uncomplicated and a woman feels well, it is usually safe to continue exercising up until delivery.

Q: What questions should women ask before exercising during pregnancy?

A: Once a woman is given the "OK" by her doctor to exercise during pregnancy, she should ask her doctor for advice on what types of activity would be safe for her. Women should also make certain they ask their doctors about and understand any warning signs to stop exercising. Symptoms such as bleeding, cramping or contracting, abdominal pain, chest pain and decrease in the movement of the baby are only just a few of the many symptoms patients need to be aware of while they are exercising. Of course, if any of these symptoms are present, a woman should contact her doctor immediately. In addition, it is always important for pregnant women to remember to stay well-hydrated while they exercise by drinking plenty of water.

Q: What are the primary concerns in deciding to exercise during pregnancy?

A: In pregnancy, the health of two individuals has to be considered when deciding to begin or continue an exercise routine. This is why it is important that a woman discuss her wishes to exercise with her doctor, so they can decide together if it is safe for both mother and baby.

Q: What impact does working out have, if any, on labor and delivery?

A: Working out clearly has a positive effect on labor and delivery. There are some studies that suggest that women who perform regular aerobic activity have shorter labors and fewer cesarean sections. Exercise has also been shown to help pregnant women sleep better, decrease their level of fatigue and help prevent constipation.

Q: What role should the OB/GYN play in a woman's decision to workout during pregnancy?

A: Obstetricians treat all of their patients as individuals. Once a woman is told by her doctor that it is safe for her to exercise, the obstetrician's role should include advice on types of exercise that are safe for that individual woman and lots of encouragement.

Q: Are there any good resources or Web sites that might be helpful to women looking for more information on the subject?

A: There are many excellent resources on the Web. There are two Web sites that I like: www.webmd.lycos.com and www.babycenter.com are both very informative.

Q: How do you stay fit?

A: I enjoy rollerblading, biking and yoga.