September 2013 | A Better You | Pampering During Pregnancy

A Better You
How to make nine months of change easy on the body
By Suzanne Martin, PT, DPT

You got the happy news: you’re pregnant! Now what? There are so many things to consider. How do you handle the demands of pregnancy while maintaining your teaching load? What can you do to help make sure your baby will be healthy? How can you sail through your pregnancy as smoothly as possible, and land postpartum fit and healthy? Here are some tips on how to juggle the joys of expecting with the joys of dancing.

In all likelihood you’ll know you’re pregnant right away. Dancers, body conscious and often slight of build, will probably notice swelling or gastric upset immediately. But your body is undergoing even more important changes. The neural tube—the nascent fetal spinal cord and brain complex—is formed within the first 22 days of pregnancy. That means that the mother’s body gets to work forming the most vital of the baby’s body parts, the nervous system, from the moment of conception.

For this reason, anyone who is trying to get pregnant, or even entertaining the possibility, should take folacin supplements in addition to general vitamin supplements. Folacin is essential for normal neural tube development and can be found in many foods such as lentils, dark leafy greens, and other vegetables. However, some studies show that folacin is absorbed better when taken as a synthetic supplement, known as folic acid, than when obtained by eating folacin-rich foods.

To help prevent neural tube defects, the CDC recommends that women take 0.4 mg of folic acid daily starting a month before becoming pregnant. Many recommend that all women of childbearing age ingest this amount daily.

Most people wait until after the first trimester to announce their joyous news, since this is the period during which miscarriage most often occurs. But keeping a pregnancy secret might not be a good idea, or even possible, for dance teachers.

Even if you’re not performing, and you think you’re not demonstrating full-out, you’re probably on your feet and very active for a good part of the day. Many women can teach throughout their pregnancies. There are, however, some issues you’ll need to keep in mind.

Dehydration

Don’t let dehydration become a problem. I knew a dancer whose nausea was so intense during her first trimester that she became severely dehydrated and ended up in the hospital receiving IV fluids.

Another teacher, who couldn’t enter the grocery store without becoming nauseated, recruited her husband to shop. She kept nausea (and potential dehydration) at bay by eating crackers and bits of papaya before her classes. Keeping a starchy element in the stomach can neutralize stomach fluids; and papaya is a digestive aid. Drinking small sips of water during class in order to avoid drinking too much at once will help keep the stomach calm.

Musculoskeletal issues

Dancers tend to be flexible, and increased levels of the hormone relaxin during pregnancy loosen ligaments to prepare the pelvis to open for birth. This can cause a variety of problems.

Teachers who have a history of back problems should be especially careful. If you’ve ever had back issues, I strongly recommend wearing a maternity belt. There are a few different types, but all are designed to support the back and lift the belly. Wearing one can decrease back strain and pelvic aching, especially while teaching. Choose one that provides as much support under the belly as possible. A wider low back strap is also more comfortable than a thinner one.

After about the third month, pregnant women are advised to avoid sleeping on their back. The added weight of the uterus can put pressure on the spine and muscles, leading to back pain. Increased pressure on blood vessels decreases the mother’s circulation, which in turn decreases blood flow to the fetus.

Avoid over-stretching. Some dancers might think pregnancy is an opportunity to improve their flexibility because of the increased relaxin levels. However, overstretching can set you up for injury down the road. Be especially careful not to overstretch pelvic ligaments.

Forward straddle splits in particular should be avoided. Although an enlarging abdomen may prevent a dancer from placing her chest on the floor, this position pulls the pelvis apart in a way that may cause sacroiliac (low-back) pain, or even permanent damage. In rare cases, overstretched pelvic ligaments may cause the baby to drop prematurely, and activate bed rest orders. If you do pelvic stretches, maintain active muscle tone and don’t stay in the stretch too long.

For pregnant women, a second-position grand plié stretch is a recommended alternative to prolonged chest-on-the-floor stretches. Use your thigh and gluteal muscles to hold yourself from going too deeply. This also builds muscle tone and stamina in preparation for childbirth.

Leg and foot pain

One of the biggest complaints during and after pregnancy is leg and foot pain. Expect swelling; pregnancy tends to block the flow of blood from the legs back to the heart. Wearing tighter tights or compression stockings can help prevent swelling.

Getting rid of swelling requires elevating the legs above heart level—sometimes an impractical position to assume. Therefore, the best approach may be to avoid swelling by sitting about every 20 minutes while teaching, as well as wearing supportive tights. That said, you can and should elevate your legs in the evenings, when your day is over.

Foot ligaments also loosen, a problem for dancers with already flexible feet. Be sure to keep feet active by doing foot-grabbing exercises like scrunching up a towel on the floor with your toes. Also consider wearing shoes that offer more support than most teaching shoes do. Split-sole dance sneakers are a good choice.

If you need more support, try orthotics. A company called Hapad makes lamb’s wool inserts that offer support and cushioning. There is a full-length insole, but my favorite is the Comf-Orthotic 3/4-Length Insole, which has enough arch support to take the pressure off the sole of the foot and can get you through those times when you feel like you’re walking on rocks.

TLC

Teaching through your pregnancy requires physical care and attention to your body. This includes using demonstrators. (For more on that, see “A Better You: Sidestepping the Sidelines,” August 2013.) You’ll also want to find substitutes who can step in if you’re feeling particularly tired or ill during pregnancy, and to cover classes during your maternity leave.

Most businesses now are family friendly. It shouldn’t be difficult to work with your employer to make your pregnancy, childbirth, and beyond as frictionless as possible for everyone.

After the baby arrives you may be able to toss the maternity belt, but you’ll still have to take precautions when you go back to teaching. Relaxin lingers in the body for about eight months postpartum; ligaments are still loose, and low-back, pelvic, and foot pain can occur.

Consider wearing Spanx or other compression garments. Wearing supportive clothing sends signals to the brain—essentially reminders—to maintain the joint closure that ensures stability. Compression garments also provide mechanical compression to joints that may be in danger of partially dislocating.

Take vitamins before conception and during pregnancy. Many recommend getting most nutrients from food after childbirth. Since babies ingest whatever the mother is taking in, be careful about what you eat and take a break from supplements unless your doctor recommends them.

Upper-body conditioning will help enormously. Some new mothers develop carpal tunnel–type problems caused by lifting and carrying a baby for months. Training before the baby comes will help you avoid these issues. Try to get to where you can easily handle at least 10-pound weights. Pull out your stretchy band and do all the arm exercises you can find. Stand on one end and pull up on it to strengthen biceps. Hold one end at your chest and push the other arm out horizontally to work your triceps. Sit with bent knees, put the band around your feet, and pull on it for back-of-shoulder strength.

With foresight, you can have a happy and uneventful teaching pregnancy. Your students, your baby, and your partner will thank you for it.

I have faith in you.