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D r. Stacey Madoff has been a practicing OBGYN since 1998 and joined Health Quest Medical Practice in 2008. She answers questions on why exercise and fitness are so important during a woman's pregnancy. Why exercise during pregnancy? In general, exercise helps a woman maintain a normal weight gain during preg- nancy and assists in delivery. Some of my patients worry that they shouldn't exercise during pregnancy, and they end up gaining more weight than they should. It's important to maintain a certain level of fitness in pregnancy. If a woman hasn't been exercising prior to pregnancy, I encourage her to slowly build it up over time. What exercises are best for pregnant women? Really most exercises are fine. During the second half of pregnan- cy, it's not a good idea to lie flat for any length of time. Lying flat can interfere with the blood flow to the placenta. The uterus sits on major blood vessels that supply blood to the baby, so any prolonged period of time on the back can restrict blood flow. But exercises like yoga and pilates can easily be adapted to change positions. I encourage women to continue the level of exercise that they're used to. If you decrease that level too suddenly, it affects everything from weight gain to mental well-being. Are there certain exercises that are off limits? I tell my patients to avoid any- thing where there's a risk of falling or getting kicked in the stomach. For instance, skiing and horseback riding are not good options. You never know if something unexpect- ed could happen. I also recommend that patients keep track of their pulse rate. A pregnant woman's pulse should not go above 140 for any length of time, since a mother's heart rate can affect the baby's heart rate. What if you're on bed rest? I recommend to patients on bed rest that they use light weights or resistance bands to keep their arms strong. They should also regu- larly flex and extend their legs and calves for circulation. Always make sure to consult with your doctor first. When can a new mother resume exercise? After a healthy vaginal delivery, a mother should avoid any excessive exercise or heavy lifting for the first four weeks. After that, exercises like light jogging or brisk walking are fine. Walking is a not only a great ac- tivity for new moms, but it's a great way to get outside and allow the baby to get some fresh air, some- thing which can be a challenge during the first few weeks. If a woman has had a caesarian section, she has an incision in the abdominal wall that needs time to heal — otherwise she can get a her- nia. A c-section is considered major surgery, so it's important to restrain from any heavy lifting or strenuous exercise for the first six weeks, even if she was in great shape before the pregnancy. As always, make sure to consult with your doctor before resuming exercise. Stacey Madoff, Board Certified OB/ GYN, sees patients in HQMP's Pough- keepsie and Fishkill offices. She deliv- ers at Vassar Brothers Medical Center. The importance of exercise during pregnancy 'It's important to maintain a certain level of tness in pregnancy.' Stacey Mado , OB/GYN Health Quest Medical Practice