Belly Dance and Pregnancy

Notes taken from a presentation by Margaret Sherburn, lecturer at University of Melbourne in Women's Health Physiotherapy. 24th May 2004

'In general, most pregnant women can enjoy dancing throughout their entire pregnancy, especially if you follow common-sense guidelines. There are special circumstances when a woman needs to exercise caution and get the advice of her doctor, or even stop dancing. But overall, belly dance is one of the safest exercises a woman can participate in – and enjoy – throughout her pregnancy.'

In general

Have the pregnant woman check with her doctor that belly dance is OK. Doctor's won't always understand belly dance, so offer to talk with them. Some doctor's won't be prepared to write a certificate giving the all-clear. Don't expect it.
Get the name and number of the doctor and an emergency contact, and get the pregnant woman to sign a liability waiver as part of your initial screeing.
Vaginal bleeding, cramps, sudden leakage of fluid, dizziness or other such events could signal a problem and should be investigated by a physician immediately.

Physical changes

From 12 weeks onwards, the body produces the hormone 'relaxin', which softens the joints. Peak production (but not peak effects) are around wks 12-13, so caution needs to be taken throughout the pregnancy. Peak effects occur when significant weight gain occurs.
Pelvic joints (at base of spine and sides of pelvis) are most affected, resulting in less stability (hence the 'waddle'), but other joints are also effected. Be careful against spraining ankles, hyper-extending knees, etc.
A pregnant woman may feel far more flexible, but be careful she doesn't overstretch. Pain the next day is a good indicator of too much stretching.
Lower blood pressure is usual, and can cause faintness. Keep pregnant women moving so blood is continually pumping – standing too long may drain blood away from the head.
If a woman has high blood pressure during pregnancy (Pregnancy Induced Hypertension) she should not be doing belly dancing.
Blood composition alters during pregnancy – with fewer red blood cells – so that many women become anaemic and less oxygen is transported around the body. This means she may become breathless more easily.

How much exercise is all right?

In general, pregnant women can safely exercise 3-4 times a week, at moderate intensity (high intensity OK for ~ 15 mins, low intensity for longer periods), with any form of exercise that doesn't stress the softened joints, or that is not dangerously competitive.
It is generally all right to take up belly dance (or other exercise) when pregnant, even if the woman hasn't done it before. Start with low intensity & increase slowly.
Avoid a very high heart rate, as this possibly means less oxygen is going to the baby. Getting puffed is all right to the extent that it's still possible to talk during the exercise.
Avoid overheating, as this overheats the baby. Ensure that the woman drinks plenty of water.
A woman who is generally unfit will get hot and tired quicker than one who is fit, so keep an eye on her particular state. Not all women will take the initiative to slow down or have a drink when they need to – keep an eye on them and tell them to take breaks when necessary.
If the woman has a lot of pain or exhaustion in the 24 hours after the class, lessen the exercise. If pain or exhaustion still continues, don't do the class.
If health remains 'normal', there's no need to stop belly dance right up to labour. It will help with fitness for labour.

Physical complaints you may have to deal with:

Backache – massage; gentle stretches (flopping forward, child's pose, cat-cow position, side stretches, chest circles, pelvic movements)
Pelvic pain – pelvic movements
Cramps – esp. lower legs; stretch calf for min. 10 seconds
Indigestion – smaller meals, less fatty food, ginger & mint teas
Incontinence – pelvic floor exercises; glide into positions rather than jumping jerkily; don't bounce.

Belly dance is not suitable for women with the following conditions:

Pregnancy Induced Hypertension (PIH) – high blood pressure
Risk of premature labour – includes women who regularly deliver early.
Placenta Previa (PP) – where the placenta lies low in the cervix. Follow doctor's recommendations. No undulations or contractions at any stage. No exercise in later stages.
Previous history of miscarriage – no belly dance until pregnancy is well established (~20 weeks).
Vaginal bleeding in 2nd or 3rd trimester
Gestational diabetes – only exclude from class if the side-effects of these warrant it (eg: high blood pressure)
High temperature risk – eg: overweight women.
Multiple pregnancy – this is contentious. Margaret thinks exercise is OK.
Breech presentation in 3rd trimester. Follow doctor's guidance.

Movements that are best for pregnant women:

During pregnancy – hip circles & 8's; rib circles & arms (esp. in later months when diaphragm is getting squashed up); 'grounded' movements; undulations (but be careful not to 'flop' stomach forward – focus more on tucking); pelvic tucks (good for pelvic floor!)
During labour – circles; shimmies; pelvic tucks; undulations

Movements to be cautious about:

Bouncing, high impact movements
Sustained aerobic movements (eg: fast routines)
Movements that stress softened joints or are easy to over-extend eg: hip lifts, drops, thrusts. Minimise these movements/ stress use of surrounding muscles to support the move.
Shimmies – not good esp. at 12-13 weeks, when there is the highest risk of miscarriage, and when close to labour. Soften/ slow down the movement.
Pelvic movements can stimulate birth, so be careful when coming up to labour (or with women who have a history of early births!).
Chest drops in later pregnancy may be uncomfortable.

Exercising after birth:

Pelvic floor exercises are great.
Don't come back too soon – placental scar tissue (where placenta detaches from uterus wall) needs time to heal. Exercising too soon can cause excessive bleeding.
After a caesarian section, wait ~3 weeks
Wait 6 weeks before aerobic exercise
Be careful about exercising too soon if blood pressure remains high after pregnancy.