Due diligence

Family There is no more important time to take care of yourself than when you are pregnant. We look at how to take a safe and beneficial approach to your health, and how to know which practices to avoid.

Pilates and yoga are low-impact exercises that can give women tools, such as strength and posture, that are helpful during labour.
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When you're pregnant, it is the perfect time to embrace a more holistic approach to your health. Not only does conventional medicine advise nothing more than a paracetamol for common ailments, but you'll also want to give your body the best chance you can to nourish your growing baby and to keep yourself comfortable and stress-free. Eating a nutritious, balanced diet is clearly important, but when it comes to exercise, treatments and general lifestyle, the advice is confusing. What is safe and good, and what is to be avoided?

It's important to remember that pregnancy is a natural event, not an illness. Though hormonal changes and the demands of your growing baby create all sorts of physical and emotional changes, experts agree that an active, hands-on approach that gives you a feeling of control over your health is the best way to deal with them. "Staying fit and strong is one of the best things a pregnant mum can do for herself," says the fitness and nutrition expert Dax Moy. "Some guidelines for things to avoid need to be taken with a pinch of salt, as some of them are silly and lead to mums getting weak, which in turn leads to tougher labour and longer recovery from pregnancy." Moy advises "a mix of activities that you enjoy", and avoiding "those that bore you yet you feel you 'should' do because you're pregnant".

If you're used to going to the gym, Moy says to avoid using machine weights and barbells, which can leave you feeling disconnected from your body. "Instead, do movements that involve your body weight, such as lunges or push-ups. These keep the muscles strong but also have an inbuilt safety mechanism, for once you get too heavy or the posture is adversely affected by 'the bump', you will naturally tend to stop doing the movements."

Gentle daily walking is ideal, while exercise in water is helpful because the buoyancy offsets the extra weight you are carrying, enabling your muscles and joints to work with less strain. If you have groin pain, officially known as Symphysis Pubis Dysfunction (SPD), it is better to practise crawl or backstroke rather than breaststroke, or hold a float and kick the legs. In the later stages of pregnancy, to help your baby shift into an ideal position for birth, swim with the abdomen forward rather than on your back.

Pilates is also good because it's a low-impact exercise that focuses on improving the condition of your abdominal and pelvic floor muscles. "Pilates helps all conditions associated with pregnancy by strengthening the core muscles, which in turn leads to improved posture and circulation," says the Pilates teacher Sarah Rosenfield. She advises pregnant women to invest in a Pilates ball, as "a comfy chair towards the end of pregnancy, and a great way to practise for childbirth and beyond".

For many, yoga is highly effective because it works on your state of mind as well as the body. Seek out a specialist class led by a teacher who knows know all the contraindications for pregnancy, or invest in an at-home DVD. I do a safe, effective and easy-to-follow daily practice using Pregnancy Health Yoga, a DVD devised by the pregnancy yoga expert Tara Lee (Dh57, www.amazon.com). "Yoga keeps women fit and helps prevent and alleviate pregnancy-related ailments such as back pain, hip pain, sciatica, heartburn and insomnia," Lee says. "It also prepares women mentally and physically for labour, providing postures and breathing exercises they can use to help cope with contractions, and building up trust in the body's inner wisdom - all of which leads to a huge boost in confidence throughout the pregnancy."

If you're already into yoga, practise it in a softer way without pushing yourself, and avoid very dynamic styles such as ashtanga or bikram, which will overheat the body and raise the heart rate too much. "Avoid postures that compress the internal organs, detoxify the body or over-tense the muscles, such as strong twists, lying on the abdomen and strong abdominal exercises," Lee says. Over-stretching should also be avoided because the increased levels of the hormone relaxin in the body during pregnancy soften the ligaments and makes it easy to overstretch.

Ayurveda is another holistic system of health that offers sensible advice for your lifestyle during pregnancy. "We emphasise how the gestation period of nine months should be spent nourishing the foetus so it has the best psychological start in life," says the Ayurvedic practitioner Jo Johnston. This includes nourishing the mother with soothing foods such as milk, honey, ghee and rice; steering clear of strong spices and avoiding noisy places, horror films and other overstimulating activities.

"Instead, create a peaceful home environment, and engage in soothing, more spiritual pursuits such as reading uplifting books or listening to relaxing music." Knowing which treatments are safe during pregnancy is important. Johnston says gentle self-massage in the first trimester is ideal, but that deep tissue massage should be avoided throughout pregnancy because it's too stimulating. "It encourages a release of toxins into the blood stream which can make you feel unwell, upset your hormonal balance and increase the risk of miscarriage."

Catherine Kavanagh, a holistic therapist at Grayshott health retreat in the UK, recommends dedicated pregnancy massage, during which pillows are used to keep you and your bump as comfortable as possible, and the practitioner knows the contraindications of your condition. "This is an excellent way of nurturing yourself at a time when you can feel uncomfy and stressed," Kavanagh says. "It encourages deep relaxation and good sleep, eases sore muscles and, in the later stages, can lessen sciatic pain, pins and needles, cramps and swollen ankles."

Other safe and effective holistic treatments during pregnancy, Kavanagh says, are reflexology and reiki to rebalance the hormones and reenergise, and shiatsu and cranial sacral therapy to rebalance the body and ease pelvic and back pain - as long as they are carried out by practitioners trained in pregnancy. Many women also find acupuncture beneficial. "It rebalances the body's energy during hormonal changes, thereby soothing nausea, constipation or backache," says Cornelia Davies, an acupuncturist and the author of Acupuncture: The Limericks.

If you're having your treatments at a spa, avoid the steam room, sauna and jacuzzi. "Heat puts too much pressure on a pregnant body, and can make you feel uncomfy and raise the blood pressure," Kavanagh says. "In later stages, it can also induce labour, increasing the risk of premature birth." Be careful what products you use on your skin, as these will be absorbed into your baby's blood stream. A spa should use a simple base oil such as almond oil, or products designed especially for pregnant women and having a safe potency level. Geraldine Howard, the president and co-founder of Aromatherapy Associates, says aromatherapy essential oils with massage can help to treat common ailments such as stretch marks, back pain and skin outbreak, and balance the emotions, but she advises expectant mothers to be careful of using essential oils at home that are too concentrated.

The most important thing to remember is that every pregnancy is different - experiment and find a routine that suits you.