I created this road map to demonstrate the complexity of attempting to apply a one size fits all activity recommendation to the prenatal population and as a tool for your use in clinical practice. You can regard this particular resource as your umbrella guide.
Page one takes you step by step through the process of exploring prenatal fitness with patients while utilizing the 4 Cs framework:
The conversation begins with curiosity through open-ended questions or through use of the CSEP Get Active for Pregnancy Questionnaire.
- From there, patients will fall into one of two categories: the first, in which they are Cleared for Exercise. In the second, they require Further Consultation with the Healthcare Provider.
- The conversation continues with compassion, particularly if the patient is not cleared for activity as this can create anxiety on the part of the patient.
For the patients who are cleared for activity, they then fall into two new categories: Not Currently Active and Currently Active.
- The Not Currently Active patient is encouraged to begin an exercise program, but to do so gradually.
- The Currently Active Patient is encouraged to continue their current exercise program and to modify as needed based on the recommendations on page two of the handout.
For the patients who are not cleared for activity, they also fall into two new categories: Relative Contraindications and Absolute Contraindications.
- Those patients with Relative Contraindications will require exercise modifications (including intensity and duration) and follow-up with their provider. Consultation with a trained exercise professional may be recommended.
- Those patients with Absolute Contraindications should continue with activities of daily living, but will need to refrain from moderate or vigorous physical activity.
- For patients in both of these categories, regular follow-up with their provider and assessment of movement protocol is indicated.
- The CSEP Healthcare Provider Consultation Form provides reminders for the two contraindication categories and various options for physical activity recommendations and follow-up.
Page two is meant to be an At-a-Glance-Guide to further help navigate this conversation.
Included:
- SOGC/CSEP 2019 Canadian Guidelines
- Activities to Avoid in Pregnancy
- Know When to Stop
- And, a reminder that if there is a change in status, reevaluation is indicated.