There once was a time when pregnant women were expected to take it easy, rest and generally not exert themselves for nine months before taking part in what could possibly be their most grueling physical challenge.
That time is not now.
More often, women are choosing -- or being advised by their doctors -- to stay active throughout their pregnancies.
"I tell my patients that pregnancy is a great time to exercise," says Deborah Berman, an assistant professor and obstetrician-gynecologist at the University of Michigan. "Health and fitness is important before, during and after a pregnancy. It's not a time to stop exercising and lose your fitness and lose your conditioning."
For some women, working out while expecting is a matter of wanting to bounce back quickly after delivery. Others exercise to remedy pregnancy-induced ailments like back and muscle aches. Most feel that by taking care of themselves, they're also benefiting their soon-to-be-born children.
"I had a great pregnancy experience and I think I owe it to staying active," says Romina Profeta, a physical therapist from Grosse Pointe Woods, Mich., who gave birth to her first son in 2004.
Knowing how to stay active while you're expecting can be tricky. Workouts that are suitable for a non-pregnant person -- such as running -- can also work during pregnancy, but only up to a point.
Gentle activities specifically geared toward pregnancy are smart choices for moms-to-be, says Carolyne Anthony, founder and director of the Center for Women's Fitness in Ann Arbor, Mich. She teaches prenatal fitness classes around the world and also trains instructors in pregnancy fitness techniques.
Yoga, water aerobics and walking are popular options.
"This is not the time to be worried about gaining weight or losing your fitness level," Anthony writes in an e-mail from southeast Asia, where she recently conducted training workshops. "It is a time to be gentle with your body and to begin exercising the correct way to help with the birthing of the baby."
Women who are physically active prior to pregnancy can usually keep up a comparable level of activity while pregnant, as long as they are checking in with a doctor and listening to their bodies' cues that they need to ease up, says Berman.
"Most women's bodies will speak to them," says Berman.
LIGHT EXERCISER TRIES YOGA
A rose-colored T-shirt creeps up to reveal a sliver of skin on Seema Erskine's softly rounded belly.
She wraps her right hand gently around her stomach and stretches her left hand over her head, exhaling as she reaches, releasing tension in her body.
It's become a weekly ritual for Erskine, 31, of Dearborn, Mich., who started practicing yoga in January when she was three months pregnant.
She used to take a Pilates class once a week before becoming pregnant.
Erskine leaves each class feeling relaxed and refreshed.
So, she says, does her baby.
"I think the baby takes a nap," says Erskine, whose first child is due in July. "It's quiet during class, whereas when I'm at work and stressed, it moves around a lot."
For Erskine, pregnancy provided an opportunity to try a new activity, something that doctors say can be good for women -- as long as the new workout isn't too strenuous.
Erskine says she sought out a class specifically for pregnant women because she wanted to know that the workouts were safe for her baby.
Plus, signing up for a weekly class makes her more likely to work out.
The yoga class she took in Dearborn is offered through Fitness Rx, a West Bloomfield, Mich., company whose instructors teach fitness classes throughout metro Detroit.
Instructor Bess Costos -- who has a 6 -month-old daughter and participated in prenatal yoga throughout her own pregnancy -- makes sure the women in her class take water breaks throughout the class to keep from overheating.
She's also aware that women's bodies change week to week during pregnancy, so she teaches those in her class to modify poses to accommodate burgeoning bellies. Most of the poses are done seated, standing or kneeling, as pregnant women generally are told not to lie flat on their backs in the second and third trimesters.
Seeing other women in the class practice yoga until they were ready to give birth has inspired Erskine to continue exercising as long as possible during her pregnancy.
"It's been good just being able to take the one hour a week for myself and the baby," she says.
WORKOUTS MADE PREGNANCY EASIER
When Karen Little was pregnant with her two daughters, now 3 years and 18 months, she spent much of the time on bed rest before going into early delivery both times.
After the birth of her second daughter, the Bloomfield Hills, Mich., mother and physician decided she was through with sitting around.
Little started exercising and lost about 40 pounds, faithfully attending Body Beautiful Boot Camp -- run by local fitness guru Jennifer Gray -- for a fix of kickboxing, circuit weight training, Pilates and aerobics three times a week.
She got hooked and didn't stop, even when she became pregnant with her third child, a son born last month at full-term.
She's convinced that working out made all the difference during her third pregnancy.
"It was the best I've ever felt," says Little, 36.
Little, who is an internal medicine doctor at Henry Ford Health System, says her own physicians encouraged her to stay active.
"They recommended that I do as much as I can tolerate," says Little.
While she was concerned about the possibility of delivering pre-term yet again with her son, Little says her previous pregnancies helped her come to understand her body's cues.
Even though the boot camp was not geared specifically to prenatal exercise, Little learned to modify the moves so she could participate.
Once jogging became too difficult, she substituted power walking. Instead of doing abdominal crunches, she did leg lifts.
While many fitness experts say it is fine for women to continue exercising without doing specific prenatal workouts, others say women should use caution and adjust their fitness expectations during pregnancy.
For Little, attending the boot camp worked best for her fitness level and interests.
After giving up the boot camp at 7 1/2 months, Little says she remained active -- playing with her daughters -- until she delivered her son, something that hadn't been possible with the two previous pregnancies.
MARATHONER TONES IT DOWN
For most women (and men), running a marathon is its own feat.
Dori Watters did it while pregnant.
It's not that she meant to; it's just that the 30-year-old orthodontist from Ferndale, Mich., didn't realize she was running for two when she took part in the Walt Disney World Marathon in January.
Since then, Watters, who is due to deliver her first child in September, has toned down her training -- but not much.
She continues to run, swim and participate at least three days a week in a Birmingham, Mich., boot camp led by her husband, Jeff Watters.
The difference is that now she runs 3 miles or less at a time, stops when she's tired, carries water with her during boot camp training and monitors her heart rate to make sure it's not too high.
For Watters and highly active women like her -- used to hard-core fitness endeavors -- working out in a way that is physically challenging but also safe for the baby's development can be one of pregnancy's biggest tests.
Before becoming pregnant, Watters says she would push herself to continue working out even when she felt tired or sick.
"Now I go with how I feel," she says.
She'll take breaks during training and her running gait is slower, though that rankles the competitor in her.
She's also prepared to move her training indoors to an elliptical machine or pool once running becomes too taxing.
To keep her mind off what she can't do, Watters says she focuses on what she can -- a tactic that doctors and fitness instructors recommend for all women who want to remain active during pregnancy.