1. Exercises need to be designed with the pregnant woman in mind and should include a warmup, cardiovascular conditioning, strengthening an toning of all major muscle groups, and exercises that increase flexibility, balance and coordination. Kegel and relaxation exercises should be incorporated into the program as well. All exercises need to follow ACOG's safety guidelines. It is important that each participant is able to self-pace the exercises according to her own individual fitness level and the stage of her pregnancy.

2. Unlike childbirth education programs, teaching exercise requires specific psychomotor skills. Instructors should be health and/or fitness professionals with a special certification in pre and post-natal fitness. When asked about what they look for in an exercise class, pregnant women repeatedly respond that they want an instructor that is empathetic to pregnant women and shares information in classes about issues surrounding the childbirth experience, ie. weight gain, common discomforts, baby tips, ante-natal testing, etc.

3. Your instructor will either make or break the program. Exercises instruction is a performing art. Therefore, instructors need to possess certain attributes to make the classes exciting and fun. Instructors should be able to project their voices easily, suitably perform exercises, and easily follow a musical beat. Instructors need to espouse your facility's philosophy. Remember, the sale begins after the sale. If you are not sure whether to hire a certain person, ask yourself, "Would I want this person teaching me?" If you have to think about it, then find someone else.

4. There is a normal attrition that occurs with maternity fitness classes. Pregnant women eventually deliver their babies and move on to other activities. For this reason, it is important to promote your classes on a continuous basis. An important source of referrals is obstetrical health care providers and their staff. Every month, send all obstetrical offices in your service area reminders of class start dates. Include "free class" coupons for providers to distribute to their pregnant clients. Offer to give inservices (on site classes) on pregnancy and exercise to obstetrical staff as well as discounts to all office employees and their spouses. Studies show that satisfied customers are your best advertisement.

5. In order to ensure high attendance and positive outcomes, maternity fitness classes need to be offered on an ongoing basis. The benefits from exercising are derived by exercising at least two days a week for muscle strengthening and toning and three days a week for cardiovascular fitness. ACOG recommends that pregnant women exercise on a regular basis rather than intermittently. Most facilities will offer classes twice a week and then encourage participants to find another day during the week to exercise aerobically.

6. Remember to cross market your services. Maternity fitness classes are a great marketing too l for other programs and services you offer at your facility. Pregnant women are brand loyal. Be sure that everyone in your maternity exercise class knows about the other programs and services you offer to pregnant women and new mothers and vice versa. Everyone in your facility should be aware of your programs, especially people answering the telephones. Include information about your maternity exercise program in all brochures and notices about other women's health education programs you offer to your community.

With proper planning, selection of instructors and an ongoing commitment to a program of excellence, your facility will gain a reputation for offering the state-of-the-art in maternity fitness.