Exercising During Pregnancy

Exercise during pregnancy is recommended for its overall health benefits for the mother and the growing baby. As we all know, regular physical activity can improve or maintain fitness levels, help with weight management and enhance psychological well being – and this is no different during pregnancy. Regular physical activity during pregnancy will also make post-pregnancy recovery easier and faster!

 

As a physiotherapist and new mother, I am aware of the significant changes (cardiovascular, respiratory, hormonal, and anatomical) that occur to a woman’s body during pregnancy. These changes may cause expecting mothers to question their ability to perform physical activity. While previous generations were advised to rest throughout pregnancy, this is no longer the consensus in the health practitioner world. Although there are some risks regarding pregnancy and exercise, following some simple modifications should enable you to enjoy a fit and healthy pregnancy.

Read on to find out the up to date recommendations, modifications, and risks to exercising while pregnant…

Recommendations

  • Women with uncomplicated, healthy pregnancies should engage in regular physical activity
  • Aerobic and strength-conditioning is recommended before, during and after pregnancy
  • 20-30 minutes of moderate-intensity exercise is recommended on most, if not all days
  • Sedentary women can also begin to exercise during pregnancy
  • Medical evaluation and clearance should be sought before commencing an exercise program to ensure there are no medical reasons that may limit exercise ability

Types of Exercises

The following are considered safe to initiate or continue during pregnancy:

  • Walking
  • Swimming
  • Stationary cycling
  • Low impact aerobic exercise
  • Yoga (modified)
  • Pilates (modified)
  • Strength training
  • Pelvic floor exercises

In consultation with your obstetric care provider the following may be safe to continue for those who previously participated in:

  • Racket sports
  • Strength training
  • Running/jogging

The following are considered unsafe during pregnancy due to the risk of injury or complication:

  • Contact sports (e.g. ice hockey, football, basketball, boxing)
  • Activities with a high risk of falling (e.g. skiing, off-road cycling, gymnastics)
  • Scuba diving
  • Sky diving
  • Hot pilates or hot yoga

Intensity and Duration

Exercise of moderate intensity for 20-30minutes on most if not all days is recommended. The “talk test” is a good indicator of whether you are performing activities of moderate intensity. Basically, you should be able to hold a conversation whilst you are exercising. Previously, heart rate has been used to monitor intensity. However due to cardiovascular changes during pregnancy this is no longer considered a reliable method (sorry Fitbit!).

Modifications/Considerations During Pregnancy

During pregnancy there are significant cardiovascular, respiratory, hormonal and anatomical changes to a woman’s body. Therefore, some modifications to exercise may be required during pregnancy. However, every pregnancy is different, so not everything may be relevant to you.

As a keen runner, I was disappointed when I found running unsuitable for me during my pregnancy. I still managed to stay fit and healthy throughout pregnancy anyway and enjoyed experiencing new activities. If you are finding it challenging to exercise like you did prior to pregnancy or would like a program tailored to your medical condition or goals, contact one of our physiotherapists today.

Weight gain is an obvious change. As the baby grows and weight is gained, more stress is placed on the lower back and joints. Further into your pregnancy, you may find higher impact activities such as running and skipping too uncomfortable and may opt for lower impact exercises like stationary cycling or swimming.

A growing baby also means a larger belly which can impact on your ability to balance. You may find rapid changes in direction more difficult.

Hormonal changes cause an increase in laxity in the joints which may cause increased stress through the joints. This, combined with an increase in weight, results in many women experiencing low back or pelvic girdle pain during their pregnancy. Specific strengthening exercises such as an individualised Pilates program can help you manage and minimise your pain during pregnancy.

It is important to avoid overheating when exercising while pregnant. Appropriate cool clothing should be worn and avoid exercising in hot conditions. Activities in air-conditioned rooms may be more preferable than exercising outside on hot summer days.

Motionless or supine (lying on back) positions, such as some yoga and pilates positions, should be avoided due to the possibility of decreased venous return and hypotension. It is important if you are participating in yoga or Pilates classes that you do so under the guidance of a qualified instructor experienced in pre and post natal exercise.

Adequate nutrition is essential during pregnancy. It is suggested that an extra 300 calories per day is required to meet the increased energy needs of pregnancy. Further intake is required to replace the energy consumed during exercise. Fluid replacement is also important following exercise.

Pelvic floor is always important – particularly during pregnancy! While many women become familiar with their pelvic floor following birth, much of the strain on these muscles actually occurs during the pregnancy. It is important that all women try to maintain their pelvic floor health before, during and after pregnancy. If you are unfamiliar with pelvic floor exercises, seek advice from a pelvic floor physiotherapist. A strong, healthy pelvic floor before and during pregnancy will make for an easier and faster recovery post birth.

Exercise and Gestational Diabetes

Gestational diabetes is becoming more and more common. It can affect both the health of the mother and growing baby and may cause complications during pregnancy. Studies have shown that exercise during pregnancy is effective in not only helping to manage gestational diabetes, but also in preventing it.

For more online information check out the Diabetes Australia website.

If you are concerned about gestational diabetes and your pregnancy, consult your primary obstetric carer.

When to STOP Exercising

If you are experiencing any of the following you should stop exercising and consult your obstetric carer:

  • Vaginal bleeding
  • Pre-term labour (regular, painful contractions)
  • Dizziness
  • Headache
  • Chest pain
  • Calf pain/swelling
  • Amniotic fluid leakage
  • Muscle weakness affecting balance
  • Dysponea (shortness of breath) before commencing

Contraindications/Pre-cautions/Risks

There are several medical conditions in which exercise may contraindicated. There are also several medical conditions in which caution must be taken, however, modified exercise can still be beneficial. It is therefore recommended that all pregnant women seek medical clearance prior to commencing exercise.

Absolute Contraindications

(The following are taken from the Guidelines of the American College of Obstetricians and Gynaecologists.)

  • Haemodynamically significant heart disease
  • Restrictive lung disease
  • Severe anemia
  • Premature labour during current pregnancy
  • Ruptured membranes (broken waters)
  • Multiple gestation at risk of premature delivery
  • Persistant 2nd/3rd trimester bleeding
  • Incompetent cervix
  • Placenta preavia >26/40
  • Pregnancy induced hypertension/pre-eclampsia

If you are looking for a fun and safe exercise program you can perform throughout your pregnancy, our physiotherapists are happy to assist you. They can tailor your exercises to your needs and goals and adapt them as required throughout your pregnancy. It is recommended you consult your primary obstetric carer before commencing an exercise program.

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About the Author



Julia completed a Bachelor of Medical Science at the Australian National University and a Masters of Physiotherapy at the University of Canberra. Julia is committed to evidence based practice and is keen to further her studies in physiotherapy. She has completed her Clinical Pilates training and is now a Certified APPI Clinical Pilates Instructor. Recently she has begun her training in Women’s Health Physiotherapy and is hoping to complete her Masters in Women’s Health in the near future.


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