PREGNANCY AND EXERCISE
All women who are pregnant without complications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy. A reasonable goal should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness.
It is important to stay well hydrated, wear comfortable and non-restrictive clothing (such as a correctly fitted bra and appropriate footwear) and where possible, avoid excessive over-heating.
BENEFITS OF EXERCISE DURING PREGNANCY
One benefit of exercise during pregnancy is improving your physical and mental wellbeing. Maintaining a healthy weight during pregnancy helps in returning to your pre-baby weight more quickly and also reduces the risk of developing gestational diabetes, which is more common in mothers who are overweight.
RISKS OF EXERCISE DURING PREGNANCY
There are currently no known adverse risks to a pregnant woman that are linked with meeting the recommended guidelines of at least 150 minutes of moderate-vigorous physical activity per week.
However, as pregnancy progresses, the body goes through significant changes, such as increased laxity (looseness) of joints, changes in centre of gravity and an increased resting heart rate. Therefore, modifications to programs may need to be considered.
Women who are pregnant and participating in activities that require a high degree of balance or rapid changes in direction should consult with their doctor first. Your doctor may recommend that you see a physiotherapist or exercise physiologist for a program that can be developed for you.
EXERCISE DURING PREGNANCY
Specific activities to avoid during pregnancy include contact sports, high-altitude exertion, including downhill skiing and scuba diving. Also, exercise in the supine position (lying on back) should be avoided after the first trimester or 16 weeks gestation. Modifying the position of the exercise to instead be performed on your side, sitting or standing is a safe alternative. Types of exercise to do during pregnancy include aerobic conditioning and strength training of all the major muscle groups and your pelvic floor.
Aerobic exercise can include:
- cycling (on a stationary bike)
- low-impact aerobic exercise classes.
- exercise in water (aquaerobics)
- yoga or pilates – tell your instructor that you are pregnant before the class
- pregnancy exercise classes.
Women who are active during pregnancy can continue with their regular exercise or sport, as long as associated risks and any recommended changes are considered (such as avoiding the specific activities above and not making rapid changes in direction).
FREQUENCY AND INTENSITY OF EXERCISE DURING PREGNANCY
Pregnant women should aim to meet the prescribed physical activity levels of the Australian Physical Activity Guidelines, which is 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise, or a combination of both. No research to date has identified a ‘safe’ upper-limit to exercise intensity.
The ‘talk test’ can be used to guide the intensity in which pregnant women are recommended to exercise. As the name suggests, the women are exercising at a comfortable intensity if she is able to maintain a conversation during exercise. She should reduce the exercise intensity if this is not possible.
Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
Aerobic activity should be performed in bouts of at least 10 minutes duration.
CAUTIONS FOR PREGNANCY EXERCISE
While most forms of exercise are safe, there are some exercises that involve positions and movements that may be uncomfortable or harmful for pregnant women. Be guided by your doctor or physiotherapist, but general cautions include:
- Avoid raising your body temperature too high – for example, don’t soak in hot spas or exercise to the point of heavy sweating. Reduce your level of exercise on hot or humid days.
- Don’t exercise to the point of exhaustion.
- If weight training, choose low weights and medium to high repetitions – avoid lifting heavy weights altogether.
- Avoid exercise if you are ill or feverish.
- If you don’t feel like exercising on a particular day, don’t! It is important to listen to your body to avoid unnecessarily depleting your energy reserves.
- Don’t increase the intensity of your sporting program while you are pregnant, and always work at less than 75 per cent of your maximum heart rate.
- In addition, if you develop an illness or a complication of pregnancy, talk with your doctor or midwife before continuing or restarting your exercise program.
EXERCISES TO AVOID WHILE PREGNANT
During pregnancy, avoid sports and activities with increased risk of falling. If you’re not sure whether a particular activity is safe during pregnancy, check with your healthcare professional. Activities to avoid include:
- Contact sports or activities that carry a risk of falling (such as trampolining, rollerblading, downhill skiing, horse riding and basketball)
- Competition sports – depending on the stage of your pregnancy, the level of competition and your level of fitness (consult your doctor, physiotherapist or healthcare professional)
- After about the fourth month of pregnancy, exercises that involve lying on your back – the weight of the baby can slow the return of blood to the heart. Try to modify these exercises by lying on your side.
- In the later stages of pregnancy, activities that involve jumping, frequent changes of direction and excessive stretching (such as gymnastics).
WHEN TO STOP EXERCISING WHILE PREGNANT
Stop exercising while pregnant if you experience:
- abdominal pain
- any ‘gush’ of fluid from the vagina
- calf pain or swelling
- chest pain
- decreased foetal movement
- dizziness or presyncope (light-headedness, muscular weakness and blurred vision)
- shortness of breath before exertion
- excessive fatigue
- pelvic pain
- excessive shortness of breath
- painful uterine contractions
- vaginal bleeding.
Ultimately, listen to your body. Be aware of these signs and symptoms, stop physical activity immediately and consult your doctor.
PELVIC FLOOR EXERCISES DURING PREGNANCY
Pelvic floor exercises include:
- Sit and lean slightly forward with a straight back.
- Squeeze and lift the muscles as if you are trying to stop a wee.
- Hold the squeeze for up to five seconds and then relax for up to 10 seconds.
- Repeat up to 10 times, three to four times per day.
- Keep breathing through the exercise.
All exercise should consist of a warm-up and cool-down phase. Stretching exercises are also useful, but should be done gently due to the increased joint laxity during pregnancy.
ELITE ATHLETES AND SPORT WHILE PREGNANT
Elite athletes who continue to train during pregnancy require supervision by an obstetric care provider with knowledge of the impact of strenuous exercise on maternal and foetal outcomes. Women with special needs may require a referral to a physiotherapist, exercise physiologist or sports medicine specialist to develop an appropriate exercise program.