Physical activity during pregnancy is a minefield of vague advice and contradicting ideas. Many pregnant women enjoy regular physical activity with multiple benefits. The majority of pregnancies are normal. As a general rule, regularly exercising women are able to continue exercising at a mild or moderate level during pregnancy as long as the pregnancy is uncomplicated.
It is important to protect your future treasure to the best of your ability. Any information in this section has been well researched but is not intended to replace the professional advice of your registered physician or midwife. Each individual’s medical history and specific needs still need to be taken into account to ensure the safety of the unborn child and its mother.
Exercise is not recommended for women with serious or potentially serious complications of pregnancy.
Those with the following conditions may not exercise during pregnancy:
- Active heart disease.
- Uterine bleeding/ruptured membranes.
- High blood pressure.
- History of pre term labour.
- Incompetent cervix/cerclage.
- Intrauterine growth retardation.
- Suspected foetal distress.
After full medical assessment of the individual case, patients may participate in medically supervised exercise programs. There are some conditions that require medical examination prior to taking part in exercise. They may not be life threatening in some individual cases but still need to be reviewed by a physician.
- Thyroid disease.
- Excessive obesity.
- Excessively underweight.
- Breech presentation in the last trimester.
In pregnancy, the more aware a mother is of certain things that can affect the unborn child, the better she may counteract these issues. Some examples of risks/theoretical risks of maternal exercise to the foetus are:
- Direct trauma to the foetus. Although this is rare it should be avoided at all costs. Therefore contact sports should be avoided.
- Intense exercise may lead to smaller birth weights of the unborn child. However there are no reports on its adverse outcomes on pregnancy. The only recommendation that regardless of the exercise, the right amount of calories must be taken in to support a growing foetus.
- When pregnant the following must be avoided: saunas/steam baths/hot tubs, prolonged standing or exercising for too long on your back. Any of these may lead to dangerously low blood pressure and early developmental abnormalities. Overheating is very dangerous for a pregnant mother.
- Lower back problems may arise from being pregnant. Much care must be taken to support the spine correctly during this time. Load bearing exercises that strain the back therefore are not recommended.
In general, physical activity is not detrimental to pregnant women. Research has shown the following benefits are common:
- An improved general physical and psychological well-being in the mother.
- Women who exercise prior to pregnancy and continue to do so in pregnancy weigh less, gain less weight and deliver slightly smaller babes than sedentary women.
- The discomfort of pregnancy and labour may be more easily handled.
- It may be easier to get back into pre-pregnancy shape and weight after the birth. Once you have the all clear from your doctor to exercise the following guidelines should help you to ensure that no damage to mother or baby occur whilst training.
General Pregnancy Guidelines
- Drinking plenty of fluids is very important during pregnancy and especially during the first trimester. The baby has no way to control its own temperature so over heating should be avoided at all cost. This can be done by ensuring adequate hydration and avoiding training in hot humid conditions. Remember that if swimming you still sweat but might not notice, so stop regularly to rehydrate.
- For women who trained regularly before pregnancy regular exercise is preferable to sporadic sessions. As a general rule, mild to moderate exercise for 20 to 40 minutes, three times a week, at a heart rate up to approximately 140 beats per minute, has been recommended. It is generally considered as important to encourage pregnant women to modify the intensity of their exercise according to their own feelings of fatigue. Exhaustive exercise should be avoided. Pregnancy is not the time to commence anything other than a very mild exercise programme.
- Pregnancy requires approximately an extra 300 calories per day. These requirements are greater for women who exercise regularly. This should be carefully observed and training should be stopped if there is an insufficient weight gain (less than 1kg per month) during the last two trimesters.
- Avoid exercise where a loss of balance or physical contact could occur, especially in the third trimester.
- Dress for an activity wearing loose fitting clothing, with a good support bra and comfortable shoes.
- Avoid exercising on your back after the first trimester since this is the time that the uterus grows out of the pelvis and this position causes the uterus to weigh down on the vena cava (major heart artery) so reducing the blood and oxygen flow to the baby.
- Non-weight bearing exercise like swimming, cycling and indoor rowing are recommended, but, if doing weight bearing exercise, avoid bouncing and jerking exercises and deep knee bends as the hormone relaxin released during pregnancy softens the ligaments and this can increase the likelihood of injury. For the same reason, be careful when stretching during warm up and cool down, especially avoiding excessive and ballistic stretches.
- Avoid standing stationary for long periods of time.
- Exercising at altitudes of greater than 3,000m (10,000ft) may be unadvised, as rates of pregnancy complications are higher, and birth weights are lower, at high altitudes. In comparison, there have been no reports of problems associated with exercise at moderate altitudes.
- Be aware that as your pregnancy progresses you will need to re-evaluate your goals – more in line with staying fit than trying to work towards a personal best.
After birth activity may resume without any complications. The changes you experience in your body after pregnancy take time to return to normal. So be careful during the first 6 weeks after delivery. If you are breastfeeding then make sure you are getting in enough calories, about 500 more per day than usual.
After a caesarean birth, wait until your doctor gives you an all-clear after 6 weeks before you resume exercise. Weight training must be broken into slowly again. Otherwise after a sufficient break there is no reason you cannot build back into your physical training program again.