Exercise during pregnancy
Regular physical activity can provide health and social benefits for many pregnant women. Suggestions for exercise during pregnancy include walking, swimming and supervised classes such as yoga or tai chi. Pelvic floor exercises are also important before, during and after pregnancy.
If you are not experiencing any complications, it should be possible to enjoy some level of physical activity throughout most of your pregnancy. However, under some circumstances exercise can be detrimental to both the expecting mother and the growing fetus.
The first step is to consult your doctor, physiotherapist or healthcare professional to make sure your exercise routine won’t harm you or your unborn baby. You may need to modify your existing exercise program or choose a suitable new one if you were exercising very little before getting pregnant.
Benefits of exercise during pregnancy
Exercise during pregnancy offers many physical and emotional benefits. Physical activity may also help manage somesymptoms of pregnancy and make you feel better, knowing you’re doing something good for yourself and your baby.
Some of the benefits of exercising regularly throughout your pregnancy include:
• More energy
• Stronger back muscles, which can help manage back pain and strain as your belly grows
• Improved posture
• Improved circulation
• Weight control
• Stress relief
• Improved sleep and management of insomnia
• Preparation for the physical demands of labour
• Faster recuperation after labour
• Faster return to pre-pregnancy fitness and healthy weight
• Increased ability to cope with the physical demands of motherhood.
Exercising and changes associated with pregnancy
There are many changes that take place during pregnancy. Some will affect your ability to exercise, or cause you to modify your exercise routine, including:
• Hormones such as relaxin loosen ligaments, which could increase your risk of joint injuries (such as sprains).
• As pregnancy progresses, your weight will increase and you will experience changes in weight distribution and body shape. This results in the body’s centre of gravity moving forward, which can alter your balance and coordination.
• Pregnancy increases your resting heart rate, so you shouldn’t use target heart rate to work out the intensity of your exercise. In healthy pregnant women, exercise intensity can be monitored using a method known as Borg’s Rating of Perceived Exertion (RPE) scale. This measures how hard you feel (perceive) your body is working.
• Your blood pressure drops in the second trimester, so it is important to avoid rapid changes of position – from lying to standing and vice versa – so as not to experience dizzy spells.
Exercise suggestions during pregnancy
It is important to discuss your exercise plan with your doctor, as each pregnancy is different. In general, healthy women who have uncomplicated pregnancies can continue their previous exercise program after consultation with a doctor. It is also considered safe to start a new exercise program during pregnancy if given the all-clear by your doctor.
Pre-exercise screening is used to identify people with medical conditions that may put them at a higher risk of a experiencing ahealth problem during physical activity. It is a filter or ‘safety net’ to help decide if the potential benefits of exercise outweigh the risks for you. Print a copy of the pre-exercise screening tooland discuss it with your doctor or exercise professional.
If you have been cleared to exercise, it is recommended that you:
• Do at least 30 minutes of moderate-intensity physical activity (according to the RPE scale) on most, if not all, days of the week.
• Do no more than three sessions per week of vigorous exercise by the third trimester.
• Let your body be your guide. You know you’re at a good exercise intensity when you can talk normally and not become exhausted too quickly.
• Be guided by your doctor, physiotherapist or healthcare professional.
Suggested exercise activities during pregnancy
Activities that are generally safe during pregnancy, even for beginners, include:
• Cycling – outdoors or on a stationary bicycle
• Exercise in water (aquarobics)
• Yoga, stretching and other floor exercises
• Pregnancy exercise classes.
Some activities are safe when done in moderation by pregnant women who had already been participating in these activities prior to pregnancy. These include running and strength training.
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. These 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).
If you’re not sure whether a particular activity is safe during pregnancy, check with your healthcare professional.
Pelvic floor exercises and pregnancy
Your pelvic floor muscles are weakened during pregnancy and during birth (vaginal delivery), so it is extremely important to begin conditioning the pelvic floor muscles from the start of your pregnancy.
Appropriate exercises can be prescribed by a physiotherapist. It is important to continue with these throughout your pregnancy and resume as soon as is comfortable after the birth.
Abdominal exercises and pregnancy
Strong abdominal muscles support your spine. The internal core and pelvic floor abdominal muscles act as a natural ‘corset’ to protect the pelvis and lumbar spine.
During pregnancy, it is common for women to experience the condition known as diastasis recti abdominis – a painless splitting of the abdominal muscle at the midline, also known as abdominal separation. Traditional sit-ups or crunches may worsen this condition, and can be ineffective during pregnancy.
Appropriate core stability exercises are recommended during pregnancy to strengthen the muscles of the abdomen:
• Concentrate on drawing your belly button towards your spine.
• Breathe out while pulling in your belly.
• Hold the position and count to 10. Relax and breathe in.
• Repeat 10 times, as many times a day as you are able.
• You can perform this exercise sitting, standing or on your hands and knees.
Warning signs when exercising during pregnancy
If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:
• Dizziness or feeling faint
• Heart palpitations
• Chest pain
• Swelling of the face, hands or feet
• Calf pain or swelling
• Vaginal bleeding
• Deep back or pubic pain
• Cramping in the lower abdomen
• Walking difficulties
• An unusual change in your baby’s movements
• Amniotic fluid leakage
• Unusual shortness of breath.
Where to get help
• Your doctor
• National Continence Helpline Tel. 1800 33 00 66
• Bicycle Network Victoria – for further information on cycling and pregnancy
Things to remember
• Exercise during pregnancy offers many physical and emotional benefits.
• Talk to your doctor, physiotherapist or healthcare professional to make sure your exercise routine won’t cause harm to you or your unborn baby.
• Any illness or complication of the pregnancy should be fully assessed and discussed with your doctor before commencing or continuing an exercise program.