Exercise during Pregnancy

By Anita Hayes

According to the American College of Obstetricians and Gynacologists (ACOG) guidelines (2015), physical activity in pregnancy has minimal risks and has been shown to benefit most women. Some modification to exercise routines may be necessary because of normal changes to the body in pregnancy. Women should be advised that there is no evidence that regular exercise during an uncomplicated pregnancy is detrimental to themselves or their baby.

It is recommended that pregnant women have a thorough clinical evaluation with their doctor prior to commencing an exercise program to ensure there are no medical reasons as to why exercise should be avoided. Those with uncomplicated pregnancies are encouraged to engage in aerobic and strength – conditioning exercises before, during and after pregnancy.

Aerobic exercise is exercise that consists of any activity that uses large muscle groups in a continuous rhythmic manner and elevates the heart and breathing rate. The ACOG guidelines recommend at least 150 minutes of moderate intensity aerobic activity per week. This should be spread out throughout the week. Usually 30 minutes on most, if not all days of the week is recommended. Walking is a practical mode of exercise during pregnancy, but must be performed at a ‘brisk’ pace for aerobic benefit. Other examples of aerobic exercise include jogging/running (in consultation with a medical practitioner running/jogging in pregnancy is safe in women who participated in these activities regularly pre – pregnancy), swimming, dancing, aerobics and aqua aerobics.

Muscular strengthening and conditioning is also an important part of a well-rounded exercise program. Pregnant women should aim for two sessions of strengthening/conditioning exercises per week, on non-consecutive days, covering the main muscle groups of the body. Examples of strength conditioning exercise include resistance training or weightlifting, Pilates, yoga and flexibility exercises.

It is also recommended that pregnant women commence or continue pelvic floor muscle training. These exercises help to tone the pelvic floor which in turn reduces the risk of incontinence and uterine or bladder prolapse.

It is important to be aware of your individual fitness and tolerance to exercise. During exercise, you should be able to hold a conversation – this is called the “talk test”. If you become breathless as you talk, then you are probably exercising too strenuously.

Another way to ensure that you are not over–exerting yourself is to use the ‘Borg Scale of Perceived Exertion’. This self assessment scale allows you to assess for yourself how strenuously you are exercising. One advantage of this technique is that it enables you to increase or decrease the intensity of your exercise as pregnancy progresses. It is based on physical sensations you feel during exercise, including increased heart rate, increased breathing rate, increased sweating and muscle fatigue. The scale ranges from 6 to 20. You should aim for a rating of between 12 to 14 on the scale. This means “somewhat hard” and indicates that you are exercising at a moderate intensity. Use the scale to speed up or slow down your movements to reach your desired range.

There are many physical and psychological benefits to remaining active and exercising throughout pregnancy. These include:

    Improved fitness
    Weight management
    Increased muscle tone, strength and endurance
    Exercise may prevent and treat gestational diabetes
    Exercise may relieve low back pain. Weight gain and the change in centre of gravity, due to the pregnancy bump, can cause back pain. Over 60% of pregnant women report back pain. This can be improved with back and abdominal strengthening exercises.
    Exercise may relieve constipation
    Exercise may reduce fluid retention, swelling and varicose veins
    Exercise can improve energy, mood and sleep
    Weight-bearing exercise throughout pregnancy can reduce the length of labour and delivery    complications

It is important to note that there are certain forms of exercise that should be avoided whilst pregnant. These include exercise where there is a risk of abdominal injury e.g.  Contact sports like boxing, soccer, and basketball and exercises where there is a high risk of falling e.g. gymnastics, horse riding, downhill skiing and cycling. Scuba diving and sky diving should also be avoided during pregnancy.

If you are pregnant and exercising and experience any of the following you should discontinue exercise and contact your healthcare professional immediately:

    Vaginal bleeding
    Regular painful contractions
    Anmiotic fluid leakage
    Shortness of breath before exertion
    Dizziness
    Headache
    Chest pain
    Muscle weakness affecting balance
    Calf pain or swelling

Here at Proactive Physio, we run physio – lead pregnancy fitness classes which are delivered by Chartered Physiotherapist Anita Hayes.

This is a fantastic program that incorporates pilates, yoga, strengthening and pelvic floor exercises with some aerobic exercise included for good measure! This pregnancy exercise class will:

      strengthen areas prone to weakness
      stretch areas prone to tightness due to postural changes
      reduce back and pelvic pain
      limit fluid retention
      strengthen the pelvic floor
     improve energy and sleep

Additionally, exercising during pregnancy will help speed up recovery post – partum! All exercises are carefully selected and suitable for pregnancy. Throughout the class you will be provided with lots of useful tips from a Chartered Physiotherapist.

References:

    American College of Obstetricians and Gynaecologists Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period.
    Obstetrics & Gynaecology. 126(6):135-142, December 2015.
    FAQ: Exercise During Pregnancy. ACOG FAQ119. August 2011.