While it has been established that in most cases it is safe to exercise during pregnancy, fewer than 15% of pregnant women achieve the minimum recommendation of exercise (150 mins per week of moderate intensity).
It seems that women find activity difficult to achieve, are unsure what to do, or are unsure if it is safe.
Unfortunately, it is difficult to implement a ‘one size fits all’ approach to exercise during and after pregnancy. This means general guidelines can be provided, however, it is always best to consult with your Obstetrician, Midwife or Physiotherapist to find out what is right for you.
BENEFITS OF EXERCISE DURING PREGNANCY
- Habitual prenatal exercise decreases the risks of complications during labour.
- Prenatal exercise reduces the odds of excessive gestational weight, which may reduce the risk of instrumental delivery.
- Prenatal exercise can reduce the severity of pain during pregnancy and post-partum.
- It is suggested that exercise during pregnancy reduces the degree of biomechanical change occurring as pregnancy advances;
- Decreasing loads on the spine
- Increasing joint stabilisation
- Contributes to better segmental control and motion
- May help reverse trunk muscle imbalance
- May initiate a pain de-sensitisation process leading to increased pain detection threshold
RECOMMENDATIONS ON EXERCISE DURING PREGNANCY
1. All women without contraindications should be physically active throughout pregnancy.
- Exercise is thought to reduce the odds of gestational diabetes, pre-eclampsia, gestational hypertension, prenatal depression and macrosomia WITHOUT increasing the odds of adverse outcomes including preterm birth, low birth weight, miscarriage and perinatal mortality.
- This recommendation includes women who were previously inactive.
- There are also benefits for those who are overweight and have gestational diabetes.
2. Pregnant women should accumulate 150min of moderate intensity exercise each week to achieve clinically meaningful reductions in pregnancy complications.
3. Physical activity should be accumulated over a minimum of 3days per week, however, being active every day is encouraged
4. Pregnant women should incorporate a variety of aerobic exercise and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may be beneficial.
5. Pelvic Floor muscle training may be beneficial and may reduce the odds of urinary incontinence.
6. Pregnant women who experience light headedness, nausea, or feel unwell when lying flat should modify their exercise position to avoid being supine.
SO WHAT SHOULD I DO?
While physical activity is encouraged during pregnancy, the type of exercise is dependent on what type of exercising the woman was completing prior to becoming pregnant.
Pelvic floor strengthening is also encouraged during pregnancy. There is some evidence to show that women who complete regular, supervised pelvic floor exercises during pregnancy may have reduced risk of urinary incontinence postpartum. It is important to make sure you are doing these exercises correctly, as it is thought about 50% of women who learn how to activate their pelvic floor from a pamphlet or website are doing them wrong. If you aren’t sure if you are doing these correctly, book an appointment to check with your Physiotherapist.
Activities/exercise that are considered unsafe include:
- Those with abdominal trauma or pressure (eg. Weight lifting)
- Contact or collision sports (eg. Soccer)
- Sports with hard, projectile or striking components (eg. Hockey, cricket)
- Falling (eg. Skiing)
- Those that require extreme balance, coordination and agility (eg. Gymnastics)
- Heavy lifting (greater than submaximal)
- High intensity training at altitude greater than 2000m
- Those lying on your back (including some yoga positions) especially in later stages of pregnancy
- Those done at high temperatures (eg. Bikram Yoga)
With the correct guidance and in the right environment, exercise during pregnancy is safe and encouraged. Regardless of your previous amount of activity, discussions regarding exercise during pregnancy should always occur with your primary carer (ie. Obstetrician, Midwife, GP or Physio).
WHAT DO I NEED TO BE WARY OF?
While there are many benefits of exercising during pregnancy, there are certain times, conditions, signs and symptoms where exercise should be avoided or ceased. The most common contraindications are listed below.
- Your waters have broken (ruptured membranes)
- Pre-eclampsia/uncontrolled high blood pressure
- You have a blood clot in your leg or lungs
- You have low lying placenta (placenta praevia) in late pregnancy
- There are concerns with your baby’s growth
- You have an incompetent cervix
- You have any vaginal bleeding
- You have restrictive lung disease
- Previous spontaneous miscarriage
- Previous preterm birth
- Mild-moderate cardiovascular or respiratory disorder
- Anaemia (low iron)
- Twin pregnancy after 28 weeks
- Extreme overweight/obesity (BMI >30)
- Intrauterine growth restriction
- Other significant medical conditions (eg. Poorly controlled type 1 diabetes, hypertension, hyperthyroisism etc).
Discussions around exercise should always be conducted with your primary carer. If you have any concerns or your symptoms change, stop exercising and ensure you seek the opinion of a professional before you continue exercising.
SIGNS WHEN TO STOP EXERCISING INCLUDE (BUT ARE NOT LIMITED TO):
- Vaginal bleeding
- Nausea or vomiting
- Feeling faint or light-headed
- Strong pain, especially from your pelvis or back
- Reduced movement of your baby
- Abdominal pain
- Amniotic fluid leakage
- Calf pain or swelling
- Chest pain/tightness or palpitations
- Shortness of breath
- Excessive fatigue
- Uterine contractions (premature and/or painful)
Please note, this information should be used as a guide only. If you have any questions or queries, discuss them with your Obstetrician, Midwife or Physiotherapist.