exercise during pregnancy

Exercise During Pregnancy

Is it safe to exercise during pregnancy?

If you are healthy and your pregnancy is normal, it is safe to continue or start most types of exercise, but you may need to make a few changes. Engaging in physical activity does not increase the risks of miscarriage, low birth weight, or early delivery. Nonetheless, it is important to talk about exercise with your obstetrician or another member of your healthcare team during early prenatal visits. Upon receiving approval from your healthcare professional to exercise, you can decide together a safe and suitable exercise routine for your needs during pregnancy.

Are there specific conditions that make exercise unsafe during pregnancy?

Women with the following conditions or pregnancy complications should refrain from exercising during pregnancy:

  • Certain types of heart and lung diseases.
  • Cervical insufficiency or cerclage.
  • Expecting twins or triplets (or more) with risk factors for preterm labor.
  • Placenta previa after 26 weeks of pregnancy.
  • Preterm labor or experiencing ruptured membranes (when your water breaks) during the pregnancy.
  • Preeclampsia or pregnancy-induced high blood pressure.
  • Severe anemia.

What are the benefits of exercise during pregnancy ?

Regular exercise during pregnancy provides benefits for both you and your baby in the following key ways:

  • Reduces back pain.
  • Eases constipation.
  • May reduce the risk of developing gestational diabetes, preeclampsia, and the need for a cesarean delivery.
  • Promotes healthy weight gain during pregnancy.
  • Improves your overall general fitness and strengthens your heart and blood vessels.
  • Helps you to lose the baby weight after your baby is born.
  • Enhances blood circulation
  • Reduces risk of anxiety and depression
  • Improves sleep and management of insomnia
  • Increases ability to cope with the physical demands of motherhood.

How much should I exercise during pregnancy ?

Pregnant women should get at least 150 minutes of moderate-intensity aerobic activity every week. Aerobic activities involve rhythmic movement of large muscles in the body, such as those in the legs and arms. Moderate intensity indicates that you are engaging in enough movement to elevate your heart rate and induce sweating. You still can talk normally, but you cannot sing.

Examples of moderate-intensity aerobic activity include brisk walking and general gardening (raking, weeding, or digging).You can break down the 150 minutes into 30-minute workouts on five days of the week or opt for shorter 10-minute sessions spread throughout each day.

For those new to exercise, initiate with a slow start and progressively elevate your activity level. Commence with as little as 5 minutes a day and increment by 5 minutes weekly until you can sustain 30 minutes of activity daily.

If you were very active before pregnancy, you can continue with your existing workout routine, pending approval from your healthcare professional. However, if you start to lose weight, you may need to increase the number of calories that you eat.

Body changes that affect exercise during pregnancy

Your body goes through many changes during pregnancy. It is important to choose exercises that take these changes into account:

  • Joints: The hormones made during pregnancy cause the ligaments that support your joints to become relaxed. This makes the joints more mobile and susceptible to injury. Avoid jerky, bouncy, or high-impact motions that can increase your risk of being hurt.
  • Balance: Balancing during pregnancy becomes more challenging due to the additional weight in the front of your body, altering your center of gravity. This shift places increased stress on joints and muscles, particularly those in the pelvis and lower back. The heightened instability raises the risk of losing balance, making pregnant individuals more susceptible to falls.
  • Breathing: When you exercise, oxygen and blood flow are directed to your muscles and away from other areas of your body. While you are pregnant, your need for oxygen increases. As your belly grows, you may become short of breath more easily because of increased pressure of the uterus on the diaphragm (a muscle that aids in breathing). These changes may affect your ability to do strenuous exercise, especially if you are overweight or obese.

What precautions should I take when exercising during pregnancy ?

There are a few precautions that pregnant women should keep in mind during exercise:

  • Stay well-hydrated by drinking plenty of water before, during, and after your workout. Signs of dehydration include dizziness, a racing or pounding heart, and urinating only small amounts or having dark yellow urine.
  • Wear a sports bra that provides ample support to safeguard your breasts. As your pregnancy progresses, a belly support belt can also help alleviate discomfort while walking or running.
  • Avoid overheating, especially in the first trimester. Maintain hydration, wear loose-fitting clothing, and exercise in a room with controlled temperature. Refrain from outdoor exercise in excessively hot or humid conditions.
  • Minimize standing still or lying flat on your back whenever possible. Lying on your back can lead to the uterus pressing on a large vein that returns blood to the heart. Standing still may cause blood to pool in your legs and feet, decreasing the amount of blood returning to your heart and potentially causing a short-term drop in blood pressure.
  • During the second trimester, as your blood pressure decreases, it is important to avoid rapid changes in position, such as transitioning from lying to standing and vice versa, to prevent episodes of dizziness.

What are some safe exercises I can do during pregnancy ?

Whether you are new to exercise or it already is part of your weekly routine, choose activities that experts agree are safest for pregnant women:

  • Walking: Engaging in brisk walking offers a comprehensive workout for the entire body while being gentle on the joints and muscles.
  • Swimming: Swimming and water workouts effectively utilize various muscle groups. The buoyancy of water supports your weight, reducing the risk of injury and muscle strain. If brisk walking becomes challenging due to low back pain, water exercise provides a beneficial alternative to stay active.
  • Stationary bicycling: Stationary bicycling is recommended, considering the impact of a growing belly on balance, making individuals more prone to falls. This choice minimizes the risks associated with riding a standard bicycle during pregnancy.
  • Modified yoga and modified Pilates: Yoga aids in stress reduction, enhances flexibility, and promotes stretching and focused breathing. Prenatal yoga and Pilates classes specifically designed for pregnant women offer modified poses that accommodate the shifting balance during pregnancy. You also should avoid poses that require you to be still or lie on your back for long periods.

If you are an experienced runner, jogger, or racquet-sports player, you may be able to keep doing these activities during pregnancy. Discuss these activities with your health care professional.

What exercises should I avoid during pregnancy ?

During pregnancy, avoid engaging in activities that heighten the risk of injury, including:

  • Contact sports and activities where there’s a risk of getting hit in the abdomen, such as ice hockey, boxing, soccer, and basketball.
  • Skydiving.
  • Activities that may lead to falls, such as downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and horseback riding.
  • Heavy lifting that can cause abdominal trauma or pressure, such as weightlifting.
  • Pursuits demanding extreme balance, coordination, and agility, like gymnastics.
  • Performing exercises in a supine position (lying on your back), as the weight of the baby may impede the return of blood to the heart. Some of these exercises can be adapted by lying on your side.
  • Wide squats or lunges.
  • “Hot yoga” or “hot Pilates,” as these practices can lead to overheating.
  • Engaging in activities with significant changes in pressure, such as SCUBA diving.
  • Activities conducted above 6,000 feet (unless you already reside at a high altitude).

Pelvic floor exercises and pregnancy

During pregnancy and childbirth, the pelvic floor muscles undergo weakening, especially with a vaginal delivery. Initiating pelvic floor muscle conditioning from the early stages of pregnancy becomes crucial.

A physiotherapist can prescribe appropriate exercises tailored to your needs. It is essential to consistently practice these exercises throughout your pregnancy and resume them as soon as is comfortable post-birth.

Abdominal exercises and pregnancy

Robust abdominal muscles play a vital role in supporting your spine. The internal core, along with pelvic floor muscles, acts like a natural ‘corset,’ safeguarding the pelvis and lumbar spine.

Pregnant women often experience diastasis recti abdominis, a painless separation of the abdominal muscles at the midline, also known as abdominal separation. Traditional sit-ups or crunches may exacerbate this condition and are generally ineffective during pregnancy.

To address this, it is advisable to engage in appropriate core stability exercises throughout pregnancy to strengthen abdominal muscles. For instance:

  • Focus on drawing your belly button towards your spine.
  • Exhale while pulling in your belly.
  • Sustain the position and count to 10. Relax and inhale.
  • Repeat this sequence ten times, as frequently as you can manage each day.

This exercise can be performed in a seated, standing, or hands-and-knees position.

What are warning signs that I should stop exercising during pregnancy ?

If you experience any of the following signs or symptoms, discontinue exercise and contact your obstetrician or another member of your healthcare team:

  • Bleeding from the vagina
  • Feeling dizzy or faint
  • Shortness of breath before commencing exercise
  • Chest pain
  • Headache
  • Muscle weakness
  • Calf pain or swelling
  • Regular, painful contractions of the uterus
  • Fluid leaking from the vagina

Why is it important to keep exercising after my baby is born ?

Engaging in postpartum exercise can enhance mood and reduce the risk of deep vein thrombosis, a condition more prevalent in women in the weeks following childbirth. Beyond these health benefits, post-pregnancy exercise aids in shedding the additional pounds gained during pregnancy.

Author

Dr Sobia Mohyuddin

MCPS, FCPS, MRCOG, Consultant Obstetrics & Gynaecology

Doctor Sobia Mohyuddin is a highly skilled and experienced Obstetrician and Gynecologist, with 25 years of training and experience in renowned, large institutions. She holds the position of Associate Professor and Fellow at the College of Physicians and Surgeons Pakistan. She is also a member of the Royal College of Obstetricians and Gynecologists (UK).