Pregnancy and Exercise

www.betterhealth.vic.gov.au 

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. Unless you have complications, it should be possible to enjoy some level of physical activity throughout most of your pregnancy.

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 sedentary before conceiving.

While exercise during pregnancy is usually encouraged, under some circumstances exercise can be detrimental to both the expecting mother and the growing fetus.

Benefits of physical activity during pregnancy

Exercise during pregnancy offers many physical and emotional benefits. Physical activity may also help manage some symptoms of pregnancy and you’ll 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
• 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.

Changes associated with pregnancy

There are many changes that take place during pregnancy. Some will affect your ability to exercise.

• Hormones such as relaxin loosen ligaments which could increase your risk of joint injuries (for example, sprains).
• As pregnancy progresses, weight increases combine with changes in weight distribution and body shape. This results in the body’s centre of gravity moving forward, which can alter balance and coordination.
• Pregnancy increases your resting heart rate, so it is not recommended to 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 Scale (RPE). 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.

General 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 now considered safe to start a new exercise program during pregnancy if given the all-clear by your doctor.

If you have been cleared to exercise, it is recommended that you:

• Engage in at least 30 minutes of moderate-intensity physical activity (according to the Perceived Exertion 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 intensity when you can talk normally and not become exhausted too quickly.
• Be guided by your doctor, physiotherapist or health care professional.

Suggested exercise activities during pregnancy

Activities that are generally safe during pregnancy, even for beginners, include:

• Walking
• Swimming
• Cycling – outdoors or on a stationary bicycle
• Exercise in water (aquarobics)
• Yoga
• Stretching
• Dancing
• Pilates
• 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
• Strength training.

General 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.
• Don’t exercise if you are ill or feverish.
• If you don’t feel like exercising on a particular day – then don’t! It is important to listen to your body to avoid unnecessarily depleting your energy reserves.

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 snow skiing, horse riding and basketball)
• Competition sports – depending on the stage of pregnancy, the level of competition and your level of fitness
• 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 the 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

The 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 the pregnancy. Appropriate exercises can be prescribed by a physiotherapist. It is important to continue with these throughout the 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. Traditional sit-ups or crunches can be ineffective during pregnancy and may make worse the condition known as diastasis recti abdominis (a painless splitting of the abdominal muscle at the midline).

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 for exercising during pregnancy

If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:

• Headache
• Dizziness or feeling faint
• Heart palpitations
• Chest pain
• Swelling of the face, hands or feet
• Calf pain or swelling
• Vaginal bleeding
• Contractions
• Deep back or pubic pain
• Cramping in the lower abdomen
• Walking difficulties
• An unusual change in your baby’s movements
• Amniotic fluid leakage.

Where to get help

• Your doctor
• Physiotherapist
• National Continence Helpline Tel. 1800 330 066
• Bicycle Network Victoria – for further information on cycling and pregnancy

Things to remember

• Exercise during pregnancy offers many physical and emotional benefits. While exercise during pregnancy is usually encouraged, you may feel it’s not right for you.
• 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. 

Summary

Regular physical activity provides many health and social benefits and may also help manage some symptoms of pregnancy. Unless you have complications, it should be possible to enjoy some level of physical activity throughout most of your pregnancy. Consult with your doctor, physiotherapist or healthcare professional before starting any new exercise program.

This artticle has been produced in consultation with and approved by: