Exercise during pregnancy is safe for mother and baby and is recommended to all pregnant women in the absence of the precautions listed below.
A systematic review in 2012 summarised all research papers that studied physical exercise during pregnancy and concluded that all pregnant women should be encouraged to participate in aerobic and strength training of moderate intensity.
Why should I exercise during pregnancy?
An inactive lifestyle during pregnancy may lead to:
- Loss of muscular and cardiovascular fitness
- Excessive weight gain
- Increased risk of gestational diabetes mellitus or pre-eclampsia
- Development of varicose veins
- Increased incidence of physical complaints such as shortness of breath or lower back pain
Exercise has been shown to reduce:
- Varicosities (enlarged veins) and swelling of the arms and legs
- Stress, anxiety and depression
- Some evidence suggests that weight-bearing exercise throughout pregnancy can reduce the length of labour and decrease delivery complications.
- Exercise is helpful in improving blood sugar control in women with gestational diabetes mellitus.
When should I avoid exercise during pregnancy?
If you have one or more of the following conditions, you need to speak with your GP or Consultant before partaking in exercise during pregnancy:
- Cardiac disease (Heart disease)
- Restrictive lung disease
- Persistent bleeding in the second and third trimesters
- Pre-eclampsia or pregnancy-induced hypertension
- Preterm labour (previous or present)
- Intrauterine growth restriction
- Cervical weakness or cerclage
- Placenta praevia or low lying placenta after 26 weeks gestation
- Preterm prelabour rupture of membranes
- Heavy smoker (more than 20 cigarettes a day)
- Orthopaedic limitations
- Poorly controlled hypertension
- Extremely sedentary lifestyle
- Unevaluated maternal cardiac arrhythmia
- Chronic bronchitis
- Multiple gestation (twin pregnancy or more)
- Poorly controlled thyroid disease
- Morbid obesity (Body Mass Index, BMI, greater than 40)
- Malnutrition or eating disorder
- Poorly controlled diabetes mellitus
- Poorly controlled seizures
- Any other medical conditions occurring during pregnancy
When should I stop exercising during pregnancy?
You should seek medical advice should any of the following symptoms occur:
- Excessive shortness of breath
- Chest pain or palpitations
- Presyncope (feeling faint) or dizziness
- Painful uterine contractions or preterm labour
- Leakage of amniotic fluid
- Vaginal bleeding
- Excessive fatigue
- Abdominal pain particularly in the back or pubic area
- Pelvic girdle pain (may require physiotherapy assessment)
- Reduced foetal movement
- Shortness of breath before exercise
- Muscle weakness
- Calf pain or swelling
How hard should I exercise?
‘The talk test’
It is recommended to exercise five times a week for 30 minutes or more.
The main goal of aerobic conditioning in pregnancy is to maintain a good fitness level throughout pregnancy without trying to reach peak fitness or train for athletic competition.
Walking and swimming are good forms of low impact aerobic exercise which can be performed during pregnancy. Yoga, Pilates and aquaerobics are other examples of low impact exercise which may include elements of stretching and strengthening. If attending classes it is best to attend a pregnancy-specific / ante natal class where exercises can be modified to suit the pregnant body.
It is recommended to exercise at a level where you are at a comfortable intensity but able to maintain a conversation during the exercise. This is known as ‘the talk test’.
If you have never exercised before, or have a sedentary (inactive) lifestyle, it is recommended to begin with 15 minutes continuous exercise 3 times a week and gradually increase to 30 minute sessions 4 times a week to daily.
Any activity which may increase your risk of falling or being hit is not recommended. These include the following: horse riding, skiing, field sports, gymnastics and cycling. Scuba diving is not recommended also.
If you are exercising in water, the temperature of the water should not exceed 32 degrees Celsius.
Why should I exercise post natally?
Benefits of postpartum exercise include improved cardiovascular fitness, weight loss, improved mood, reduced anxiety and depression and increased energy levels. Strengthening your pelvic floor muscles may reduce your risk of urinary stress incontinence.
Current recommendations suggest that, if the pregnancy and delivery are uncomplicated, a mild exercise programme consisting of walking, pelvic floor exercises and stretching may begin immediately. However, if your delivery is complicated or occurs by caesarean section, you will need to speak with your doctor or physiotherapist before resuming pre pregnancy levels of physical activity.
It is advised to return to pre pregnancy exercise levels gradually, not resuming high impact activity too soon.
If you are having any of the following symptoms, it is recommended that you are reviewed by a doctor or physiotherapist prior to return to pre pregnancy levels of exercise:
- Urinary incontinence
- Pelvic girdle pain- new onset or unresolved
- A feeling of something ‘coming down’ or pressure within with pelvis
- A large diastasis of the rectus abdominus muscles (large tummy muscle gap)
If you have any concerns or questions regarding exercise during your pregnancy, please feel free to speak to a member of the physiotherapy team.
You may attend the Post natal class after your baby is born. The physiotherapists run a class every Monday Wednesday and Friday from 11.30am to 12.00pm.
You may also meet us at the Post Natal Reunion Class on the third Tuesday of every month in the classroom outside St. Angela’s ward. You can book this class online at www.uhgmaternity.com
This information is evidence-based and comes from the following documents:
Royal College of Obstetricians and Gynaecologists (2006) Statement No. 4 ‘Exercise in Pregnancy’
The American College of Obstetricians and Gynecologists (2015) Committee Opinion ‘Physical Activity and Exercise During Pregnancy and the Postpartum Period’