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Jun 19

Exercise in pregnancy

Physical activity is essential in pregnancy.

In pregnancy, a woman can expect to gain 10-15kg. Some women gain 30 kg, which makes for a tremendous change to her size, how she moves, how hard her heart works and this all happens in a really short time frame. It is a massive stress on the body. As with most types of stress, being physically fit and active will help the body to adjust and to cope.

The 2019 Canadian guidelines of exercise in pregnancy provides up with the most up to date, evidence based recommendation for all pregnant women.

For most women (including women who were previously inactive or overweight) exercising at a moderate intensity three or more days a week has been shown to decrease the rate of pregnancy complications including;

  • pre-eclampsia
  • gestational diabetes
  • gestational hypertension
  • preterm labour
  • low birthweight 
  • prenatal mental health disorders
  • Urinary incontinence
  • Pregnancy related back and pelvic pain
Vital Core Mummycise classes twice a week

What sort of exercise is appropriate?

A variety of exercise is best. Through out the week including cardiovascular and resistance based training as well as stretching and mobility exercise. 

Cardiovascular fitness

A walking program can be designed to cover the cardiovascular component. It’s amazing how easy it can be to get 30 minutes of walking in most days – even if you work full time!

Water based exercise is AMAZING! Especially in later pregnancy. Buoyancy is the antidote to heavy weight on legs. So swimming or simply walking in water is wonderful.

Exercise bikes can be great dependent on where the tummy is sitting. We don’t advise road riding much because of the risk of falls or being knocked off your bike. Remember your reflexes generally aren’t as good as they usually are.

Running is generally not advised because of the impact through the pelvis and strain on the pelvic floor. However we have had a huge number of women who have comfortably continued to run (at a gradually decreased distance and pace) up until the mid 20 weeks. Some women are able to keep it up without ill effect all the way through pregnancy!

Resistance training

Joining our Vital Core mummycise exercise class will ensure you get all the strengthening and stretching you need.

An evening program of simple stretches can ensure you are not getting to tight through your back from the postural loads each day.

A few strengthening exercises in front of the TV every other night can cover the resistance component required to keep you strong as your body changes.

Vital Core mummycise classes – all the resistance AND stretching you need.

Yes you CAN continue with your gym based weights program, however you will likely need some modifications and monitoring.

Pelvic floor muscle exercises have been shown to decrease prenatal incontinence by up to 50%! So you simply must get onto this. However the correct advice for you is essential as more than 1/3 of women do not contract their pelvic floor correctly.

Having your Vital Core physio to help you is invaluable for working out what will work best for you.

Who can’t exercise?

There are some medical conditions in pregnancy that limit or sometimes prevent a woman exercising. Most women who are at risk will be managed very closely by their doctor. Here are the main “contra-indications” for exercise in pregnancy (mother can not exercise);

  • Significant heart disease
  • Restrictive lung disease
  • High risk of a premature labour
  • Persistent vaginal bleeding after the first trimester
  • Placenta praevia after 26 weeks
  • Experienced premature labour this pregnancy.
  • Ruptured membranes

There are a number of conditions that require a woman to be monitored closely including;

  • Severe anaemia
  • Chronic bronchitis
  • Poorly controlled heart arrhythmias
  • Seizures
  • Thyroid disease or type 1 diabetes
  • Extremely underweight or morbidly obese
  • Heavy smoker.

Warning signs to stop exercise when pregnant include:

  • Vaginal bleeding
  • Shortness of breath before exercising
  • Dizziness
  • Headache
  • Chest pain
  • Excess fatigue

Does a women’s fitness level prior to conceiving change what she can do while pregnant?

If a woman is not very fit before conceiving, she will need to start gently with an exercise program, but that is not a hindrance. Walking, pelvic floor muscle training, and water based exercise are all excellent exercise and require little background.

A woman who is very fit and active before pregnancy may need to adjust her expectations of herself. Many women are shocked at how quickly they get puffed out, because of the additional blood volume and consequent load on her heart – it is normal to get puffed very early on, and is not a sign of being unfit! Some more normal gym exercises will need to cease at some stage during the pregnancy such as strong abdominal work like planks, as well as hopping and other higher impact activities.

Pregnancy is not the time to start a heavy weights program, and most women will instinctively reduce the weight they are lifting. As long as she has a good pelvic floor muscle contraction (protecting her pelvic floor is essential) and can keep breathing throughout the lift, it is possible to weight train with heavier weights well into the pregnancy.

Are there modifications women can make to their past fitness routines so it’s appropriate to continue while they are pregnant?

Usually, reducing the intensity, duration and/or the impact will be sufficient. Specific advice from your Vital Core physio is essential to determine individual variations.

Strong strong abdominal work does need to stop, as you need the abdominal muscles to be able to lengthen and relax to accommodate the growing baby, rather than staying very short and tight. They need to be strong but not tight.

Common exercise modifications

From quite early in the pregnancy, there is a significant increase in blood volume, which means the heart has to work much harder to pump blood around. Many pregnant women feel puffed quite quickly – even after only a short flight of stairs. It’s important to allow for that – go a little slower, so that the effort remains the same. The baby is well protected during exercise in terms of its blood supply, so although mum is puffed, baby is doing just fine in there.

Exercise at a level that feels comfortable. Working hard can mean that talking is getting difficult but you are still comfortable. If you do feel more short of breath, then just wind it back for a moment – walk slower or sit down for a moment.

As the pregnancy progresses and the foetus takes up more space in the abdomen and pelvis she may find that she can’t rotate well through her trunk, so her stride has to be a little shorter – any walking buddies have to slow down just a little!

Some women find that lying on their back much after the first trimester is uncomfortable, as the baby within the uterus could put some pressure on the vena cava (the main vein returning blood from the legs and pelvis to the heart). If this happens, the mother may feel light headed, dizzy or a bit nauseated. You should roll onto her side and wait for those symptoms to subside (which they will quite quickly), and then probably avoid lying on your back thereafter.

Avoid over heating during exercise.

Don’t get too hot. In general, avoid exercising in hot, humid conditions and keep well hydrated. Fans are great to allow your sweat to cool you down!

Environments where you could fall heavily or are generally at higher risk of injury should be avoided. Bike riding on roads, trail running or riding or horse riding or rock climbing is not advisable. Similarly contact sports and scuba diving have a higher risk of injury to both mother and baby and (in our opinion) just aren’t worth the risk!

How do I know what is right for me?

Expert advice is invaluable. Vital Core physiotherapists are highly trained and experienced in helping women exercise through the child bearing year regardless of their previous exercise experience or how their pregnancy is progressing. For more than 15 years we have been helping women feel their best during the child bearing year and beyond. We can help you. Read more about the pregnancy and post natal period.