Exercise safely and effectively in pregnancy
Exercise in pregnancy can be confusing. What can and can’t you do? What do you need to look out for? Let us help.
When pregnant a woman can expect to gain 10-15kg although some will gain 30kg. This makes for a tremendous change to her size, how she moves, how hard her heart and lungs work.
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;
- gestational diabetes
- gestational hypertension
- preterm labour
- low birthweight
- prenatal mental health disorders
- Urinary incontinence
- Pregnancy related back and pelvic pain
What sort of pregnancy exercise is appropriate?
A variety of exercise is best. Through-out each week pregnant women should aim to cardiovascular, resistance as well as stretching and mobilising exercises.
Simple exercise can include;
Walking – 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!
Swimming – Water based exercise especially in later pregnancy is A.M.A.Z.I.N.G!
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 during pregnancy because of the impact through the pelvis and strain on the pelvic floor. However, at Vital Core we have had a huge number of women who have comfortably continued to run up until the mid 20 weeks. Some women are able to keep it up without ill effect all the way through pregnancy!
Joining our Vital Core mummycise exercise class will ensure you get all the strengthening and stretching you need.
There is no minimum ‘stage’ you need to be at to join. Whenever you (and your Vital Core physio) feel it’s right for you. Similarly you can continue in the Mummycise class as long as you feel comfortable. Being a physio lead class it can be individualised.
Mummycise classes are on Thursday evenings and Saturday mornings. It can be hard especially after work to head out to an exercise class. However trust us you will feel so much better and you will sleep easier afterwards.
In the class you will mobilise your spine, stretching out those tight muscles. You’ll strengthen through the hips and pelvis to alleviate the common conditions of Pelvic girdle pain. You will learn how to exercise your pelvic floor – that super important area that you may only just be learning about now that you’re pregnant. You will also keep some tone around your tummy muscles to make carrying that baby out in front a little easier.
Importantly you’ll do all this with the guidance and support of a qualified and experienced Women’s Health Physio, in a supportive and social environment.
Outside classes, an evening program of simple stretches can ensure you are not getting too tight through your back from the postural loads each day. Vital Core physio’s can set you up with a home exercise program using our easy-to-use App based exercise software.
You can also 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 when pregnant?
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
- 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
- Chest pain
- Excess fatigue
Does a women’s fitness level prior to conceiving change what she can do while pregnant?
Walking, pelvic floor muscle training, and our own Mummycise all excellent exercise and require little background. Almost everyone can do it.
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.
This is 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!
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. However guidance from a Women’s health physio is recommended.
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 Women’s physio is essential to determine individual variations.
Strong abdominal work does need to decrease, as you need the abdominal muscles to be able to lengthen and relax to accommodate the growing baby. Lots of strong abdominal work may cause these muscles to tighten and shorten which is not ideal.
Common pregnancy exercise modifications and considerations
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 you may find that you can’t rotate well through her trunk when walking so your stride has to be a little shorter – any walking buddies will just have to slow down 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.
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. For more than 16 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.