Exercise During Pregnancy: A Comprehensive Guide for Expecting Mothers by Kathryn Melvin APA Women's Health Physiotherapist
Pregnancy is a unique and transformative time for women, and staying active can play a crucial role in both maternal and fetal health. Regular exercise during pregnancy, when done correctly and safely, can offer numerous benefits. However, it’s essential to follow the right guidelines to ensure the health of both the mother and the baby.
In this blog post, we’ll delve into the latest research on exercise during pregnancy, review the guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), and explore the different types of exercises suitable for each trimester. We’ll also discuss some common pregnancy-related injuries and conditions that require attention, and highlight the importance of pelvic floor training.
The Benefits of Exercise During Pregnancy
Exercise during pregnancy can bring several benefits, not just for the expectant mother, but also for her baby. Research in Australia has consistently shown that physical activity in pregnancy can:
1. Improve cardiovascular health – Exercise helps maintain a healthy heart and circulatory system, which is important as blood volume increases during pregnancy.
2. Control weight gain– A steady and moderate exercise regimen helps regulate healthy weight gain and prevents excessive weight gain that can lead to complications.
3. Reduce the risk of gestational diabetes – Active women are less likely to develop gestational diabetes, a condition that affects a significant number of pregnant women.
4. Enhance mood and reduce stress – Physical activity is known to boost mood, combat fatigue, and reduce symptoms of anxiety and depression.
5. Prepare for labor – Regular exercise can improve endurance, strength, and flexibility, which may help with labour.
6. Improve sleep– Staying active during pregnancy can help reduce sleep disturbances, which are common during pregnancy.
7. Postpartum recovery – Exercise helps to regain strength, flexibility, and fitness after childbirth, facilitating a faster recovery.
General Exercise Guidelines for Pregnant Women
The RANZCOG guidelines (2023) and recent research from Australian health organizations emphasise the importance of staying active during pregnancy. According to these guidelines:
Duration: Aim for at least 150 minutes of moderate-intensity aerobic activity per week, spread over several days (e.g., 30 minutes five times per week). Alternatively, 75 minutes of vigorous-intensity aerobic activity spread over several days is also acceptable.
Strength training: Incorporate strength training exercises at least two days a week. This helps with muscle tone and joint stability, particularly in the pelvic region.
Rest periods: Take regular breaks during exercise, and avoid exercising to the point of exhaustion. If the woman is new to exercise, she should gradually build up intensity and duration. Always check with a healthcare provider before beginning any new exercise routine.
Exercise Recommendations for Each Trimester
First Trimester (Weeks 1-12)
In the first trimester, many women experience fatigue, nausea, and dizziness. The body is adjusting to pregnancy, so it’s important to keep exercise gentle and manageable. Suitable activities during this time include:
- Walking: A low-impact and safe exercise that increases heart rate without putting stress on
the joints.
- Swimming: Provides full-body workout while minimizing joint strain.
- Yoga/Pilates: Focus on relaxation and flexibility
- Strength training: Light strength training, using resistance bands or weights, can help improve muscle strength and joint stability.
Second Trimester (Weeks 13–26)
The second trimester is often when energy levels improve, and many women experience
fewer pregnancy-related symptoms. However, as the belly grows, balance may become a concern, so exercises that target the core and stability are vital:
- Cycling (stationary): A safe cardiovascular exercise that doesn’t put strain on the joints.
- Walking and hiking: Increases cardiovascular health while being gentle on the body.
- Strength training: Focus on low-resistance, high-repetition exercises to maintain muscle
strength without overburdening the body.
Third Trimester (Weeks 27–40)
As the pregnancy nears its end, balance and comfort become more challenging. Exercises should be adjusted to accommodate a growing belly and any discomfort:
- Walking: Continue walking as long as it feels comfortable.
- Pelvic floor exercises: Essential for strengthening the pelvic muscles in preparation for
labor and delivery.
- Breathing exercises: Practice relaxation techniques to manage stress and prepare for
labor.
- Gentle stretching and yoga: These activities can help with flexibility and alleviate tension in
the back and hips.
Exercise to Avoid During Pregnancy
Some exercises are not recommended during pregnancy, particularly those that pose a risk to the mother or baby:- Contact Sports: Activities such as basketball, soccer, or boxing should be avoided due to the risk of falls or injury.
- Scuba Diving: Diving can put pressure on the fetus and may lead to complications.
- Exercises that require lying flat on the back after the first trimester: This can lead to
decreased blood flow to the uterus and fainting.
- High-Risk Activities: Any activity with a high risk of falling or injury (e.g., skiing, horseback
riding).
Contraindications to Exercise During Pregnancy
Certain pregnancy-related conditions require caution or may limit exercise altogether. Ensure you seek advice from your GP, Obstetrician or Women’s Health Physio if the following issues arise, your exercise routine should be adjusted to cater for this.
- Pre-eclampsia: High blood pressure during pregnancy, which can lead to complications.
Exercise may need to be modified or avoided.
- Gestational Diabetes: Exercise can help manage blood sugar levels, but it’s important to
monitor glucose levels and avoid overexertion.
- Pelvic Girdle Pain: Pain in the pelvic region can be exacerbated by high-impact exercises,
so low-impact activities like swimming or walking are recommended. Avoid single leg
exercises like step ups, lunges, side stepping/ sliders.
- Round Ligament Pain: Sharp pains on one or both sides of the abdomen are common and
can be worsened by certain movements.
- Diastasis Recti: A separation of the abdominal muscles, which requires special care during
exercise to avoid exacerbating the condition.
- Wrist Issues and Varicosities: These are common but should be monitored carefully to
avoid strain or worsening of symptoms.
Pelvic Floor Exercises
Pelvic floor exercises, or Kegel exercises, are critical during pregnancy. These exercises strengthen the pelvic floor muscles, which support the uterus, bladder, and bowel.
The benefits of pelvic floor training during pregnancy include:
- Prevention of urinary incontinence: Strengthening these muscles reduces the risk of
leakage.
- Support during labor: A strong pelvic floor can assist during childbirth, particularly in
pushing.
- Recovery after birth: It can help the pelvic floor muscles regain strength more quickly after
delivery.
Conclusion
Exercise during pregnancy is not only safe but highly beneficial when done according to the right guidelines. The key is to choose the right type of exercise for each stage of pregnancy, considering any medical conditions, and following guidelines to ensure safety. Maintaining an active lifestyle throughout pregnancy can improve maternal and fetal health, prepare thebody for labor, and speed up postpartum recovery. Always consult your healthcare provider before starting any exercise program, and listen to your body for the best outcomes.
With regular, moderate exercise, you can enjoy a healthy pregnancy, stay active, and feel confident in your body’s ability to handle the challenges of labor and childbirth.
References:
1) Australian Health Ministers' Advisory Council (AHMAC). 2019. pregnancy: *Physical activity during pregnancy. A review of the evidence* Canberra: Australian Government.
2) Australian Government Department of Health. 2020. *Physical activity and pregnancy: A guide for health professionals* Canberra: Australian Government. Available at: https://www.health.gov.au
3) Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). 2023.
*Exercise during pregnancy* RANZCOG Guidelines. Available at: https://ranzcog.edu.au
4) Simmons, D., & Taylor, R. 2020. ‘The impact of exercise on pre-eclampsia: A systematic review.’ *Journal of Clinical Hypertension*, 22(6), pp. 945-952. Available at: https://doi.org/10.1111/jch.13941
5) Gottlieb, M., & Rice, L.J. 2019 ‘Exercise and pelvic floor health during pregnancy: A review of literature and the importance of pelvic floor training. ’ *Journal of Obstetrics and Gynaecology*, 39(1), pp. 10-15. Available at: https://doi.org/10.1111/jog.13901
6) Barakat, R., & Perales, M. 2019. ‘Exercise during pregnancy: Beneficial effects on maternal
and fetal outcomes.’ *Matern Child Health Journal*, 23(8), pp. 1065-1070. Available at: https://doi.org/10.1007/s10995-019-02789-1
7) Norton, C., & Binns, C. 2020. ‘Pelvic floor exercises: Benefits and techniques for pregnancy and post-partum recovery.’ *Australian and New Zealand Journal of Obstetrics and Gynaecology*, 60(2), pp. 220-225. Available at: https://doi.org/10.1111/ajo.13162
By Kathryn Melvin APA Women’s Health Physiotherapist