Exercise suggestions during pregnancy

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Aim to do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. If you are new to exercise, start slowly and progress at your own pace. You can start with separate session of 10 minutes each, and build up to longer durations as your body and fitness allows.

Let your body be your guide. You know you’re at the right exercise intensity when you can talk normally and do not become exhausted too quickly. If you cannot talk while you are exercising you are probably going to hard. If you can sing, you will need to step it up a bit.

Before exercising when pregnant, consult your doctor, or healthcare professional. Discuss appropriate physical activities suited to your stage of pregnancy, health and fitness level. Don’t just do an exercise because the pregnant woman next to you is doing it. You may need to modify your existing exercise program or choose a suitable new one if you were exercising very little before getting pregnant. And remember that exercise tolerance will change as pregnancy progresses, and can be reduced from early in the first trimester.

 

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

  • walking

  • swimming

  • stationary cycling

  • water based exercise

  • low impact muscle strengthening exercises, including pelvic floor exercises

  • pilates

Things to be mindful of:

While many forms of exercise are safe, some exercises involve movements and/or positions hat 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.

◦      Monitor your body temperature during exercise. Don’t soak in hot spas or saunas and avoid exercising to the point of heavy sweating.

◦      Stay well hydrated

◦      On hot or humid days, reduce your level of exercise

◦      Wear light-weight clothing

  • Don't exercise to the point of exhaustion.

  • If including weight training exercises, choose low weights and avoid lifting heavy weights altogether

◦      This will help to protect your pelvic floor, pelvis and back, which are all being affected by pregnancy hormones and the increasing weight of the uterus and baby.

  • Perform controlled stretching and avoid over-extending.

  • Avoid single leg exercises

  • If you don’t feel like exercising on a particular day, don’t! It is important to listen to your body to avoid unnecessarily depleting your energy reserves.

  • Avoid exercise if you are ill or feverish.

  • If you develop an illness or complication of pregnancy, talk with your doctor or midwife before continuing or restarting your exercise program

Activities to avoid:

Some sports and activities should be avoided during pregnancy. These include sports and activities where there is increased risk of, or characterised by:

  • collision, tripping or falling, or heavy body contact (e.g. martial arts, soccer, basketball, down-hill skiing)

  • a potentially unsafe environment

◦      high temperatures (e.g. hot yoga, spas, saunas),

◦      use of heavy equipment (e.g. weight lifting)

◦      use of striking implements (e.g. hockey, softball),

◦      repetitive high impact exercise (trampolining, or lots of twisting and turning, high stepping, or sudden stops that cause joint discomfort, instability or pain (hockey, netball abdominal trauma or pressure – such as weightlifting

◦      extreme balance, co-ordination and agility (e.g. gymnastics, acrobats)

◦      high-altitude training at over 2000 m

◦      significant changes in pressure (e.g. scuba diving)

  • lying on your back from 13 weeks (second trimester) – the weight of the baby and uterus can slow the return of blood to the heart; some of these exercises can be modified by lying on your side or using a wedge support

  • wide squats or lunges.

If you're not sure whether a particular activity is safe during pregnancy, check with your healthcare professional.

Warning signs when exercising during pregnancy

Be alert to any of the following signs during or after exercise.. If you experience any of these, please STOP exercising immediately and get yourself checked out by a health professional:

  • 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, pubic or pelvic pain

  • cramping in the lower abdomen

  • nausea or vomiting

  • walking difficulties

  • an unusual change in your baby’s movements

  • amniotic fluid leakage

  • unexplained shortness of breath

  • excessive fatigue

  • muscle weakness.

You should avoid exercise in pregnancy if you have the following medical conditions:

  • uncontrolled high blood pressure

  • pulmonary or venous thrombus

  • low lying placenta (placenta praevia)

  • foetal growth restriction

  • vaginal bleeding

  • pre-eclampsia.

  • bone or joint problems that may be made worse by physical activity

  • indicators of increased risk of premature labour (multiple pregnancy, ruptured membranes, premature contractions or shortened cervical length).

  • Severe anaemia.

  • Poorly controlled pre-existing medical condition (i.e. asthma, heart disease, diabetes, thyroid disease).

References

  1. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Exercise in Pregnancy (position statement). Last updated July 2016. https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Exercise-during-pregnancy-(C-Obs-62)-New-July-2016.pdf?ext=.pdf

  2. Lewis, E. 2014. Exercise in pregnancy. AFP. 43(8), 541-542

  3. Sports Medicine Australia. Exercise in Pregnancy and the Postpartum Period (position statement). Last updated 19/07/16. https://sma.org.au/sma-site-content/uploads/2017/08/SMA-Position-Statement-Exercise-Pregnancy.pdf

  4. Aladabe, D, Ribeiro, DC., Milosavljevic, S & Dawn Bussey M. 2012. Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. Eur Spine J, 21, 1769-76.

  5. Borg-Stein JP, Fogelman, DJ & Ackerman, KE. 2011. Exercise, sports participation, and musculoskeletal disorders of pregnancy and postpartum. Semin Neurol, 31, 413-22.

  6. Evenson, KR, Mottola, MF, Owe, KM, Rousham, EK & Brown, WJ. 2014b. Summary of international guidelines for physical activity after pregnancy. Obstet Gynecol Surv, 69, 407-14.

  7. Melzer, K, Schutz, Y, Boulvain M & Kayser, B. 2010. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med, 40, 493-507.

  8. Morkved, S. & Bo, K. 2014. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. British Journal of Sports Medicine, 48, 1-13.

  9. Nascimento, SL, Surita, FG & Cecatti, JG. 2012. Physical exercise during pregnancy: a systematic review. Curr Opin Obstet Gynecol, 24, 387-94.

  10. Zavorsky, GS & Logno, LD. 2011. Exercise guidelines in pregnancy: new perspectives. Sports Med, 41, 345-60.

World Health Organisation. Global recommendations on physical activity for health. 2011. https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf

Authors:

Peta Titter & Dr. Rhea Psereckis

Marco van der Heide