Pregnancy and exercise

About pregnancy and exercise

There are numerous potential health benefits for women who exercise during pregnancy, including better weight control, improved mood and maintenance of fitness levels. Regular exercise during pregnancy can also decrease the risk of pregnancy-related complications such as pregnancy-induced hypertension and pre-eclampsia.

Before exercising when pregnant, consult your doctor, physiotherapist or healthcare professional. You may need to modify your existing exercise program or choose a suitable new one if you were exercising very little before getting pregnant.

Benefits of exercise during pregnancy

Exercise during pregnancy offers many physical and emotional benefits. Physical activity may also help manage some symptoms of pregnancy and make you feel better, knowing you’re doing something good for yourself and your baby.

Some of the benefits of regular exercise throughout your pregnancy include:

• enjoyment
• increased energy
• improved fitness
• reduced back and pelvic pain
• decreased risk of pregnancy complications such as pre-eclampsia and pregnancy-induced hypertension
• preparation for the physical demands of labour
• fewer complications in delivery
• faster recuperation after labour
• prevention and management of urinary incontinence
• improved posture
• improved circulation
• weight control
• stress relief
• reduced risk of anxiety and depression
• improved sleep and management of insomnia
• increased ability to cope with the physical demands of motherhood.

Exercising and changes associated with pregnancy

Your body will undergo many changes during pregnancy. Some will affect your ability to exercise, or require you to modify your exercise routine, including:

• Hormones such as relaxin loosen ligaments, which could increase your risk of joint injuries (such as sprains).
• As pregnancy progresses, your weight will increase and you will experience changes in weight distribution and body shape. This results in the body’s centre of gravity moving forward, which can alter your balance and coordination.
• Pregnancy increases your resting heart rate, so don’t use your target heart rate to work out the intensity of your exercise. In healthy pregnant women, exercise intensity can be monitored using a method known as Borg’s Rating of Perceived Exertion (RPE) scale. This measures how hard you feel (perceive) your body is working.
• Your blood pressure drops in the second trimester, so it is important to avoid rapid changes of position – from lying to standing and vice versa – so as not to experience dizzy spells.

Beginning exercise during pregnancy

Pre-exercise screening is used to identify people with medical conditions that may put them at a higher risk of experiencing a health problem during physical activity. It is a filter or ‘safety net’ to help decide if the potential benefits of exercise outweigh the risks for you.

Read through the pre-exercise self-screening tool before embarking on a new physical activity or exercise program.

If you have been cleared to exercise, and you participated in physical activity before you were pregnant, it is recommended that you:

• Do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week.
• Let your body be your guide. You know you’re at a good exercise intensity when you can talk normally (but cannot sing) and do not become exhausted too quickly.
• If you are healthy and you are not experiencing complications in your pregnancy, continue this level of activity throughout pregnancy, or until it becomes uncomfortable for you to do so.
• Be guided by your doctor, physiotherapist or healthcare professional.

If you have been cleared to exercise, but you were inactive before your pregnancy:

• Start with low-intensity exercises such as walking or swimming, and build up to moderate intensity activity.
• Aim to do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. You can start with separate sessions of 15 minutes each, and build up to longer durations.
• Let your body be your guide. You know you’re at a good exercise intensity when you can talk normally (but cannot sing) and do not become exhausted too quickly.
• If you are healthy and you are not experiencing complications in your pregnancy, continue this level of activity throughout pregnancy, or until it becomes uncomfortable for you to do so.
• Be guided by your doctor, physiotherapist or healthcare professional.

Suggested exercise activities during pregnancy

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

• walking
• swimming
• cycling – outdoors or on a stationary bicycle
• jogging
• muscle strengthening exercises, including pelvic floor exercises
• exercise in water (aquarobics)
• yoga, stretching and other floor exercises
• Pilates
• pregnancy exercise classes.

Cautions for pregnancy exercise

While most forms of exercise are safe, there are some exercises that involve positions and movements that 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 – for example, don’t soak in hot spas or exercise to the point of heavy sweating. Reduce your level of exercise on hot or humid days. Stay well hydrated.
• Don't exercise to the point of exhaustion.
• If weight training, choose low weights and medium to high repetitions – avoid lifting heavy weights altogether.
• Perform controlled stretching and avoid over-extending.
• Avoid exercise if you are ill or feverish.
• 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.
• Don’t increase the intensity of your sporting program while you are pregnant, and always work at less than 75 per cent of your maximum heart rate.
• In addition, if you develop an illness or a complication of pregnancy, talk with your doctor or midwife before continuing or restarting your exercise program.

Exercises to avoid while pregnant

During pregnancy, avoid sports and activities with increased risk of, or characterised by:

• abdominal trauma or pressure – such as weightlifting
• contact or collision– such as martial arts, soccer, basketball and other competition sports
• hard projectile objects or striking implements – such as hockey, cricket or softball
• falling – such as downhill skiing, horse riding and skating
• extreme balance, co-ordination and agility – such as gymnastics
• significant changes in pressure – such as SCUBA diving
• heavy lifting
• high-altitude training at over 2000 m
• supine exercise position (lying on your back) – the weight of the baby can slow the return of blood to the heart; some of these exercises can be modified by lying on your side
• wide squats or lunges.

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

Pelvic floor exercises and pregnancy

Your pelvic floor muscles are weakened during pregnancy and during birth (vaginal delivery), so it is extremely important to begin conditioning the pelvic floor muscles from the start of your pregnancy.

Appropriate exercises can be prescribed by a physiotherapist. It is important to continue with these throughout your pregnancy and resume as soon as is comfortable after the birth.

Abdominal exercises and pregnancy

Strong abdominal muscles support your spine. The internal core and pelvic floor abdominal muscles act as a natural ‘corset’ to protect the pelvis and lumbar spine.

During pregnancy, it is common for women to experience the condition known as diastasis recti abdominis – a painless splitting of the abdominal muscle at the midline, also known as abdominal separation. Traditional sit-ups or crunches may worsen this condition, and can be ineffective during pregnancy.

Appropriate core stability exercises are recommended during pregnancy to strengthen the muscles of the abdomen. For example:

• Concentrate on drawing your belly button towards your spine.
• Breathe out while pulling in your belly.
• Hold the position and count to 10. Relax and breathe in.
• Repeat 10 times, as many times a day as you are able.
• You can perform this exercise sitting, standing or on your hands and knees.

Warning signs when exercising during pregnancy

If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:

• 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
• walking difficulties
• an unusual change in your baby’s movements
• amniotic fluid leakage
• unusual shortness of breath
• excessive fatigue
• muscle weakness.

Where to get help

• Your GP (doctor)
• Midwife
• Physiotherapist
• National Continence Helpline Tel. 1800 33 00 66
• Bicycle Network Tel. (03) 8376 8888 – for further information on cycling and pregnancy