Women & Activity – Part 2

Many women are unsure if exercise during pregnancy is safe or what type of exercise they should be doing and for how long. This blog aims to give you some guidance for exercising during pregnancy.

Exercise during pregnancy is a safe and effective way to improve general emotional well being , maintaining optimal weight management, and controlling blood glucose levels. The current guidelines on exercise from the American College of Obstetricians and Gynecologists’ supports regular moderate low-impact exercise in a low-risk pregnancy.

What are the Benefits of Exercise during Pregnancy?

The advantages of exercise during pregnancy relate more to the general physical and psychological well-being of the mother rather than the effects on the pregnancy itself.

• Women who exercise before pregnancy and continue during pregnancy weight less, gain less weight, and deliver slightly smaller babies than sedentary women.
• Increased fitness may enable women to cope better with labor.
• Even overweight women who commence an aerobic exercise program can improve fitness throughout pregnancy.
• However, there is no evidence that women who exercise during pregnancy have shorter or easier labors – sorry!.
• Exercise during pregnancy is also good for the prevention of conditions such as gestational diabetes(GD). Those who are active during pregnancy have approximately 50% reduction in risk of GD compared with inactive women.

When is Exercise not suitable during Pregnancy?

Exercise is contraindicated in women with any serious or potentially serious complication of pregnancy. These should be assessed by your GP.

Some warning signs for women to stop exercising:

• Amniotic fluid leakage
• Decreased fetal movement
• Preterm labor
• Vaginal Bleeding
• Heart palpitations or chest pain
• Headache or dizziness
• Shortness of breath prior to exercise
• Nausea or Vomiting
• Muscular weakness or numbness
• Calf pain/swelling (until DVT is ruled out)

Guidelines for Exercise During Pregnancy

Most women are able to exercise during their pregnancy to benefit their health and well being.

Most of the time, provided that pregnancy progresses normally, women are able to maintain a reasonably high level of training until discomfort forces them to reduce training usually around the sixth month.

1. Before beginning an exercise program, it’s recommended that you meet with your GP to determine any possible risks to exercise while pregnant.
2. 30 minute of moderate exercise between 3-4 times per week is sufficient. Exercise should be gradually introduced and self-paced in low impact aerobic forms.
3. Avoid prolonged exercise on your back after the first trimester.
4. Avoid exercising in hot weather.
5. It is recommended that an extra 300 calories of nutrition be consumed for every exercise session including 250ml of fluid intake.
6. Ensure a good warm-up and cool-down.
7. Avoid excessive stretching
8. Wear a firm supportive bra.
9. Stop activity immediately should any abnormal symptoms develop (see above).

What Type of Exercise should You Do during Pregnancy?

Firstly, it is best to choose a type of exercise that you enjoy. Swimming , walking, running in water, and water aerobics are all great forms of exercise during pregnancy. For comfort reasons you may decide to change from jogging to water exercise late in the pregnancy.

Jogging – is a very popular type of exercise that can be continued during pregnancy. Distances run can be reduced especially in the later stages. Wear runners with good support and run on softer surfaces to reduce impact and prevent injuries.

Aerobic classes – can be continued but movements involving excessive bending back or lying on your back should be avoided especially after the fourth month. Low impact aerobics is the best option during pregnancy where bouncing movements should be avoided.

Cycling – has the advantage of being a non-weight bearing activity. Using a stationary bike in the later stages may be  more suitable due to balance problems caused by the shift in your center of gravity. 

Pelvic Floor Exercises – these are important to provide you with an awareness of the muscle groups so that you can learn to contract and relax the pelvic floor. Trunk stability exercises are also important during pregnancy due to increased load on the spine and postural changes. 

Weight training – may be continued if you already have experience in weight training before pregnancy but heavy weights should be avoided. The focus should be on higher repetitions with low weight. 

Should you have any concerns about any individual contraindications to exercise it is best to get checked by your GP to ensure you are safe to exercise.

Exercise after Pregnancy

After normal delivery, gentle exercise such as walking or stretching can be started as early as the mother is comfortable. However, care should be taken in the first 6 weeks after delivery to avoid sudden high impact or contact exercise. You should avoid excessive stretching or lifting anything heavier than the baby in this period. 

After a C-section you should avoid strenuous activity for around 6 weeks and heavy weight training for around 12 weeks. Here the focus should be on restoring strength and control of the pelvic floor muscles. 

It is common for women to experience musculoskeletal pain after pregnancy, especially in the lower back, upper back, and pelvic areas. Diastasis Recti (separation of the abdominal wall) occurs in up to two – thirds of women after pregnancy where a gap of 2.5cm is important.

Read more about Diastasis Recti here & How Physiotherapy can help the condition. 

How can Physiotherapy help you return to Exercise after Pregnancy?

• Postnatal women can benefit from an individualised assessment and guided abdominal and pelvic floor rehabilitation for the prevention and management of pelvic organ dysfunction, urinary incontinence and for improved sexual function.
• Your physiotherapist can guide your progression from low impact exercise to higher impact exercises like running after 3 months. 
• Strength and control exercises for the muscles and joints help with pre existing hyper-mobility issues that may lead to injury on return to exercise.
• Treatment and rehabilitation of lower back and pelvic pain after pregnancy.
• Returning to Running  – Strength & Biomechanical assessment

Check out Part 1 here – Women & Activity Related Issues

If you are looking for a Pelvic Muscle Rehabilitation Program, a Return to Exercise program or if you are dealing with back pain then you can get in contact with us on +353872740700 or book online here.

Conor Tierney