• Exercise During Pregnancy: The Do’s, Don’ts and Why’s

Exercise During Pregnancy: The Do’s, Don’ts and Why’s

By Candice West

So you’re pregnant, planning on falling pregnant (or know someone that is) and perhaps trying to untangle the confusion on exercise during pregnancy? You may have heard that it is important to exercise but not sure if it is safe, especially because your previous hobby mainly involved pushing ZZZ’s and not iron. Well, now more than ever is the best time to start and there is a plethora of research telling us that why.

The Do’s

Rating of Perceived Exertion

Firstly, don’t just contemplate, get out there and move!  There are obvious modifications but ideally, you want a combination of moderate aerobic and strength exercise on most days for 30-45 mins.  Your aim during pregnancy is to maintain (or in some cases, attain) fitness not reach peak performance.  Any longer than 45 mins can significantly reduce blood glucose levels which can negatively affect fetal growth. Short bursts of high-intensity exercise are okay but in this case, keep the session to 30 mins max.  You want to make sure your heart rate doesn’t get higher than 90% as this can lower your baby’s heart rate. The rate of perceived exertion (RPE, see image) is a simple gauge on how intense you should be working.  Try to stick to level 12-13 of exertion e.g. feeling a little puffed but still able to talk.

Do also make sure you start pelvic floor exercises, especially from 20 weeks. These are specific exercises that help maintain muscle integrity ‘down below’. This is to prevent bladder/bowel leakage in the future as well as pelvic organ prolapse which are common problems after having children. Pelvic floor muscles aren’t always easy to exercise, so if you are unsure about how to do them (or what they are), consult your physiotherapist. Lastly, monitor how you are feeling. If you experience sudden sharp pains, excessive fatigue, difficulty breathing, irregular heartbeat, nausea, fainting or excessive muscle pain then cease the exercise and consult your Obstetrician, GP or health professional before continuing. Screening forms should also be filled out prior to starting exercises classes.

Get out there and move!

Exercises to consider:

  • Gym: light weights, cross trainer, bike, spin class, treadmill
  • Sports: change focus- i.e wind trainer – cycling, water running
  • Classes: Physio led Pilates (mat/reformer), aqua, yogalates etc.
  • Personal trainer led boot camps, one on one (Make sure trainer understands guidelines in pregnancy)
  • Any prenatal exercise classes

The Don’ts

There are a few things that are a no-no during pregnancy, some not as obvious as others. It’s best to avoid exercises where you are lying on your back from 16 weeks onwards, similarly for why it’s recommended not to sleep on your back. This position is where your pregnant belly puts excessive pressure on your inferior vena cava (a large vein that runs under the right side of the uterus to the heart) which may cause a drop in blood pressure (Supine hypotensive syndrome) and potentially cause lack of oxygen to the baby.  The symptoms are obvious and easily monitored for the mother (dizziness, nausea, rapid heartbeat) but not so for the baby.

Stay away from high intensity abdominal exercises.  These impacts foetal heart rate even more but can also contribute to excessive strain through the abdomen which may lead to/increase rectus diastasis (separation of your abdominal muscles). It also puts extra stress on your pelvic floor muscles.

Don’t stand in one position for too long.  This drops cardiac output more than lying on your back or doing abdominal work, therefore, lowering blood pressure which is not good for the baby.  Keep your feet moving when doing exercise classes (and just in general).

Avoid exercising intensely late in pregnancy- this is the time to taper off. Your body is going through many changes that are more apparent at this time including more load on your joints, ligaments, and muscles including your pelvic floor. Your ability to regulate your body temperature is harder (as your core temperature is increasing).  Hard or increasing levels of exercise at this stage may cause lower birth weight.

Finally, do not exercise if you experience pregnancy induced hypertension, persistent bleeding, preterm rupture of membranes, an incompetent cervix or if the baby is small for gestational age.

The Why’s:

So why is it important to exercise during pregnancy? Put simply, it reduces the risk of developing many complaints during pregnancy and it’s good for your baby. Exercise can improve your cardiovascular function and therefore reduce your risk of developing gestational hypertension, diabetes and especially pre-eclampsia. It can limit the amount of swelling in your legs and pregnancy weight gain. It can also reduce the likelihood of developing pelvic girdle pain, low back pain and cramping. Physically active women also have shorter labours and don’t have to push as hard compared to inactive women.

Prenatal exercise can help your baby

Prenatal exercise can help your baby by lessening the need for forceps and operative delivery, lowering the rate of childhood obesity and reducing the risk of premature birth. Other benefits include advanced foetal development and maturation.

So, it’s definitely a good idea to exercise while you’re pregnant but obviously, monitor how you’re feeling and back off the intensity towards the end of the last trimester. Remember you want a balance of strength based (like squats) and cardiovascular exercise (like brisk walking) with specific pelvic floor exercises and you want to be doing this most days of the week. If you are unsure if it is safe to exercise, speak with your Obstetrician or GP.

Contact us at Orion Family Physiotherapy on 3470 1203 if you’d like an assessment for exercise suitability, to teach you how to use your pelvic floor and prepare for pre/post labour or if you are interested in our Pilates classes.

For more information on pregnancy guidelines:
Sports Medicine Australia
Canadian SOCG/CSEP Clinical practice guidelines
ICS Guidelines
Pelvic Floor First
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