What are the BENEFITS of exercise during pregnancy?
When should a pregnant woman STOP exercising?
AEROBIC EXERCISE
Exercise should be ceased immediately and not recommenced until clearance from your medical practitioner has been attained if you experience: Vaginal bleeding Uterine contractions/preterm labour Dizziness Unusual shortness of breath Headache Amniotic fluid leakage Chest pain Decrease foetal movements Sudden swelling of ankles, hands and face Muscle weakness Calf pain or swelling (need to rule out clot)
1. Maternal weight control – some studies have shown women that exercise before and during pregnancy weigh less and gain less weight. As stated above weight gain during pregnancy is on average 10-15kg and this is normal. Weight loss is not advised during pregnancy nor is excessive weight gain. For clarification please consult your medical practitioner. 2. Improved mood – can possibly (not proven) reduce the incidence of post natal depression. 3.
Maintenance of fitness levels
4.
Prevent Gestational Diabetes Mellitus –
The American Diabetes Association endorses exercise as “a helpful adjunctive therapy” for gestational diabetes mellitus when not controlled by diet alone.
How MUCH exercise is safe? The American College of Obstetricians and Gynaecologists’ guidelines for exercise during pregnancy and the post-partum period state that… “There are few instances that should preclude otherwise healthy, pregnant women from following the same recommendations” … when referring to recommendations of 30mins of accumulated moderate intensity exercise (equivalent to brisk walking) daily. The Sports Medicine Australia guidelines also endorse pregnancy being a safe time to START exercising in healthy women with non-complicated pregnancies and in consultation with their medical practitioner practitioner..
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Exercise during pregnancy is not advised if you have the following health conditions, unless cleared by your medical practitioner: • • •
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There are no studies which have determined the safe upper level of exercise but common sense along with the natural progression of pregnancy (increased weight, change in body shape and fatigue) tends to cause most women to lessen their physical activity levels. As previously mentioned, once the pregnancy has progressed to the third trimester no more than three vigorous exercise sessions per week are advised.
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Heart disease Restrictive lung disease Pregnancy induced hypertension (high blood pressure)/ Pre-eclampsia Incompetent cervix/cerc cervix/cerclage lage Multiple gestation at risk of premature labour Persistent second or third trimester bleeding Placenta praevia after 26 weeks Premature labour Ruptured membranes Severe anaemia Cardiac arrhythmia Diabetes Extreme morbid obesity Extreme underweight Intrauterine growth restriction Poorly controlled seizure disorder Poorly controlled thyroid disease Heavy smoker/ extremely sedentary
Exercise in Pregnancy
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Exercise during pregnancy can be a very beneficial experience if you are conscious of the precautions to take and knowledgeable about the effects that exercise can have on you and your baby. Pregnancy is a nat ural condition rather than an illness requiring confinement and is being recognised as a unique time f or women to make positive decisions regarding their health and lifestyle habits which could improve their health for the rest of their life. In a normal healthy pregnancy there is no reason why a woman cannot participate in regular exercise. Advanced Physiotherapy strongly urges all women who are planning to continue or commence exercise or sport while pregnant to discuss the specifics with their medical practitioner as well as following these general guidelines.
How does pregnancy affect my body and physical ability? INCREASED BODY WEIGHT During normal pregnancy your body weight can increase on average by 10-15kg. This normal increase changes the way weight is distributed and your overall body shape. This means that your centre of gravity is moved forward and your spine develops an increased curvature. Combining the increase in body weight with changes in your body shape means that some activities become more uncomfortable (i.e. jogging/running), it also alters your sense of balance and co-ordination.
RESTING HEART RATE INCREASES
What TYPE of exercise is safe?
During pregnancy your natural resting heart rate increases and your maximum heart rate decreases. This makes monitoring your exercise intensity through you heart rate difficult. The recommendation from Sports Medicine Australia (endorsed by the Royal Australian and New Zealand College of Obstetrics and Gynaecology) is to monitor your intensity levels by the rate of perceived exertion (see Borg’s Rating of Perceived Exertion Scale).
AEROBIC EXERCISE
BLOOD PRESSURE DECREASES Blood pressure drops in the second trimester as blood vessels develop to supply the growing placenta. From approximately the fourth month, it is recommended that you avoid rapid changes in position, from both lying to standing and vice versa – t his will reduce your experience of dizzy spells. Stopping suddenly can also cause dizziness as the cardiovascular system has a delayed response which may result in dizziness or fainting. Prolonged lying on your back should also be minimised from the fourth month onwards as the weight of the foetus can slow the return of blood to the heart. Try to modify any exercises that require lying on your back to laying on your side. Motionless standing should also be avoided.
PELVIC FLOOR The pelvic floor is an important sling of muscles which support the abdominal contents and the foetus while pregnant. With this extra load the pelvic floor can weaken during pregnancy and
Low impact moderate intensity aerobic exercise is commonly accepted as the safest way to keep up or even start to exercise whilst pregnant. Activities such as swimming, walking, jogging, hiking, aerobic dance, rowing, cross country skiing, dancing, rope skipping and cycling (stationary later in pregnancy) are accepted. Generally activities that increase the risk of falls such as skiing or those that can involve excessive joint stress like jogging or tennis should not be attempted, especially if the activity is not a regularly undertaken pre-pregnancy. However it can be evaluated in terms of suitability on an individual basis by the treating medical practitioner.. practitioner
RESISTANCE (WEIGHT) TRAINING Individually and professionally, prescribed light-to-moderate weight training exercises are safe during pregnancy. It is recommended to perform these using free weights, weight machines or a combination of both and to perform multiple repetitions at these low loads. loads.
Does exercise have any associated RISKS during pregnancy? There are theoretical risks associated with exercise during pregnancy to the mother and to the foetus; however these are considered theoretical as no studies to date have proven there to be a risk.
2. Contact sports – there is no research to support risk to the foetus while playing contact sport (i.e. netball). The accepted advice is that each woman consults with her treating medical practitioner. This discussion needs to consider the type of sport, pregnancy status and her history of participation in sport. For example it would be ill advised for a woman who has never water skied to attempt it for the first time at 30 weeks pregnant. 3. Over-heating – some studies of animals have shown that overheating of the mother could cause an increase in the risk of neural tube defects. Humans do have different heat dissipation methods to the animals studied, but following common sense when exercising should prevail i.e. do not exercise in the heat of the day or in humid conditions, stay well hydrated while exercising, wear loose comfortable clothing, take regular breaks and avoid prolonged aerobic exercise (limit more strenuous phase to 15mins).
RISKS TO MOTHER Risks to the mother have been discussed in the physical adaption section.
