A bumpy run

Should women exercise during their pregnancy? Chartered physiotherapist Dan Lawrence looks at the pros and cons

Posted on February 2, 2012 by
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The answer in short is yes! It is generally accepted that exercise during pregnancy is beneficial for both the physical and emotional well-being of the mother. There is little understanding of the benefits for foetal development, but the mother’s awareness of the potential risks and warning signs is important.

Generally speaking, a previously active, expectant mother with a low-risk single pregnancy can continue to exercise as long as she adheres to some simple guidelines. One formal research paper concluded: “Parachute jumping should be avoided!”

Paula Radcliffe and former Bupa Great North Run winner Kara Goucher are among top female athletes who have continued albeit scaled-down training regimes well into pregnancy.

What are the advantages?

Knowledge of the advantages is mainly focused around the physical and psychological benefits for the mother. Continuing to exercise during pregnancy allows mothers to gain less weight and to deliver, on average, slightly smaller babies than inactive women. Unfortunately, there is no evidence to suggest that labour will be easier, although in theory a better level of fitness would be beneficial during the labour period. Beginning exercise during pregnancy has proved to be of benefit if done correctly.

Exercise also has protective effects, helping to reduce the risk of pregnancytriggered illnesses such as gestational diabetes and pre-eclampsia. The reduced risk of gestational diabetes is achieved through the increased use of blood sugars (glucose) and the resultant increase in insulin sensitivity.

Women that engage in exercise during pregnancy are reported to be half as likely to suffer from this condition.

Are there any risks?

Yes. Lots of information is available detailing the risks, contraindications and dangers. An informed and commonsense approach is usually enough to avoid any issues, but speaking with a GP or midwife is always recommended as they need to be aware of anything which could change your health status for the better, or for the worse.

As a pregnancy develops, increased weight, altered balance and hormonal changes will increase the risk of musculoskeletal injury. This can be avoided by a change in training to include lowerimpact activities and utilising supports when necessary. The pelvic support belts are very helpful for lower spine and pelvic pain. During pregnancy, joints – including those of the pelvis – become unstable as their supporting ligaments relax under the influence of an aptly named hormone called relaxin. Low blood pressure can also pose a problem for pregnant women. Both standing and lying down can cause reduced blood pressure (hypotension). When lying down flat, the uterus can compress the large blood vessels and reduce blood flow.

What types of exercise are suitable?

Despite what you may have read or heard from fitness experts, there is no one recommended exercise to benefit all pregnant women. Women should continue to do the exercise they enjoy as long as it doesn’t cause discomfort or the onset of any concerning symptoms. There are many common (and less common) reasons why women cease exercise during pregnancy, these should be discussed with a GP or midwife. Contact and potential collision or impact sports such as jump-based activities should be avoided for obvious reasons but running can be continued with modifications as required. It may be advisable to switch to water-based activities later in the pregnancy, which will take away any impact related stresses.

Core stability is very important during pregnancy because of the increased weight and general weakening of the supportive muscles. Diastasis of the abdominal muscles refers to the separation of the main abdominal muscle to allow for expansion. This returns to normal following pregnancy, but any activity that causes a bulging of the abdomen, such as sit-ups, should be avoided. Simple pelvic floor and transverses abdominal training can be performed on a regular basis. Your GP or midwife will have a good knowledge of these.

Weight training should favour higher repetitions and lower weights, accompanied by a good breathing technique to avoid the build-up of internal pressure. Breathholding should be avoided.

Altitudes above 10,000 feet (3000 metres) are known to cause an increase in the likelihood of complications and should therefore be avoided. There have been no reported complications at lower altitudes.

Can you resume training as soon as the baby is born?

After a normal delivery, the answer is yes. Care should be taken though for a few weeks as the body takes its time to return to normal as hormones, posture and balance readjust themselves. Extra care should be taken after a caesarean section and strenuous activity should be avoided for the first six weeks. Pelvic floor muscle-strengthening is important following both types of delivery. Adequate fluid and energy intake remains important, especially for lactating women. A supportive bra may also be required, depending on your choice of activity.

Other considerations

Exercise and training are often an important part of an athlete’s identity and any sudden change to this can be detrimental to their well-being. Some well-known athletes have continued to train hard and even compete while pregnant, but this is not normally recommended and individual circumstance and health status should be considered alongside the ability to regularly monitor the vital health markers of both the mother and foetus. The maintenance of a comfortable and healthy pregnancy should take absolute precedent over any competitive or training objectives.

Warning signs to look for

Stop exercise if you experience any of the following:
» Dizziness
» Headache
» Chest pain
» Vaginal bleeding
» Weakness
» Calf pain
» Fluid leakage
» Contractions
» Decreased foetal movement

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