The below, are general guidelines, it is best that you consult your Doctor or Women's Health Physiotherapist prior to embarking on any exercise program.
It is very important that you do some form of exercise whilst you are pregnant. This is not to say that you need become a first time runner at your first glance towards a positive sign on your pregnancy test, but mild to moderate exercise sessions, at least three times a week, will help you significantly in preparing for the labour process. Giving birth is hard work, and the more prepared that you can be for some of the most physically intense hours of your life, the better. Even if you are planning to have a caesarian section, a regular exercise program that you are comfortable with, is essential.
I am also constantly surprised at how the physically fit, active women that I meet, recover so much more rapidly after child birth than those who are less active during their pregnancies.
There are however, a few things that you need to keep in mind.
Whilst you are pregnant, you are at greater risk of injuring yourself during exercise. This is due to the secretion of the relaxin hormone during pregnancy. This hormone causes an increase in joint laxity, which makes you more flexible and your joint strength and stability can be compromised. As the foetus inside you grows, your posture may change (think belly pulling you forwards, with an increased curve in your lower back) and your centre of gravity is shifted forwards. This can impair your balance and coordination and again put you at greater risk of hurting yourself when exercising.
As a general rule, I advise that pregnant ladies partake in non vigorous exercise. However, if you are used to exercising heavily, and your Doctor is happy with this, you can continue to do so.
Do avoid vigorous exercise in hot or humid weather, or of you are running a temperature. Your heart rate shouldn't exceed 140b.p.m, nor should you exercise vigorously for more than 15 minutes at a time. Remember to always drink fluids before and after you exercise too.*
Avoid vigorous exercise when pregnant, if you suffer from any of the following:*
Cardiovascular (heart) disease
A history of spontaneous miscarriages
Preterm labour in previous pregnancies
If you are carrying more than baby
Vaginal bleeding or ruptured membranes
Suspected IUGR or foetal distress
Thrombophlebitis or Pulmonary embolism
Chronic hypertension (high Blood Pressure), active thyroid, cardiac, vascular or pulmonary disease
Uncontrolled type 1 diabetes
Also be weary of vigorous exercise whilst pregnant if you:*
Are unused to high levels of exertion
Have any blood disorders such as sickle cell disease and anaemia
Have any thyroid disease
Are extremely obese or underweight
Have a breech presentation in the third trimester
Exercise of a competitive nature is also best avoided during pregnancy.
Hopefully, you don't fall into any of the above categories, but even if you don't, it's advisable that you avoid any jerky, bouncy or ballistic (explosive movement) exercises. You will probably find that later in your pregnancy your pelvic floor control will remind you to avoid these exercises too:)
When doing aerobic exercise, avoid high impact exercises, and find an exercise that suits you, that is rhythmical and uses your large muscle groups. The best for this is brisk walking or cycling.*
Stretching is important during pregnancy, however, positions of extreme stretching of a joint should be avoided as you are at more risk of injuring yourself as mentioned above.
Other than brisk walking, there are three forms of exercise that I recommend every pregnant woman try and partake in.
The first of these is Swimming. Even for you non swimmers, the pool offers the perfect environment for the pregnant body to exercise in. The buoyancy of the water supports your increasing body weight, whilst allowing you to continue to tone up, and improve your overall strength and endurance. A study (Katz, 1996) also showed that water based exercise offers pregnant women several physiological advantages. If you are suffering with any pain around your pelvis then it is best to avoid breast stroke, as the widening motion of the hips can exacerbate this pain. If the thought of swimming laps fills you with dread, then 'water walking' and some basic exercises can be beneficial too.* Contact me if you would like some examples of these.
Second is Yoga. Often on this blog have I sang the praises of yoga as a form of exercise and relaxation. However, again it is important that you aren't over stretching, and that you are avoiding any postures that exacerbate your lumbar lordosis (curve at the base of your spine). You need to ensure that the class that you attend is specifically suited to pregnant woman, and that your teacher is qualified and confident to be teaching pregnancy yoga. Yoga classes are also an excellent way for you to be reminded of and perform your pelvic floor exercises.
Third and probably the most important, is Pilates. Again you need to ensure that your teacher and the class are pregnancy specific, as whilst you are pregnant you only want to be doing the very gentle but essential abdominal activation exercises. Pilates focusses on developing body awareness and physical fitness, which begins with a central core of stability focussing on the abdominal and pelvic floor muscles. Hence Pilates is essential for you whilst you are pregnant and post nataly, to maintain and retrain your pelvic floor and abdominal muscles, as well as focussing on your posture and coordination.* A general Pilates class with lots of 'sit up' like exercises is not recommended whilst you are pregnant.
Nausea, lower back pain, round ligament pain and fatigue have all been shown to reduce with exercise during pregnancy (Sternfeld et a 1995). A reduction in insomnia and anxiety and a higher level of psychological well-being have also been found to occur with exercising when pregnantt (Goodwin et al 2000).*
Please feel free to contact me if you have any more questions about exercising whilst you are pregnant.
Happy Exercising whilst you are pregnant, it is definitely worth it.
*Information sourced from Physiotherapy in Obstetrics and Gynaecology, Second Edition, by Jill Mantle, Jeanette Haslam and Sue Barton. 2004.