Exercise in pregnancy

“Eating alone will not keep a man well; he must also take exercise. For food and exercise… work together to produce health.” Hippocrates, CA. 400 B.C.

Over the past decade or so it has become more and more clear that a good diet alone does not guarantee good health. Rather, good health results from a combination of genetics, diet, lifestyle and activity or exercise. Recent studies have shown that exercise is beneficial for your heart, lungs, arteries, blood pressure, muscles, bones, metabolism and for your nervous system. This is especially true in pregnancy, with a host of added benefits.


The Benefits of Exercise During Pregnancy

  • Maintenance of prenatal aerobic  and musculoskeletal fitness levels, promotes muscle tone, strength and endurance
  • Decreased number of interventions in labor
  • Decreased cesarean rate
  • Prevention of excessive maternal weight gain
  • Increased energy, relieves fatigue
  • May result in a shorter labor and faster recovery from labor
  • Promotion of good posture
  • Prevention of gestational glucose intolerance
  • Reduces the risk of preeclampsia
  • Prevention of low back pain, constipation, bloating and swelling
  • Improved psychological adjustment to the changes of pregnancy
  • Improves your mood
  • Helps you sleep better

    (ACSM’s Exercise is Medicine & ACOG, Piyarnik, et al., 2006, Sinclair, 2004)

 

What the Studies say about the safety of exericse during pregnancy

  • There is no increased risk of miscarriage in women who exercise.
  • Although the baby’s heart rate does increase by 5-25 beats per minute when a woman exercises, this has not been found to cause any damage or dangerous stress to the fetus.
  • No harm has been documented due to the rise in the mother’s temperature related to exercise.
  • Studies have shown that exercise later in the pregnancy does not cause preterm delivery. In fact, women who exercise straight through their pregnancy have shorter labors and few perinatal complications.

   (Riemann & Kanstrup-Hansen, 2000)

Like everything else, there are some rules…

Warning Signs: Stopexercising and call your midwife if you have any of these symptoms:

  • Vaginal bleeding
  • Dizziness or feeling faint
  • Increased shortness of breath
  • Chest pain
  • Headache
  • Muscle weakness
  • Calf pain or swelling
  • Uterine contractions
  • Decreased fetal movement
  • Fluid leaking from the vagina

 

Ask your midwife to modify your exercise routine to your needs if you currently have or have a history of:

  • Hypertension
  • Anemia
  • Thyroid disease
  • A sedentary life
  • Known cardiac or respiratory illness
  • History of bleeding during a previous or current pregnancy
  • Placenta previa after 26 weeks
  • Twin pregnancy
  • Pregnancy induced hypertension
  • Insufficient cervix
  • Preterm rupture of membranes or preterm labor
  • Intrauterine growth restriction
  • A history of delivering a small for gestation baby

(ACSM & ACOG)

Your Exercise Plan

The Exercise Plan by the American College of Sports Medicine, the American Heart Association and Harvey Simon from Harvard Medical School. (Harvey, 2006) (Jonas & Phillips, 2009)

 

There are four parts of a holistic exercise plan. Each section can be modified to your level of need and ability, so look at these lists and diagrams and start filling in your exercise chart.

 

1.    Cardio such as vigorous walking, running, biking or swimming is the part of the exercise routine where you get your heart and respiratory rate above its resting speed. The more you can do, the more you and the baby will benefit, but even a little something is better than nothing, so give it a go and see what you can accomplish.

  • How much and how often:

o  Moderate: moderate-intensity (which means your heart rate is up, you are sweating, but you can still talk) a minimum of 30 minutes a day five days a week. A brisk walk counts as moderate-intensity, so make a goal and start walking toward it.

o  Vigorous:  If you have been exercising vigorously prior to pregnancy, it is still safe to do so until your body tells you to slow down.  If you are in this category you need to exercise vigorously three times a week for twenty minutes. As you begin to slow down, lengthen the duration and number of sessions per week to keep up your cardio health. 

 

2.   Strength Training makes your joints, muscles and bones strong and healthy, especially for women, who tend to lose more bone density with age than men. Strength training is most commonly known as weight lifting (with dumb bells or weight machines) but can also be from resistance training (elastic bands) or yoga. 

  • How much and how often:

o  Eight to 10 strength training exercises with eight to 12 repetitions twice a week.

 

3.   Stretching is necessary for strong, stable and flexible joints. This is especially true in pregnancy as the pregnancy hormones loosen your joints to get ready for the passage of the baby through the pelvis. An inflexible or too loose joint is more likely to be injured when pushed or pulled during movement or exercise which may cause strains (injury to a muscle or tendon) or sprains (injury to the bone). Stretching can improve posture and your ability to exercise safely as well as help release tension and promote relaxation.

  • How much and how often: Stretching is one area where we do not have good evidence or clear rules regarding how many stretches and how often. Many suggest stretching prior to exercising to warm up and after exercise to cool down. Alternatively, a daily stretch can be part of your labor preparation – take a moment to relax and breathe for your physical and mental wellbeing.

 

4.   Balance is more about safety than about building a strong happy baby. In pregnancy your center of gravity is changing weekly, and while you may not wake up one morning and notice it because you adapt as it changes, your center of gravity is changing immensely. It is because of this balance chance that we do not suggest you hop on a bike in mid-pregnancy if you’ve not been biking regularly up until that point. It is not the bike or exercise that is dangerous, it is the change in your center or balance point that causes risk. If you haven’t been on a bike for months, try a stationary bike instead, the reclining ones even have space for your belly.

  • How much and how often: if your balance is in good form today, you don’t need to do specific exercises for balance, but do try to be aware of your balance limitations as the pregnancy continues.
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5.   Keep it Safe: Be sure to stay hydrated, avoid prolonged periods of overheating and be realistic about what to expect as the pregnancy progresses.

 

Short lil’ balance test

Can you:

-    Stand from a chair without using your hands?

-    Stand with your feet together and your eyes shut?

-    Walk and talk at the same time?

-    Brush your teeth while standing on one foot?

Reading Just for Fun

1. Long Distance Running in Pregnancy 

2. Abs during pregnancy - yes, you can keep them, or even build them safely. 

3. Exercise Benefits:

  - Reduces likelihood of c-section

  - Lower Gestational Diabetes risk factors

4. Even Cosmopolitan has an opinion.