When my sister first got pregnant, I leaped with joy. My first question, if I remember correctly, was the gender but obviously it was too soon to tell! However, being a physiotherapist, one of my first few questions to her was, ” Are you exercising?!” and she, of course replied,
“Can I??”
This is one of the most frequently-asked questions that many women, particularly active ones, have with regard to pregnancy. Exercise during pregnancy is no laughing matter as we have two lives at stake here — mother and child. So, is it safe to exercise when you are pregnant?
“Absolutely!”
There are many reasons why pregnant women would think that exercise is more harmful than helpful when it comes to their unborn child.
During pregnancy, there are many anatomical and physiological changes (physical and functional changes) in your body! A hormone known as ‘relaxin‘ acts to relax your ligaments to open up your pelvic region. Furthermore, cardiovascular changes are necessary to sustain you and your baby during rest and exercise. Moreover, weight gain and increased curvature in your lower back changes your centre of gravity, thus throwing off your balance.
How could anyone possibly exercise with all these bodily changes?
You most definitely can! However, there are many things you need to know about exercising in order to keep you and your baby safe. This includes precautions, contraindications (absolute no-nos), tell-tale signs to stop exercising, frequency, duration and suitable types of exercise.
So, to save you time, here is a summary of recommendations from multiple clinical guidelines.
What are the benefits of exercise in helping me and my baby?
Exercise is, without a doubt, safe for you and your baby during and after pregnancy. Done within the right parameters, it would benefit you by:
- Improving general fitness
- Reducing risk of gestational diabetes
- Improving post-natal recovery (get back into shape quicker!)
- Reducing risk of postnatal depression (also known as ‘postnatal blues’)
- Maintaining healthy weight
- Improving mood
- Reducing risk of back pain
What are things I should consider before starting exercise?
Complications during pregnancy range from, but are not limited to, cardiovascular complications, bleeding, previous complicated births or abortions, placenta previa, gestational diabetes, anaemia and pre-eclampsia. It is important that you consult with your gynaecologist, physiotherapist or doctor before exercising.
How much exercise should I be doing?
The general recommendation is 30 minutes of moderate-intensity aerobic exercise for 3-4 times a week.
It is common practice for non-expectant individuals to be using heart rate monitors to regulate their exercise. When you are expecting, however, heart rate monitors are less reliable. The ‘talk test’ is a good gauge of how hard you are working out. If you are able to carry a conversation without getting too breathless, you are working at an adequate pace.
Some guidelines recommend the Borg’s Rate of Perceived Exertion (RPE) scale. On an RPE scale of 6-20, you should be working between 12 to 14 (SOMEWHAT HARD).
However, for women who are used to sedentary lifestyles, it would be best to start off with a low-intensity exercise of 15 minutes while working towards 30 minutes of moderate intensity exercise.
For women who are extremely active, most guidelines recommend a slight reduction in exercise intensity and duration depending on which trimester they are in.
What types of exercises am I allowed or not allowed to do?
Swimming, is the safest exercise any woman can do. Other suitable exercises include:
- Kegel exercises
- Stationary cycling
- Walking
- Running (only if you are a seasoned runner)
- Modified yoga and Pilates
- Strength training
- Low-impact aerobics
Strengthening exercises have also been recommended but these have to be prescribed by a physiotherapist or an exercise physiologist. You will most likely be started on a regime incorporating very light weights with high repetitions.
High-impact sports such as tennis, gymnastics, volleyball, horseback riding, water-skiing, and soccer, which involve fast-changing and twisting motions predispose you to a risk of falling or receiving trauma to the abdomen. Clinical guidelines have strongly discouraged women from engaging in these sports.
Be mindful that in your first trimester, exercises involving you lying on your back is not permitted due to the risk of decreased venous return and hypotension. Hence, yoga and Pilates-related activities must be modified by a trained professional.
What types of environments should I exercise in?
As you exercise, your body temperature rises. Given our extremely warm and humid climate in Malaysia, guidelines state that a cooler environment would be recommended to avoid overheating your body. Be sure to hydrate yourself constantly to maintain your body temperature at an optimum level.
When should I stop exercising?
Listen to your body! If you display of these signs, stop immediately and seek advice from a health professional:
- Dizziness/nausea
- Vaginal bleeding
- Abdominal pains
- Back or pelvic pain
- Leg cramps
- Presyncope (sensation of fainting)
- Shortness of breath at rest
- Amniotic fluid leakage (‘Water Breaking’)
Some of you may have heard of Serena William’s recent win at the 2017 Australian Open while she was pregnant. Please bear in mind that Serena was under the close supervision and advice of medical professionals leading up to her win.
Regardless of whether you are an elite athlete or just someone who wants to get fit, do get the green light from your gynaecologist, doctor and physiotherapist before starting an exercise regime.
Chiropractic and pregnancy: To read more on whether receiving chiropractic treatments during your pregnancy is safe, you can read more over here.
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This post was written by our physiotherapy rehab specialist, Liesl Tan who has a real passion for young mothers and children. Besides being the “personal” physiotherapist to her sister, Liesl has the wealth of experience that is well beyond her years. Having had experience training within the Victorian medical healthcare system in Australia, she has since had the opportunity to work with individuals who need a variety of level of care. From Practice Members with acute injuries or scoliosis to individuals who are well past the injury phase and are in the process of optimising their function.