Exercising While Pregnant

A woman who exercises before, during and after her pregnancy is better equipped to meet the challenges of giving birth and caring for her newborn child. The benefits for both mother and baby are enormous, and any risks involved are easily avoided. The best approach is to attain a good level of fitness before conception, maintain a moderate level of activity throughout pregnancy, and revert to the pre-pregnancy level and type of activity slowly and gradually once the baby is born.

A woman needs to be aware of the benefits and risks of exercising during pregnancy. Her level of activity prior to conception influences the activities she is able to perform during pregnancy. Most women are able to pursue gentle activities, such as walking, swimming and stretching exercises. Stretches that focus on strengthening the pelvic muscles are particularly useful preparation for labour, and also help to tone the pelvic region after childbirth. A woman’s return to her pre-pregnancy activities is determined by the type of labour she has experienced and the advice of her doctor.

BENEFITS AND RISKS

A woman who conceives when she is fit is less likely to suffer from the minor ailments of pregnancy: fatigue, backache, leg cramps and other nagging aches and pains. Also, labour is an immensely physical activity and a woman who is strong and supple is likely to cope better with the demands it imposes. Regular exercise helps a pregnant woman to relax and makes circulation more efficient, ensuring that she and the foetus are supplied with plenty of oxygen and nutrients. Exercise after childbirth helps to restore a woman’s body to its pre-pregnancy shape.

During exercise, pain-relieving opiate-like substances called endorphins are released. These are responsible for the feel-good effect of exercise or the ‘exercise high’. When a pregnant woman exercises, both mother and baby benefit from the resulting increase in endorphin levels.

While she is exercising, some of a pregnant woman’s blood supply to her baby is diverted to her own organs and muscles. When she stops exercising, the foetal blood supply returns to normal reasonably quickly. If the mother is in good health, this temporary shortage of circulation is not detrimental to the foetus. There is some evidence, however, that raising foetal temperature can have harmful effects – doctors therefore recommend that a pregnant woman should not get overheated during exercise and should keep her heart rate below 140 beats per minute.

FIT FOR CONCEPTION

Doctors recommend that women pay special attention to both diet and exercise during the six months before they plan to conceive. In terms of exercise, this means making sure that the body reaches a good overall level of fitness. For a woman preparing for pregnancy, the usual general guidelines about fitness apply: for example, aerobic exercise three times a week for at least 20 minutes per session combined with strength and flexibility exercises.

EXERCISE CHOICES

It is both safe and beneficial for a pregnant woman to continue exercise, provided that she does not over-exert herself. Women who have previously led a sedentary lifestyle should wait until after the baby is born before taking up new activities such as running or tennis. If a pregnant woman attends an exercise class, she should always let the teacher know about her pregnancy so that the teacher can give advice on which exercises should be omitted or modified. All pregnant women, whatever their level of fitness, should practise pelvic floor exercises daily throughout the pregnancy.

During pregnancy and childbirth, the physical demands on a woman’s body increase greatly. The average woman gains around 11.5kg (25lb) and her heart rate increases to meet the foetus’ demands for oxygenated blood. A pregnant woman therefore tires more easily during exercise, and should avoid over-exertion. Exercising to the point of discomfort or exhaustion is never advisable during pregnancy.

From the earliest weeks of pregnancy, the increase in the hormone progesterone starts to soften the ligaments in preparation for giving birth, and a pregnant woman may find that she is more supple than before. Gentle stretching has excellent benefits during pregnancy, but should be done with care so as not to overstretch the ligaments. Jogging or high-impact aerobics can jar the joints (and are also uncomfortable for heavy, sore breasts), and so should be avoided.

As the foetus grows and becomes heavier, a woman’s centre of gravity changes and the back muscles can easily become strained. Weight-bearing activities should therefore be avoided. In late pregnancy, a woman should not lie on her back, as the weight of the abdomen can put pressure on the major blood vessels in the torso, causing breathlessness and dizziness.

The abdominal muscles become very stretched during pregnancy, and actually-separate along the midline of the abdomen. A pregnant woman should not therefore do sit-ups, abdominal ‘crunches’, or leg lifts when lying on her back, because these strain the muscles and may displace the foetus.

AFTER THE BABY IS BORN

Unless a woman has had a Caesarean delivery, she can start to do a little gentle exercise a few days after the birth. If she has an episiotomy tear that is still healing, it is advisable to check with a doctor or midwife first. A woman who has had a Caesarean birth should wait at least four weeks before starting to exercise, and must consult her doctor or midwife first.

Because each woman has a different experience of pregnancy and birth, it is up to her and her doctor or midwife to judge when she can return to a full exercise routine.

Pelvic floor and pelvic tuck exercises are important after childbirth because they tone the muscles stretched during pregnancy and labour. Stomach muscles can also be toned gently by pulling them in while breathing out, holding them for a few seconds, then relaxing and repeating as often as possible throughout the day.

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