Exercise During Pregnancy
Being active prior to and during pregnancy brings many health benefits, including reduced back pain and better preparation for birth. In particular, exercise helps to:
- Increase insulin sensitivity for 24-48 hours, reducing risk of gestational diabetes
- Maintain your strength for childbirth and the demands of being a mother i.e. lifting, carrying and nursing your baby
- Reduce the chances of an assisted delivery, such as caesarean or forceps deliveries
- Reduce risk of blood pressure problems
- Manage mood and stress during pregnancy and after baby is born
- Reduce constipation - as long as you are consuming enough fibre and drinking plenty of water
Talk to your GP or midwife before starting any new exercise regime. If you have never exercised before you can start with 15 minutes, 3 days per week and build up over the coming weeks. For non-exercisers or occasional exercisers, aim for at least 30 minutes of moderate intensity exercise most days (150 minutes) per week. You should still be able to talk while you exercise. Suggested activities include:
- Jogging (only if experienced runner)
- Strengthening exercises
- Yoga/pilates (tell the instructor you are pregnant)
Let your body be the guide. If you are not having issues, you can exercise throughout the pregnancy or until it becomes uncomfortable. Highly active women (vigorous exercises) may continue to exercise as long as they stay healthy and the activity is appropriate for their changing body. Getting advice from an accredited Exercise Physiologist or Physiotherapist, especially one experienced in working with pregnant women, improves your chances of being able to continue exercising safely during your pregnancy.
What to avoid:
- Rapid changes in position, since blood pressure drops in the second trimester
- Strenuous exercise in hot or humid weather
- Activities that increase abdominal pressure, like heavy weight lifting
- Activities that might cause collision or heavy contact with the abdomen such as contact sports like martial arts, soccer, basketball, hockey and cricket
- Lying on your back after 20 weeks – the weight of the baby can slow the return of blood to the heart
Pelvic floor health
Your pelvic floor muscles will weaken, and widen during pregnancy, so it is important to regularly exercise them. The Continence Foundation of Australia has written a booklet for pregnant women who are with information on the pelvic floor and resuming exercise, see here.
If you have problems with your bladder or bowel prior to or after pregnancy, it would be worth talking with your GP, seeing a physiotherapist or a continence nurse to ensure that you have an individualised management plan .
Returning to exercise after the birth of your baby
After your baby is born, doing gentle exercise for your pelvic floor and abdominal muscles can help you recover. You can start gentle walking after a week or so when your pain and discomfort allow. You may notice that your abdominal muscles have separated during your pregnancy. You should avoid sit ups, crunches or lifting anything heavier than your baby until any separation improves. Strengthening the deep abdominal muscles can help improve this separation.
Try to keep your exercise gentle or at a moderate pace for at least the first 12 weeks after birth, while your muscles are healing. This is particularly important if you have had an assisted delivery (forceps, vacuum or episiotomy). If you would like to return to more strenuous exercise after birth, consider seeing a Physiotherapist who can assess your muscle recovery.
It is common for women to have bladder problems after birth. If you experience any urine leakage during activity or exercise, you can try activating the muscles before starting, for example before you cough or lift something. You should see your GP if you experience bladder leakage more than 3 months after birth.
For more information on how to exercise safely in pregnancy or returning to exercise see the links below:
[Source: SMA Position Statement Exercise in Pregnancy and Post-Partum 2016; Continence foundation; Pregnancy Birth and Baby; The Royal Women’s Hospital Victoria]