Many pregnant women often have many questions regarding exercise and their pregnancy. Exercise forms a part of most people’s lives, whether we realise it or not. Actions such as climbing stairs, walking to the shops or window shopping all involve some form of exercise. Some individuals inAnguillalive very sedentary lives and it is important for these women to be involved in some physical activities during their pregnancy.
What is recreational exercise?
Recreational exercise here refers to any planned regular exercise that a woman takes during her pregnancy, which involves energetic (aerobic) exercise (such as swimming or running) and/or strength conditioning exercise.
What are the benefits of recreational exercise during pregnancy?
Recreational exercise during pregnancy can benefit both the pregnant woman and the developing fetus.
Many women find that recreational exercise helps them to adjust to the physical changes that occur during pregnancy. It may help relieve tiredness, lower back pain and reduce varicose veins and swelling of the feet and ankles. Recreational exercise improves muscle tone, strength and endurance. It makes it easier to carry the weight gain during pregnancy and helps prepare the pregnant woman for the physical challenge of labour.
Recreational exercise promotes a sense of wellbeing. Staying fit during pregnancy may help to reduce feelings of stress, anxiety and depression. Recreational exercise also improves sleep.
Recreational exercise during pregnancy may help to prevent medical conditions such as:
• gestational diabetes mellitus (diabetes that develops during pregnancy)
• hypertension (high blood pressure)
Recreational exercise also reduces the risk of developing colon cancer and may reduce the risk of developing breast cancer later in life.
Women who do strength conditioning exercise during pregnancy tend to have a shorter labour time and fewer delivery complications.
What are some risks of recreational exercise during pregnancy?
Although recreational exercise can be beneficial during pregnancy, there may also be certain risks. These are related to the physical changes that occur as your body adapts to pregnancy. Complications include the following:
Getting too hot (hyperthermia)
When you exercise during pregnancy, your overall body temperature increases more than it would do normally. If your body temperature rises above 39.2°C in the first 12 weeks, this may affect the baby’s development leading to disability at birth.
To reduce the risk of getting too hot, you should:
• ensure that you drink lots of water before and during exercise
• avoid over-exerting yourself, particularly in the first 12 weeks of pregnancy
• avoid exercising in a very hot and humid climate until you have acclimatised – this will take a few days
Low blood pressure (hypotension)
When you lie flat on your back, the growing baby presses on the main blood vessels, and this may lead to low blood pressure (hypotension). This is more likely after 16 weeks of pregnancy.To reduce the risk of low blood pressure, you should avoid exercises which involve lying flat on your back, particularly after 16 weeks.
Physical injuries
Hormonal changes during pregnancy can result in changes in your joints and ligaments. When your joints and ligaments are less stable, you are at increased risk of injuring yourself.
To reduce the risk of physical injury, you should:
• make sure that you do warm-up and cool-down exercises
• avoid sudden changes of direction, if you are doing aerobic exercise
• consider wearing pelvic support belts during exercise
• wear comfortable exercise footwear that gives strong ankle and arch support
• avoid rocky terrain or unstable ground when running or walking. Your joints are more lax in pregnancy, and ankle sprains and other injuries may occur
• avoid lifting weights above your head and using weights that strain the lower back muscles
• take frequent breaks, and drink plenty of fluids during exercise
Pregnant women should note that exercise does not increase the risk of miscarriage in a normal low risk pregnancy.
What kind of recreational exercise should you avoid?
If you are pregnant, prior to starting any exercise programme you should see your obstetrician. The following are best avoided:
• You should avoid exercises which involve lying flat on your back, particularly after 16 weeks.
• You should avoid contact sports, where there is a risk of being hit in the abdomen, such as footfall, softball, and cricket.
• You should take particular care when doing exercises where there is a possibility of falling or losing your balance, such as horse riding, tennis and cycling.
• You should avoid scuba diving for your entire pregnancy because the baby has no protection against decompression sickness and gas embolism under water.
• You should avoid exercising over 2500 metres until you have acclimatised.
When should you stop exercising?
If the pregnant woman has any unusual symptoms, she should not continue to exercise. She should contact her healthcare professional immediately afterwards. She should stop exercising if the following occur:
• dizziness or feeling faint
• headache
• shortness of breath before exertion
• difficulty getting your breath whilst exercising
• pain or palpitations in your chest
• pain in your abdomen, back or pubic area
• pain in your pelvic girdle
• weakness in your muscles
• pain or swelling in your leg/legs
• painful uterine contractions or preterm labour
• fewer movements from baby
• leakage of your ‘waters’ (amniotic fluid)
• bleeding.
It is important for all pregnant women when exercising to listen to their bodies. Your body will naturally give you signals that it is time to reduce the level of exercise you are performing.
Never exercise to the point of exhaustion or breathlessness. This is a sign that your baby and your body cannot get the oxygen supply they need.
Exercise after childbirth
If a woman had an uncomplicated pregnancy and delivery, then she should be able to do mild recreational exercise, such as walking and stretching, immediately after birth. She should be advised to do pelvic floor exercises after the birth, as this reduces the risk of urinary and faecal incontinence.
Recreational exercise does not affect the amount of milk you produce or its quality. The baby’s growth will not be affected.
Women who do recreational exercise during pregnancy tend to continue to exercise after birth. The benefits of exercising at this time include the following:
• feel better
• feel less anxious and depressed
• have more energy
• lose weight
• feel fitter (improved cardiovascular fitness).
The woman should return to the exercise routine she maintained before pregnancy only when she feels ready to do so. She should not try any high impact activity (where both feet leave the ground at the same time such as jumping or jogging) too soon.
During pregnancy abdominal muscles are stretched and pulled to the side. The woman should follow the advice of her obstetrician about when and how to exercise in the first few days and weeks after birth.
If there were complications during pregnancy, then she should discuss what exercise is safe to do, after birth, with a healthcare professional.
Conclusion
There are many benefits from exercise for the pregnant woman. If the pregnant woman has a complicated pregnancy, or a medical disorder, she should first see a qualified and experienced obstetrician prior to starting an exercise programme during pregnancy. The vast majority of pregnant women can take part in recreational exercise during pregnancy and continue these exercises after childbirth.The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth.
Ask Your Doctor is a Health Education Column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty nine years in clinical practice. He has a medical practice in the Johnson Building in The Valley.
