Exercise during pregnancy

Emily Stephens

August 10, 2021

Physical activity is an important aspect for every person throughout their lifespan, especially women during their childbearing years. Lifestyle choices made during pregnancy impact both the mother and baby during pregnancy and in the time following birth. It is recommended that pregnant women complete 150 minutes of moderate intensity exercise per week, over a minimum of three days, during their pregnancy (Mottola, et al., 2019). Currently less than 15% of women actually meet this recommendation (Mottola, et al., 2019). This is largely due to the uncertainty of women and their care providers of the benefits and risks associated with exercise for both mother and baby. In recent years there has actually been an increase in rates of pregnancy complications such as gestational diabetes, pre-eclampsia (high blood pressure), gestational hypertension and macrosomia (large birth weight). This is believed to be linked to an increase in maternal obesity (Laredo-Aguilera, et al., 2020) and the general decline in physical activity across the population.


There are many benefits to exercising during pregnancy. Modifications may need to be made for exercises

Benefits of exercise

It has been found there are a number of benefits of participating in prenatal physical activity. These include a reduction in the odds of developing gestational diabetes mellitus, pre-eclampsia, gestational hypertension, prenatal depression and macrosomia (Mottola, et al, 2019). These conditions are all linked to excessive gestational weight gain during pregnancy (Laredo-Aguilera, et al., 2020). As with the general population, exercise during pregnancy improves muscular strength and endurance, cardiovascular function and physical fitness (Sports Medicine Australia SMA, 2016).  Interestingly, it was reported that women with a higher aerobic capacity had a shorter labour time (Zavorsky & Longo, 2011). Exercise also helps to improve mental health and reduce fatigue in pregnant women, reduces back and pelvic pain associated with carrying the baby, and prevents urinary incontinence. Following pregnancy women are more likely to return to a prenatal weight if they have maintained an active lifestyle during pregnancy (SMA, 2016).

Type of exercise

It is recommended that pregnant women who are already physically active, continue with their current level of exercise and make the necessary modifications as their pregnancy progresses. Women should accumulate 150-minutes of moderate intensity exercise each week.  This exercise should include a combination of aerobic exercise, resistance training and gentle stretching (Mottola, et al., 2019). It is also recommended that women complete pelvic floor exercises daily to help reduce the risk of developing urinary incontinence issues following the birth of their child (SMA, 2016). Moderate intensity exercise is classified as an activity that gets your heart beating faster than at rest, the woman should be able to talk but not sing. This could be activities such as brisk walking or jogging, swimming, cycling, aerobics, etc. Resistance training during pregnancy is encouraged to maintain muscle strength as the women’s body changes to support the weight of the growing baby. Resistance training can be completed twice weekly, with submaximal exercises using the women’s own body weight, light weights or resistance bands working large muscle groups (SMA, 2016).

Helpful Resources

  • PARmed-X for Pregnancy

A screening tool used by health professionals before participation in prenatal physical activity. This resource also includes information about prescription of exercise, healthy eating and considerations when completing strength training.

  • Pelvic Floor First website

Provides information on safe pelvic floor exercises. They have also developed an app for pregnant women or people with pelvic floor issues to provide safe exercises.

Absolute Contraindications

It is recommended that women who have any of the following conditions do not participate in strenuous activities and just continue with their usual daily activities. Your obstetrician will inform you if any of these apply to you.

  • Ruptured membranes.
  • Premature labour.
  • Unexplained persistent vaginal bleeding.
  • Placenta praevia after 28 weeks’ gestation.
  • Pre-eclampsia.
  • Incompetent cervix.
  • Intrauterine growth restriction.
  • High-order multiple pregnancy (eg, triplets).
  • Uncontrolled type I diabetes.
  • Uncontrolled hypertension.
  • Uncontrolled thyroid disease.
  • Other serious cardiovascular, respiratory or systemic disorder

Relative Contraindications:

Women with the following conditions should discuss the advantages/disadvantages to completing moderate-vigorous exercise with their obstetrician.

  • Recurrent pregnancy loss.
  • Gestational hypertension.
  • A history of spontaneous preterm birth.
  • Mild/moderate cardiovascular or respiratory disease.
  • Symptomatic anaemia.
  • Malnutrition.
  • Eating disorder.
  • Twin pregnancy after the 28th week. 
  • Other significant medical conditions.

If you have any further questions on exercising during pregnancy contact one of our physios or speak to your Physician/ Obstetrician. Check out our Prenatal/ Pregnancy Pilates exercise classes at our Geelong and Torquay clinic. These are small group classes designed to build/ maintain strength, core stability and mobility at your individualised level. Prior to starting the class our Physiotherapist will assess you 1:1 and tailor the class to your level. Call the clinic for any further enquiries.

About the author:

Emily has a special interest in ante and post natal physiotherapy care and is trained in Clinical Pilates call 52772151 to book a consultation or book online

Emily Stephens Clinical Pilates instructor

References:

Hinman, S. K., Smith, K. B., Quillen, D. M., & Smith, M. S. (2018). Exercise in pregnancy: A clinical review. Sports Health, 7(6), 527-531.

Laredo-Aguilera, J. A., Gallardo-Bravo, M., Rabanales-Sotos, J. A., Cobo-Cuenca, A. I., & Carmona-Torres, J. M. (2020). Physical activity programs during pregnancy are effective for the control of gestational diabetes mellitus. International Journal of Environmental Research and Public Health, 17(17). https://doi.org/10.3390/ijerph17176151

Mottola, M. F., et al. (2019). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52, 1339-1346.

Sports Medicine Australia (2016). Position statement: Exercise in pregnancy and the postpartum period.  Retrieved: https://sma.org.au/sma-site-content/uploads/2017/08/SMA-Position-Statement-Exercise-Pregnancy.pdf

Zavorsky, & Longo, (2011). Exercise Guidelines in Pregnancy. Sports Medicine, 41(5), 345-360.