The Latest Guidelines on Exercising during Pregnancy.

Julia Allan-Goodwin

May 28, 2020

The Latest Guidelines on Exercising during Pregnancy.

Exercising during pregnancy is extremely important to maintain health and fitness. Our physio Julia attended the Sports Medicine Australia conference where the leading researchers in their fields presented their latest findings in Sports Medicine. Currently Australia’s exercise guidelines are being updated for exercise during pregnancy which was discussed at the conference.

Here is Julia’s summary from the conference talk but feel free to speak with her directly or book an appointment if you need individual guidance.

There are many benefits to the mother and the baby when the mother is physically active with evidence to show the benefits. Here is a list of the latest proven benefits with strong evidence.

Benefits of Exercise for the Mother:

– Cardiovascular fitness
– Reduces weight gain during pregnancy
– Reduces risk of Gestational Diabetes and improves blood sugar level control for those that do have gestational diabetes.
– Prevent Incontinence (pelvic floor exercises – more info below)

Benefits for the Newborn Baby/Labour:

– Reduced risk of Pre-term birth
– Reduces Risk of Macrosomia (birth weight for baby > 4kg).
– Higher chance of Normal Vaginal Delivery

**
No added risk of endurance or strength training on causing difficult labour/poor delivery outcomes.
No added risk of vigorous exercise in causing preterm birth (one study actually showed vigorous exercise may protect against pre-term.

Do Pelvic Floor Exercises Work? Short Answer is      YES!

– Most pregnant women are now well informed on the importance of pelvic floor exercises in preventing urinary incontinence during and post pregnancy as well as improving the muscle repair after birth. Unfortunately, for those that are overweight and have a BMI >30 are at a much higher risk of developing pelvic floor issues during pregnancy and post

What is the latest evidence on this topic?

– Pelvic floor exercises have very good evidence for all pregnant women with a 30% reduction in experiencing symptoms if they are started preventatively (prior to any symptoms).
– The effectiveness is much less if already experiencing symptoms but they are still effective.
– These exercises are also more effective if taught and supervised by a trained practitioner (such as a women’s health physio).
– There is a much higher risk in women who are overweight with a BMI >30.

Other Resources for Pelvic Floor:
Physiotherapist description of how to activate your pelvic floor. Also has a link to their APP that is a good resource for pelvic floor programs. Click here for link.

Blog specifically on Pelvic floor exercises from physiotherapist Physio Laura as well as other great pregnancy specific blogs available at – Physio Laura link here

THE HOT TOPIC!

Is High Intensity/Vigorous Exercise Safe?

This is a difficult question to answer for many reasons which were explained at the conference:

1. Many people complete vigorous exercise in the first trimester when they don’t know they are pregnant (so this is also hard to study).
2. It is quite difficult to measure the foetal heart rate with a monitor during intense exercise and it is hard to know if it is accurate.
3. When researching this topic it is hard to define what is vigorous (may mean different things to different women/health practitioners), hard to quantify and ethically it is hard to get approval for such a study as the consequences could be dire if there are negative effects.

However, these summary points from the conference are good in helping educate pregnant women on what we do know so that they can make an informed decision on their exercise intensity:

– In the past HIIT exercise was thought to increase the risk of a miscarriage – however a recent study (although low in quality) showed there was no increased risk.
– Blood flow requirements from the placenta are higher for the baby in the third trimester which is why vigorous exercise was previously thought to be a risk. However, there is no real evidence to prove this.
– A recent review of the research found that HIIT (>95% max HR) during the 3rd trimester does reduce the blood flow to the baby and reduces the foetal HR transiently. But the HR does return to normal and they are unsure if there are any longer term consequences.
– HIIT during the 2nd trimester was found to potentially cause a healthier placenta and was linked to less preterm births (however, it was concluded that this was potentially linked to those doing vigorous exercise are likely healthier individuals at baseline).
– The recent exercise guidelines from the Sports Medicine Australia position statement has recently removed the warning regarding avoiding High Intensity exercise. The recommendation states if you are new to exercise to start slow and if you have a long history of exercising you may continue to do so – but potentially reduce your intensity

SAFE HEART RATE ZONES:

Here is a nice summary table of more recent research on safe heart rate training zones for healthy pregnant women specific to their age and fitness level.

When It’s not safe to exercise:

Ruptured membranes, premature labour
Persistent second or third trimester bleeding/ placenta previa
Pregnancy-induced hypertension or pre-eclampsia
Incompetent cervix
Evidence of intrauterine growth restriction
High-order pregnancy (e.g., triplets)
Uncontrolled Type I diabetes, hypertension or thyroid disease, other serious cardiovascular, respiratory or systemic disorder

Caution with exercise:

History of spontaneous abortion or premature labour in previous pregnancies
Mild/moderate cardiovascular or respiratory disease (e.g., chronic hypertension, asthma)
Anemia or iron deficiency? (Hb < 100 g/L)
Malnutrition or eating disorder (anorexia, bulimia)
Twin pregnancy after 28th week
Other significant medical condition

** If you have any concerns please consult your medical practitioner to ensure it is safe for you to exercise.


If you’re pregnant and keen for some physio specific home workouts we have made an Exercise Portal for our community to be able to access videos from home and there are many videos specific for pregnancy including:
Pre-Natal Matwork Beginner
Prenatal Matwork Workout Intermediate
Pre-Natal Stretch session
Office Worker Stretch and Self Massage Session.

For More Information or to sign up click on the link here!

For more information on research based exercise guidelines during pregnancy you can read more info here or book an appointment with one of our physios for individual advice.

Info links:
SMA Position Statement on Exercise in Pregnancy – https://sma.org.au/sma-site-content/uploads/2017/08/SMA-Position-Statement-Exercise-Pregnancy.pdf

Physical Activity Australia – link