Exercise and Pregnancy – Debunking myths and confirming the facts

Exercise and Pregnancy – Debunking myths and confirming the facts

In today’s day and age, we see a lot of advertisements and videos on social media about women exercising whilst pregnant. Today I want to address some of the comments on these types of videos. Before I do this, I want to first state that you should always consult your doctor prior to engaging into any physical activity during pregnancy. Please also note the lists below regarding contraindications to exercise.

 

Absolute Contraindications (NO exercise):

 

  • 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 (consult Doctor prior to engaging in exercise):

 

  • 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

Below I have chosen a few comments to address that I noticed on certain exercise videos of a woman at 21-29 weeks
pregnant doing various resistance exercises (machine and light-medium weight and theraband training).

“I’m scared to work out during pregnancy, but I walk more”

Why? Is it that you are afraid you’ll hurt your baby/yourself? Miscarriage? Research shows exercising from your first trimester actually reduces your risk of developing various complications during pregnancy such as gestational diabetes, pre-eclampsia, gestational high blood pressure, foetal macrosomia (large baby >4kg) and even reduces risk of miscarriage as well as various other health benefits to mum and baby, provided you don’t have any contraindications to prevent you from exercising. Discuss with your Physio or Doctor to come up with a safe exercise program for you.

“I just find this so wrong”

Why? The latest exercise guidelines currently recommend 150 minutes of moderate intensity exercise over a week, preferably spread over a minimum of 3 days and better if some physical activity was undertaken every day for pregnant women, not that much different from your regular non-pregnant person. Yes, there are some limitations to exercise and things you should avoid which I will list further below but unless contraindicated, exercise is extremely beneficial for mum and baby.

“This type of exercise is not what you should be doing”

Actually, the latest research recommends both aerobic and resistance exercise to achieve greater benefits, with yoga/stretching to accompany this. Of course, warm up and warm down are crucial with any type of exercise. One study incorporated aerobic and resistance training three times weekly for 55-60min from 9weeks until 38-39weeks pregnancy and concluded that overall labour time was reduced for these women (vaginal delivery). If you previously were not very active, there is no reason why you shouldn’t exercise during pregnancy, however you want to start slow and gradually increase your activity, so it is recommended to liaise with your Physio/Doctor to ensure safe commencement of an exercise program.

“I wish I was as motivated as you and could exercise like that whilst pregnant”

Remember, every woman’s pregnancy journey is a different one and everyone will be able to tolerate and do different things. Nutrition and sleep are just as important as exercise in Pregnancy, so ensure you are eating and sleeping well. Even if all you can manage is a half hour walk every second day, this is fine. The current research shows “something is better than nothing” in terms of reducing risks of complications. Discuss with your doctor or Physio for alternative exercise suggestions if you are finding it difficult to do exercise – there are plenty of options from cycling programs (stationary bike), to water-based exercise (hydrotherapy), pregnancy pilates and so much more.

Below I have directly taken the lists for safety precautions for exercise and when you should stop exercise and seek
medical advice, from the most current recommended guidelines for exercise during pregnancy.

List of Safety Precautions for Exercise:

  • Avoid physical activity in excessive heat, especially with high humidity (including activities such as hot yoga).
  •  Avoid activities which involve physical contact or danger of falling (horse riding, gymnastics, contact martial
    arts, hiking on unstable terrain, mountain biking etc).
  • Avoid scuba diving.
  • Avoid activities that involve exercise in changes of altitude >2500m above sea level (eg; mountain
    hiking/biking)
  • Those considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and foetal outcomes (most commonly the case with professional/elite athletes).
  • Maintain adequate nutrition and hydration—drink water before, during and after physical activity.
  • Know the reasons to stop physical activity and consult a qualified healthcare provider immediately if they occur (as below).
    When to Immediately Stop Exercise and Consult your Doctor:
  • Persistent excessive shortness of breath that does not resolve on rest.
  • Severe chest pain.
  • Regular and painful uterine contractions.
  • Vaginal bleeding.
  • Persistent loss of fluid from the vagina indicating rupture of the membranes.
  • Persistent dizziness or faintness that does not resolve on rest.

Hopefully the above has helped de-bunk a few myths and confirm some things you can do whilst pregnant. I have attached below the link to the current guidelines for more thorough reading. If you have any questions or would like to know more, feel free to contact us on 9279 7411!

 

References:
Mottola, M.F. et al. (2019) 2019 Canadian Guideline to physical activity Throughout Pregnancy. Link: https://bjsm.bmj.com/content/52/21/1339

Barakat, R. et al. (2018) Exercise during pregnancy is associated with a shorter duration of labor. A randomized
clinical trial. Link: https://www.ejog.org/article/S0301-2115(18)30096-4/abstract

Author

Jovana Bozic

Physiotherapist

This month’s blog post is by our Physiotherapist Jovana Bozic. 

Jovana enjoys treating a wide range of musculoskeletal conditions. She has previously worked with state touch football teams, local rugby union clubs and plays touch football socially herself. She also has a keen interest in Women’s Health and is able to assess and treat for Pelvic girdle pain, other antenatal aches and pains, post natal care including abdominal diastasis, and general pelvic floor training. She is also able to assess and treat various continence issues. Read more

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