Previously active and healthy pregnant women with an uncomplicated pregnancy can and should continue to exercise throughout pregnancy until birth or until such times that it becomes too uncomfortable to do so.

Women who were inactive prior to pregnancy, should be encouraged to become physically active during pregnancy, even if it is for the first time ever in their lives. It is advisable for them to start with low intensity activities and consult their health care provider prior to initiating exercise.

Pregnancy is an ideal time for behaviour modification and for adopting a healthy lifestyle because of increased motivation and frequent access to medical supervision. Physical inactivity is the fourth leading risk factor for global mortality behind tobacco smoking, high blood pressure and elevated blood glucose. Physical inactivity during pregnancy is almost as risky to your health as smoking, hypertension and diabetes.

Benefits of exercise during pregnancy

  • Improved or maintained physical fitness
  • Help with weight management
  • Enhanced psychological well-being
  • Improved muscular strength and endurance
  • Improved cardiovascular function
  • Decreased risk of pregnancy related complications such as gestational hypertension and pre- eclampsia
  • Decreased risk of gestational diabetes
  • Decreased risk of excessive gestational weight gain
  • Reduced pelvic and back pain
  • Reduced fatigue, stress, anxiety and depression
  • Decreased severity of depressive symptoms
  • Fewer delivery complications and lower risk of instrumental delivery
  • Fewer newborn complications
  • Decreased post-partum weight retention
  • Prevention and management of urinary incontinence

Despite the evidence regarding the benefits of exercise for a pregnant woman and her growing baby, a perception sometimes remains that exercise might be harmful to the mother and/or her unborn child. Some women worry that blood flow to exercising muscles may result in less oxygen available for their baby and some worry that exercise might lead to miscarriage, preterm labour or other neonatal complications. There is no evidence that this happens. During an uncomplicated pregnancy, there are specific adaptations that occur in the mother to make sure her foetus compensates for any transient changes to blood flow during maternal exercise. The baby is not at risk of harm when the mother exercises, even for previously sedentary pregnant women.

Light to moderate physical activity does not increase the risk of miscarriage or preterm delivery in uncomplicated pregnancies.

Pregnant women who want to continue or initiate an exercise program should be evaluated for medical and obstetric factors that may increase their risk for maternal or foetal complications.

There are a small group of women in situations where the risk of physical activity during pregnancy is likely to outweigh the benefit.

Absolute contraindications

  • Ruptured membranes
  • Premature labour
  • Unexplained persistent vaginal bleeding
  • Placenta previa after 28 weeks
  • Pre-eclampsia or uncontrolled hypertension
  • Incompetent cervix
  • Growth restricted foetus
  • Multiple gestation above triplets
  • Uncontrolled type 1 diabetes or thyroid disease
  • Other serious cardiovascular, respiratory or systemic disorders

There are also relative contraindications to exercise during pregnancy and specific situations where professional advice should be sought before exercising.

Relative contraindications

  • Recurrent pregnancy loss
  • Gestational hypertension
  • Previous spontaneous preterm birth
  • Mild or moderate cardiovascular or respiratory disease
  • Symptomatic anaemia
  • Malnutrition or eating disorder
  • Twin pregnancy after 28 weeks
  • Other significant medical conditions

If you are a woman wishing to start or continue exercise during your pregnancy, Shire Sports Medicine has specific pregnancy consultations for individualised advice and assessment regarding physical activity during your pregnancy.