Pregnancy and post pregnancy

Recommendations for Exercise During Pregnancy

All women without contraindication should be physically active throughout pregnancy. This includes women who were inactive prior to pregnancy, even if they’ve never exercised before.

How much exercise?

Recommended exercise prescription for health in pregnancy follows the same principles and guidelines as non-pregnant people, modified to reduce the risks to the mother and foetus.

30 minutes of moderate intensity exercise such as brisk walking is recommended 5 days per week (to accumulate at least 150 minutes per week), but as little as 10 minutes of light exercise per day to start with can be beneficial for previously sedentary women.

Pregnant women should participate in physical activity at least 3 days per week but being active every day is encouraged.

What type of exercise?

It is advisable for previously sedentary women to start with low intensity activities and consult their health care provider prior to initiating a physical activity program.

The “talk test” can be used to monitor intensity, and women performing moderate exercise should still able to talk in sentences during physical activity. Using heart rate to monitor intensity is not as accurate during pregnancy as all pregnant women experience an increase in resting heart rate as one of the normal changes during pregnancy.

Pregnant women should participate in both resistance training and aerobic (cardio) exercise such as walking, jogging (in early pregnancy while still comfortable), cycling, swimming, rowing or crosstrainer to get better health benefits.

Pelvic muscle training during pregnancy can prevent and treat urinary incontinence during pregnancy and after birth. 8-12 pelvic floor contractions performed 3 times per day on most days is recommended.

Recreational or elite athletes who want to continue to participate in competitive sport during their pregnancy are advised to discuss the risks and benefits with their health care provider.

Some sporting activities are contraindicated during pregnancy

  • Activities with a high risk of falls or abdominal trauma from physical contact due to the risk of placental abruption and foetal trauma
  • Scuba diving because the foetus is at increased risk of decompression sickness (the bends)
  • Sky diving and hot yoga due to adverse affects on the foetus
  • Exercise at altitude – above 2500m (6000 feet) due to reduced oxygen availability (for people normally residing at low altitude)

Higher risk activities

Other types of exercise may come with some risk and women should talk to their health care provider to clarify their risk and make modifications if necessary.

  • Exercises that require jumping and quick change of direction can stress joints and increase the risk of joint injury
  • Exercises performed lying on your back after 28 weeks have the potential to restrict blood return to the heart by the uterus compressing the vena cava which can then cause maternal low blood pressure
  • Strenuous strength training should be adjusted to avoid the valsalva manoeuvre and excessive pressure towards the pelvic floor. Strength training can be performed but the focus should be on low intensity and high repetition

Reasons to stop exercising

A pregnant woman should stop exercising and consult her health care provider if she experiences any of the following warning signs:

  • Persistent excessive shortness of breath that doesn’t resolve on rest
  • Severe chest pain
  • Vaginal bleeding
  • Regular and painful uterine contractions
  • Amniotic fluid leakage
  • Persistent dizziness or faintness that doesn’t resolve on rest
  • Muscle weakness affecting balance
  • New calf pain or swelling

Exercise modifications

Prolonged exercise should be performed in the shade, in air conditioning or in front of the fan, with close attention paid to proper hydration and nutrition. Drink water before, during and after physical activity.

Exercises normally done on your back can be modified by lying on a 45-degree incline or by performing them on your side, in sitting or in standing.

Absolute contraindications to exercise

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

This includes those with:

  • 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

Relative contraindications to exercise

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

  • 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.