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Exercise & Pregnancy - A Closer Look

Welcome back to Part 2 of our series focusing on exercise and activity during pregnancy. Part 1 looked at the safety and benefits of exercise and pregnancy, as well as looking at the amount and type of exercises you should be doing. It also examined some Do's and Don'ts during that time. Part 2 will focus more on extra concerns while training, some tips to exercise more effectively and safely. We will also be looking at recreational activities during pregnancy and training as a pregnant competitive athlete.

Training Concerns Whilst Pregnant

With all the body and physiological changes during pregnancy, there are extra factors that need to be considered whilst exercising. Let’s take a closer look at things you might want to consider when participating in exercise:

  • Extra Weight - Increased weight can place extra forces on your joints during weight bearing exercises. While there is no clear evidence that weight increases during pregnancy lead to joint injury, it should still be accounted for before commencing exercise.
  • Back Pain - Many if not most women experience changes in posture known as ‘lumbar lordosis’, where you arch your lower back to help distribute the weight better. However, by doing so, it can lead to lower back pain which almost half of all pregnant women get.
  • Balance - Changes in posture can also affect your balance which can lead to increased falls.
  • Lax Ligaments - During pregnancy, hormones are going haywire and you experience increases in oestrogen and relaxin. Relaxin will help to relax ligaments in preparation for birth. This may place you at increased risk of sprains or strains, however there is little evidence to support this theory.
  • Pre-term Birth - False alarms due to unrelated uterine contractions are quite common the closer you get to birth. Exercise has been said to increase the chances of uterine contractions. However, measurements of exercising pregnant women 2 months before birth suggest no changes in uterine activity. However if you know that you are at risk of pre-term labour, then it is advised to reduce the intensity and workload of exercise.
  • Heart - While pregnant, you will experience changes in blood pressure, heart rate and blood volume. These occur as a way to provide extra blood supply to the baby and surrounding organs as well as extra nutrition. During moderate intensity exercise, there is no danger of reduced blood and nutrition supply to the baby. However, it is advised not to perform strenuous high intensity exercise
  • Breathing - The size of the baby will also push against your diaphragm and along with an increased rate of breathing, this can make activities you normally perform seem harder than usual.
  • Body Temperature - Your basal metabolic rate (the energy you use while you are resting) will increase as a result of pregnancy. This increased rate will lead to increased body temperature. It should be noted that large rises in body temperature during activity of up to 1.5 degrees have been shown to cause defects in the baby.
  • The Baby - Many pregnant women wonder whether or not exercise will redistribute blood away from the placenta providing nutrition, blood and oxygen to the baby. There isn’t a large amount of evidence available due to difficulties in taking such measurements, however, early indirect evidence suggests no lasting effects of the temporary redistribution of blood flow. This is mainly as a result of the foetus’ response by increasing blood pressure.

Tips For Training When Pregnant

Following are some great tips to make your training more effective, safe and pain free.

  • If you feel joint pain or discomfort during weight bearing exercise such as walking, jogging or running, then it might help switching to other forms of exercise such as cycling or swimming.
  • If you have lower back pain, the pain can increase in intensity especially during activities where you are standing. Consider sitting down exercises such as the reclining bike or swimming to take the pressure of your lower back.
  • If you have poor balance, ensure that you hold onto rails lightly if available or participate in activities requiring less balance.
  • Wearing proper footwear and going at a moderate pace will help ensure less chance of sprains or strains due to relaxed ligaments.
  • Go slow and increase intensity in small increments. Remember that getting oxygen in will become slightly more difficult.
  • To ensure that body core temperature does not go up dramatically, work out in loose, breathable clothing. Also consider adequate hydration and working out in a cool environment with good ventilation.
  • If you are worried about blood flow going away from the baby, water based exercises may be helpful as there is generally a central flow of blood while under water.

Recreational & Competitive Sport When Pregnant

Unfortunately there are not many studies looking at recreational sports and its effect on women. But common sense dictates that pregnant women avoid high body contact sports such as hockey, basketball and soccer. Similarly, those sports which carry a high risk of falling such as horseback riding, gymnastics, skiing and high intensity racquet sports should be avoided as they carry high risk of trauma for the mother and baby. Any sports that involve abdominal impact should be avoided at all costs. Recreational activity at altitude such as hiking or normal activity depending on where you live is tolerated well to about 2500 metres above sea level. In one particular study conducted at 2500 metres above sea level, no adverse effects on mother or foetus were seen with low-moderate intensity exercise. If you’re a competitive athlete who has just become pregnant, the idea of exercising at reduced capacity probably isn’t appealing to you or your coach. However, it is important to understand that continuing with high intensity elite level training places you and your baby at a much higher danger of level than moderate level activity. Lax ligaments, increased weight and changes in balance will all affect your athletic capabilities and increase your chances of injury. Endurance levels will most likely be reduced due to increased work of breathing and increased blood volume related anaemia. Exercising at intense levels will also put you at greater danger of increasing your body core temperature to levels which may be harmful for the foetus. Ensure that you are well hydrated and keeping cool between and prior to exercises.

Stay Active During Pregnancy

At the end of the day, a healthy, uncomplicated birth is what we hope for. Keeping yourself in tip top shape will certainly help make this happen. Exercising during pregnancy is safe and can be effective in controlling maternal weight gain, maintaining fitness and helping with gestational diabetes and mental health. Before commencing exercise, ensure you are cleared to do so by your doctor or obstetrician. Having done so, aim for 30 minutes of moderate intensity exercise on 5 or more days of the week. Continue to get regular check ups with your doctor or obsstetrician to ensure that you are tolerating your exercise program well. Be aware that pregnancy comes with many body changes which may affect your ability to do exercise. If you are planning to continue with recreational or competitive sport, ensure you seek accredited professional information before doing so. Good luck for the next couple of weeks or months and don’t forget to come back and check out the post pregnancy training article.

1 Sports Medicine Australia. SMA statement: the benefits and risks of exercise during pregnancy. J Sci Med Sport. 2002;5:11–19.
2 ACOG Committee. Opinion no. 267: exercise during pregnancy and the postpartum period. Obstet Gynecol. 2002;99:171–3.
3 Artal R & O’Toole M. ‘Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.’ Br J Sports Med 2003;37:6–12
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