There is growing evidence that regular physical activity during pregnancy contributes positively to physical and psychological health. Since pregnancy is a period of profound physical and psychological changes in a woman’s life, it is an opportune moment for a woman to identify, modify, and adopt habits and behaviours at the level of healthy lifestyles. Women with uncomplicated pregnancies should be encouraged to exercise as part of a healthy lifestyle before, during, and after pregnancy.
Women should be encouraged to engage in aerobic and muscle strength conditioning exercises as these activities have an essential role in health maintenance and the prevention and treatment of disease in all stages of life, including pregnancy. Regular aerobic exercise during an uncomplicated pregnancy maintains or improves physical fitness and cardiorespiratory function, enhances psychological well-being, and reduces the risks for sedentary lifestyle-related medical conditions. However, exercise routines may have to be modified during pregnancy to accommodate the normal anatomic and physiological changes that occur in pregnant women and to avoid adverse effects on the fetus.
Pregnant women can and should exercise during their pregnancy to improve cardiorespiratory and muscular fitness, facilitate recovery from labor, return faster to their prepregnacy weight, and strength levels, have more energy, gain less weight, improve psychological well being, mood and self concept, reduce feelings of anxiety, stress and depression, and adopt permanent healthy lifestyles (Artal, 2013).
Exercise training may also be beneficial in preventing or treating conditions such as low back pain, pelvic floor muscle dysfunction, pregnancy related urinary incontinence and chronic muscleskeletal conditions.
Participation in an exercise program may reduce the risk of developing conditions associated with pregnancy including preeclampsia (pregnancy induced hypertension) and gestational diabetes mellitus (Rocha, 2019).
Some things to consider:
After the first trimester of pregnancy, the back-lying (supine) position results in restricted venous return of blood to the heart because of the increasingly larger uterus. This position reduces cardiac output and may cause supine hypotensive syndrome. Consequently, exercises performed on the back should be avoided before the start of the second trimester. These include abdominal curls, bench presses, supine exercises on a stability ball, and stretching exercises with the back on the floor. As an alternative, pregnant women can perform exercises in a seated position, or side lying position.
During pregnancy, hormonal changes are thought to induce a greater laxity in joints, assisting in the softening of the pubic symphysis to accommodate delivery (Wayne et al, 2004). Because of joint laxity, exercises should be performed slowly and in a control manner to avoid damage to the joints as there is a higher risk of strains or sprain.
Also strengthening the abdominals and pelvic floor area is of major importance because these muscles provide the basis for postural support and prepare a woman for delivery. The transverse abdominis helps to support the lumbar spine and prepare a woman for the pushing stage of birth.
Additionally, the need for more oxygen during pregnancy is paralleled by the need for more energy substrate. Pregnant women typically use an extra 300 kilocalories per day to meet the increased metabolic requirements for homeostasis of their expanded life functions. Pregnant women must attain an adequate intake of nutrient dense foods and stay well hydrated through a balanced but expanded nutritional program. This is a good time to see a qualified nutritionist!
The intensity, duration and frequency of exercise should start at a level that does not result in pain, shortness of breath or excessive fatigue. Exercise may then progress at a rate that avoids significant discomfort. Pregnant women should be counseled to perform frequent self-assessments of physical conditioning and well-being, including hydration, caloric intake, quality of rest and presence of muscle or joint pain. It should be stressed that decreases in exercise performance are common, especially later in pregnancy. The goal is to allow the pregnant patient to obtain the maximal benefits of general well-being derived from exercise, while ensuring that no detrimental effects occur in the mother or the fetus.
Activities that require exceptional balance or extreme range of motion should be avoided in late pregnancy. The patient should also be discouraged from performing exercises that involve sudden changes in body position. The shift in center of gravity may result in increased instability and a greater risk of falls. Activities that incur the risk of fetal and maternal injury from abdominal trauma should be avoided.
Intensity, frequency, and duration of exercise depend on patient-specific factors. For most healthy pregnant women, the following exercise prescription is reasonable: Moderate-intensity exercise (able to carry on a normal conversation during exercise) that includes aerobic exercise and strength training, performed for 30 minutes daily, five to seven days per week. Previously sedentary women should begin with 10 to 20 minutes of continuous low-intensity exercise three times per week, increasing the intensity, frequency, and duration gradually.
Physically active women can engage in moderate to vigorous physical activity. They should strive to maintain a good fitness level throughout pregnancy without trying to reach their peak fitness level or train for athletic competition (Simone et al, 2012). Women may need to adjust the exercise intensity, duration, or both on any given day depending on how they feel.
“Mamas to be”, working out during your pregnancy is generally regarded as safe and is highly recommended throughout your entire pregnancy. But remember! This is not the time to aim for PR’s and tough workouts! Listen to your body and do not work through any pain. Exercise should be your energy booster and not your punishment! Your goals during pregnancy should focus on maintaining your fitness level, keeping your body strong, and staying active as much as possible till you see your little one! Until then, take a big breath and everything will be fine!