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The new expert guidelines for exercise during pregnancy are hot off the press and it’s the first time the guidelines have been updated in 15 years!! These guidelines provide evidence-based recommendations for exercise during pregnancy focusing on the health of the mother, fetus and the new-born baby.
A lot of women are unsure of what is safe to do for exercise during pregnancy, adding to this uncertainty is the conflicting advice on the internet from people claiming to be specialists in pregnancy. This uncertainty often means that women will shy away from exercise during pregnancy.
So let’s clear up the confusion!
Keeping active during pregnancy has been shown to result in less newborn complications as well as improving maternal health. Exercise decreases your risk of pre-eclampsia, high blood pressure, gestational diabetes, excessive weight gain, increased blood sugar levels as well as depression. Keeping fit during pregnancy also helps to decrease the need for instruments such as forceps and vacuum during delivery, helps to prevent urinary incontinence and the need for a ceserean section.
What about the risks?? The great news is that exercise during pregnancy (even in the first trimester) is NOTassociated with complications such as miscarriage, stillbirth, neonatal death, preterm birth, low birth weight, birth defects, induction of labour or birth complications. In fact the evidence suggests that NOT engaging in physical activity during the first trimester increasing your odds of developing pregnancy complications.
The new guidelines recommend that exercise throughout the entire pregnancy should be a first-line treatment and prevention to reduce pregnancy complications and optimise the mothers’ and baby’s physical and mental health. As you can see the reasons to exercise during pregnancy are compelling but what should we exactly be doing?
The recommendation is:
150 minutes of moderate intensity exercise per week, over a minimum of 3 days/week, however exercising every day is encouraged.
150 minutes over 7 days equates to just 20 minutes a day – a very achievable goal!!
Moderate intensity means that you can still talk while you’re exercising – so if you can no longer chat to your friend as you walk, you need to slow down your pace!The research found that doing resistance or strength trainingas well as aerobic exercise was more effective at improving health benefits than just aerobic exercise alone.
Therefore aerobic exercise such as walking or swimming as well as a couple of sessions a week of light strength exercises such as a pregnancy specific Pilates classwould be a perfect combination.
What about pelvic floor exercises? Pelvic floor exercises have been shown to be very effective at preventing urinary incontinence both during pregnancy and post-partum. The recommendation is that every pregnant woman should be doing pelvic floor exercises daily. However the exercises need to tailored to you specifically and you need to know that you’re doing the correct contraction – up to 50% of women are doing them wrong! Therefore a pelvic floor assessment with a Women’s Health Physiotherapist is a mustwhen you are pregnant.
Is there anything I should avoid doing? The guidelines recommend that if you feel unwell or experience light-headedness or nausea while lying on your back then you should avoid lying flat during exercise as well as avoiding any exercise where there is the potential to fall such as horse riding, bike riding, skiing and contact sports such as hockey and netball. Pregnant women should also avoid exercising in extreme heat to avoid dehydration and therefore should avoid hot yoga classes.
Can I still work on my “core” or do abdominal exercises? During pregnancy your abdominal muscles stretch a lot to allow your baby to grow and it is normal to see a separation between your muscles. To prevent an abdominal separation following birth called a “Rectus Abdominal Diastasis”, it is recommended to avoid strong abdominal or core exercises as these place too much strain on the muscles increasing your risk of a separation following birth.
The following abdominal exercises are a “no-no” during pregnancy:
Planks
Sit ups
Push ups
Any exercise where you have both legs in the air such as dead bugs or leg lowers
However there are modified and gentle abdominal exercises that are safe and good to do during pregnancy. The guidelines recommend that women should seek physiotherapy advice to learn what abdominal exercises to do during pregnancy.
The take home message from these 2019 guidelines are that every women during pregnancy should be exercising regularly, include a combination of aerobic and resistance training as well as daily pelvic floor exercises to prevent complications, optimise their health as well as their baby’s health, and experience an easier birth.
At PROmotion, our Women’s Health Physiotherapist, can provide a pelvic floor assessment and prescribe you an individualised pelvic floor exercise program. We also run pregnancy specific Pilates and exercise classes which provide you with the recommended resistance training as well as modified and safe abdominal exercises.
Check out the Womens’ Health section of the website for more info. Reference:
2019 Canadian guideline for physical activity throughout pregnancy in British Journal of Sports Medicine 52(21):1339-1346 · November 2018. DOI: 10.1136/bjsports-2018-100056