Q: WHAT ARE THE BENEFITS OF EXERCISE?

Aside from the obvious…. it makes us all feel wonderful, there are many proven benefits associated with maintaining a regular exercise regime during pregnancy (1,2,3,4,5).

There is no strict guideline on how to exercise but listening to your body and knowing what your personal preferences are will help ensure you stay motivated and get the most out of physical activity. The American Heart Association (6) recommends a minimum of 30 minutes of moderate exercise on 5 days of a week to help prevent chronic diseases. This is a general guideline applicable to most ages and populations. Aim for 150 minutes each week. I’m going to help you with about 90 minutes of that and the rest is up to you.

Q: HOW DO YOU KNOW WHAT TYPE OF EXERCISE TO CHOOSE? 

There are many different types of exercise which are safe and low impact which include: pregnancy Yoga, pregnancy Pilates, walking, stationary bike riding, moderate weights training, pregnancy hydrotherapy, and swimming. This program is all about strength and flexibility training because I feel so many women come to me saying “I feel weak”.

Stationary bike riding is safe and an awesome way to get some cardio while not loading your joints too much. Sometimes in the later stages of pregnancy mums like a lower impact form of cardio and using the stationary bike helps to maintain leg strength and also offload the pelvis and hips. If you're trying to spice things up a bit, why not try adding some arm weights or intervals during your ride.

Walking is safe throughout pregnancy and it’s fine to walk as much as you like. Just be mindful to keep your hydration levels up and eat small snacks regularly. That advice is across the board for exercise. Also, wearing loose and comfortable clothes is important to keep your body temperature at a good level.

Pregnancy water aerobics is a great choice if you love the pool and enjoy the assistance of the water in reducing your body weight. Sometimes women just feel too heavy or swollen to exercise on land in the later stages of pregnancy. Transitioning to the water is a great way to continue moving. Swimming is definitely allowed but as your tummy grows certain strokes may become more challenging to achieve.

To date, no study (7) has demonstrated any adverse effect or increased risk of injury with stretching and strength training using light to moderate weights, weight machines and body weight exercises. It is noted in the literature that lifting heavy weights and breath holding is not advised. The reason being that these movements have a significant effect on blood flow and also place a lot of pressure on your pelvic floor. Light to moderate weights and exercises that allow for normal breathing to occur are generally safe. One benefit of strength training is that it helps women to accommodate to the natural postural changes which occur during pregnancy, as well as preparing the body for the postural and lifestyle loads of motherhood.

Q: ARE THERE ANY CONTRAINDICATIONS FOR EXERCISE DURING PREGNANCY?

Yes! There are some conditions that are absolute contraindications during pregnancy (8). A contraindication refers to a condition that prevents you from participating in exercise programs completely. The following conditions have been identified by the American College of Obstetrics and Gynecologists as contraindications to exercise during pregnancy, which means no exercise.

But there are contraindications and relative contraindications, which means you must consult with your treating Doctor or Obstetrician for medical clearance before embarking on a physical exercise routine.

Q: HOW HARD SHOULD I EXERCISE?

Due to the increase in resting heart rate and decrease in maximal heart rate during pregnancy, it is not recommended using target heart rate to determine intensity of exercise (9).  Instead, perceived rate of exertion (PRE) is a recommended scale for determining how hard to work. This is often referred to as the PRE scale or BORG scale, which gives a rating out of 10 on how hard you are working. 

This scale can get a little tricky to gauge. During pregnancy you’re aiming for a 3-4 which will feel like you get a little puffed, a little hot and sweaty, but if you can't continue a conversation because you're breathing is too hard, then you're working too hard.  If you have been exercising regularly prior to pregnancy, then a level 5 might be acceptable too. Exercising with a buddy is always an easy way to ensure you're breathing and conversation rate remains at a constant level. :) Here is a great visual representation of this scale (10).

Generally 30-45 minutes is plenty of time to exercise and you want to keep in mind what is happening to your body temperature during that time. 

 

Q: WHEN SHOULD I STOP EXERCISING?

If you ever experience the following symptoms during exercise, you should stop exercising and seek a medical opinion (11,12).

REFERENCES:

1. Hellenes, O. M., Vik, T., Løhaugen, G. C., Salvesen, K. Å., Stafne, S. N., Mørkved, S., & Evensen, K. A. I. (2015). Regular moderate exercise during pregnancy does not have an adverse effect on the neurodevelopment of the child. Acta Paediatrica, 104(3), 285-291.

2. Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy: a systematic review. Current Opinion in Obstetrics and Gynecology, 24(6), 387-394.

3. Norman, E., Sherburn, M., Osborne, R. H., & Galea, M. P. (2010). An exercise and education program improves well-being of new mothers: a randomized controlled trial. Physical Therapy, 90(3), 348-355.

4. Stafne, S. N., Salvesen, K. Å., Romundstad, P. R., Stuge, B., & Mørkved, S. (2012). Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta obstetricia et gynecologica Scandinavica,91(5), 552-559.

5. Stafne, S. N., Salvesen, K. Å., Romundstad, P. R., Eggebø, T. M., Carlsen, S. M., & Mørkved, S. (2012). Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstetrics & Gynecology,119(1), 29-36.

6. American Heart Association. Recommendations for exercise for physically active adults.https://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/FitnessBasics/American-Heart-Association-Recommendations-for-Physical-Activity-in-Adults_UCM_307976_Article.jspaccessed April 25th 2015.

7. Brown, W. J., Finch, C., Robinson, D., Torode, M., & White, S. (2002). SMA Statement: The benefits and risks of exercise during pregnancy. Journal of Science and Medicine in Sport, 5(1), 11-19. 

8. Artal, R., & O'Toole, M. (2003). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British journal of sports medicine, 37(1), 6-12.

9. Sports Medicine Australia. Exercise in Prenancy. http://sma.org.au/wp-content/uploads/2009/10/WIS-ExPreg.pdf accessed April 25th 2015.

10. Image courtesy of Google Images http://www.askdoctornat.com/wp-content/uploads/2013/02/borg-img-docstoccdn-com.png accessed September 22nd 2015.

11. Sports Medicine Australia. Exercise in Prenancy. http://sma.org.au/wp-content/uploads/2009/10/WIS-ExPreg.pdf accessed April 25th 2015.

12. Artal, R., & O'Toole, M. (2003). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British journal of sports medicine, 37(1), 6-12.