Excercise in Pregnancy

Exercise in Pregnancy

World Health Organization recommends aiming for 150 minutes of moderate intensity activity every week during pregnancy, including strengthening exercises at least 2x/week.

Benefits of Exercise

• Decreased risk of premature labor
• Decreased maternal weight gain
• Decreased risk of cesarean
• Increased insulin resistance (decreased risk of gestational diabetes)
• Improved psychological well-being and mood
• Increase oxygen and nutrient availability to baby
• Increased aerobic capacity

Contraindications to Exercise

Absolute:

• Incompetent cervix or cerclage
• Persistent 2nd or 3rd trimester bleeding
• Placenta previa after 26 weeks gestation
• Twin or multiples pregnancy at risk of premature labor
• Ruptured membranes
• Preeclampsia or pregnancy-induced hypertension
• Severe anemia
• Certain heart and lung diseases
• Premature labor

Relative:

• Incompetent cervix or cerclage
• Persistent 2nd or 3rd trimester bleeding
• Placenta previa after 26 weeks gestation
• Twin or multiples pregnancy at risk of premature labor
• Ruptured membranes
• Preeclampsia or pregnancy-induced hypertension
• Severe anemia
• Certain heart and lung diseases
• Premature labor

Activities That Should Be Avoided:

• Contact sports
• Scuba diving
• Sky diving
• Activities with a high risk of falling (horseback riding, rope climbs, gymnastics, downhill skiing, etc.)
• Hot yoga or Pilates

Reasons to Stop Exercise in Pregnancy:

• Vaginal bleeding
• Dizziness
• Headache
• Shortness of breath prior to exertion
• Chest pain
• Decreased fetal movement
• Calf pain or swelling

General Guidelines for Exercise in Pregnancy

Heart rate may not be an accurate measure of exertion during pregnancy.

• Heart rate increases by 4-5 weeks gestation; 15% increase by third trimester
• Instead, use the "talk test" as a guide for intensity level
• You should be able to hold a conversation during exercise

10-15% of pregnant women will experience supine hypotensive syndrome (compression of inferior vena cava from supine position longer than 3-10 minutes)

• Symptoms include shortness of breath, dizziness, restlessness, nausea, numbness/tingling, visual changes
• Recommended to avoid prolonged supine position
• Short bursts of exercise in supine position are likely accessible provided they do not experience discomfort

It's recommended to avoid or limit

• Max-out lifts or movements that require breath holding due to increased intra-abdominal pressure (increased pressure through abdomen and pelvic floor)

• Higher impact exercises due to load on pelvic floor and risk of falling
• Barbell movements where bar path will be affected
• Movements where you cannot control abdominal doming/coning

Reason to Modify Your Movement

The following could be signs that the demand of the exercise is greater than what you can handle right now. If you are experiencing any of the following with exercise, it is recommended you modify the movement and/or seek further guidance from a pelvic health professional.

• Urinary or fecal incontinence
• Increased urinary urgency
• Difficulty controlling gas
• Pelvic or vaginal pain
• Pubic symphysis pain
• Vaginal pressure or heaviness (feeling like a tampon is falling out)
• Abdominal doming or coning
• Low back pain
• Tailbone pain
• Increased vaginal bleeding

Ways to Modify

There are several different ways to modify the demand or strategy of the exercise.

• Reduce the resistance
• Reduce the range of motion
• Reduce the number of sets or repetitions
• Change the timing of your breath
• Adjust the effort of your muscle contraction
• Adjust your body positioning
• Take longer rest breaks