Pregnant? Want to keep exercising?

The government suggests exercising for 150 minutes per week but what should you do if you’re pregnant?

Read on for some advice regarding physical activity and exercise from the Department of Health and Social Care.

Pregnancy is an ideal time to adopt a healthy lifestyle with the increased motivation and frequent access to maternity care. Whilst the guidelines do not differ to those for the general population, women who have been sedentary before pregnancy are recommended to follow a gradual progression of exercise.

‘Every activity counts’

A recommendation to pregnant women would be to begin gradually with 10 minute bouts of moderate-intensity continuous exercise building up to a total of 150 minutes. This activity should be spread throughout the week.

An achievable target would be to gradually accumulate your 150 minutes of exericse in 10 minute bouts of activity throughout the week.

Pregnant women who are already active should maintain their physical activity levels. However, you may need to change the type of activity undertaken and adapt your activity throughout pregnancy, for example, replacing contact sports with noncontact sport or an appropriate exercise class.

 “Moderate intensity activity can easily be described as ‘activity that makes you breathe faster’.

Pregnant women can easily relate to and understand the required intensity. Further clarification is an intensity that increases breathing rate whilst still being able to hold a conversation.

Activities for pregnant women

A variety of activities are recommended, apart from those with a high risk of falling or impact injuries and those that involve lying supine after the first trimester.

There is little consistent evidence regarding sedentary activity and pregnancy. A sensible approach would be to avoid prolonged periods of sitting and to break up sedentary time. This reflects the guidelines for the adult population.

Light to moderate muscle strengthening exercises have been shown to have no adverse health effects during pregnancy and there is evidence to suggest improvements in muscle strength. Pregnant women are likely to receive the same benefits all adults receive from these exercises. Therefore, we recommend, in keeping with the adult guidance, that pregnant women perform 8–12 repetitions of muscle strengthening activities involving all major muscle groups twice per week.

…and what to avoid?

Activities to avoid during pregnancy can be divided into those with an increased risk of trauma, those with physiological risk factors and those that involve lying in supine positions after the 1st trimester.

Activities with an increased risk of trauma…

These include activities where there is a higher risk of falling or high impact injuries e.g. skiing, water skiing, surfing, off-road cycling, gymnastics, horse riding and contact sports such as ice hockey, boxing, football or basketball.

Activities with physiological risks factors…

Scuba diving is not recommended due to the possibility of decompression sickness and gas embolism whilst sky diving or vigorous exercise above 6000ft is not recommended due to potential lowering of uterine blood flow.

Activities involving lying in supine positions after the 1st trimester…

Activities lying flat on your back are not recommended after the 1st trimester e.g. aerobics, yoga or pilates in supine positions. This is due to the increased risk of reduced cardiac output and orthostatic hypotension that can occur as the uterus enlarges. This is in keeping with other worldwide recommendations. Note that pregnancy specific yoga or pilates classes should not include these exercises, and can therefore be encouraged.

Activities pregnant women who are not already active should avoid…

Running, jogging, racquet sports, and strenuous strength training may be less suitable for women who were not already active before pregnancy, due to a reduced capacity to cope with the exercise intensity.

Image result for pregnant running imageSafety message 1:

No evidence of harm (maternal or infant)

Concern is sometimes expressed that physical activity in pregnancy is not safe. The evidence supporting this statement found no adverse maternal or infant outcomes for healthy women resulting from moderate intensity physical activity during pregnancy.

Safety message 2: Listen to your body and adapt

Due to physiological changes during pregnancy, women may find that some activities feel different. Pregnancy may affect the frequency, intensity, type and amount of physical activity women can perform. We recommend women ‘listen to their body’.

A general rule is if it feels pleasant keep going, if it is uncomfortable stop and seek advice.

The warning signs of when physical activity should be discontinued and medical advice sought are apparent and many are irrespective of exercise. They include breathlessness before or following minimal exertion, headaches, dizziness, chest pain, muscle weakness affecting balance and calf pain or swelling.

Women may also be advised to reduce/stop physical activity following pregnancy complications such as vaginal bleeding, regular painful contractions or amniotic fluid leakage.

Women should be encouraged to adapt, not stop, their physical activity throughout pregnancy. They should be supported to consider the physiological changes that are occurring which may influence the type of activities they can perform. For example, vigorous running can be replaced with moderate jogging or walking. Supine exercises for strength can be adapted to side or sitting exercises. Adjustments should be considered for any physical work-related tasks.

Safety message 3: Don’t bump the bump

This message refers to all activities which place pregnant women at an increased risk of injury through physical contact. We recommend avoiding contact sports and any physical activity where there is a high risk of falls/trauma.

Noelia is our specialist Woman’s Health Physiotherapist – call 01189462299 to book your appointment.

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