Exercising and pregnancy

Exercise during pregnancy
Research suggests that in the absence of medical or obstetric complications, exercise should be encouraged and participated in throughout pregnancy. As long as the exercise is safe and appropriate, studies have shown that there are minimal risks associated. In fact, being inactive can actually increase risk of developing health problems during pregnancy.  

How is exercise beneficial?
Exercise during pregnancy has proven benefits to both the mother and the baby, as long as these exercises are appropriate to each stage of pregnancy.
These benefits include:

• Reduces the risk of gestational obesity, diabetes and other associated complications
• Enhances mental well-being, body image and self-esteem
• Helps to prevent and reduce musculoskeletal conditions such as pelvic and back pain
• Lowers the risk of pregnancy-related high blood pressure and pre-eclampsia
• Helps to maintain cardiovascular fitness and physical conditioning that may be required for labour and caregiving following pregnancy

Exercising throughout pregnancy
In general, if you feel well and have been exercising consistently prior to pregnancy it is safe to continue with this during the first trimester. This means that even if you have been exercising at high intensities it is safe to continue to do so. However, if you have not been exercising prior to pregnancy it is recommended that you commence at low intensities.

Once the pregnancy progresses to the second and third trimester, there are changes that need to be made to ensure continued safety with exercise. It is recommended to engage in light resistance and aerobic exercise, as the evidence suggests that at these intensities there is no negative effects on risk of pre-term labour, mode of delivery, newborn health, or gestational age.

Changes to exercise prescription
The following changes should be made to exercise prescription during the second and third trimester of pregnancy.

1. Extra caution needs to be given to explosive / ballistic type movements. With pregnancy the laxity of joints increases due to the release of specific hormones such as Relaxin, placing individuals at a greater risk of overextending joints.  
2. Exercises that are completed on your back or lying down need to be avoided after 16 weeks. This is because increased weight from the baby can temporarily put increased pressure on the vena cava which returns the deoxygenated blood from the body back to the heart. Increased pressure on the vena cava can result in feelings of dizziness and breathlessness.
3. Abdominal exercises should be avoided if abdominal separation occurs (which is referred to as diastasis recti). Diastasis recti can also be exacerbated by poor form and lifting heavy weights as this places increased pressure around the abdominal region.
4. Thermoregulation is harder to achieve during pregnancy so extra consideration should be given to the location of exercise, the clothing that you wear, and it should be ensured that hydration is adequate.
5. Exercises should be avoided that increases the risk of falls or physical injury, including jumping, contact sport, horse riding or scuba diving.

Signs and symptoms that mean you should stop exercising
It is recommended to seek advice from your doctor or midwife in the event of the following

• Muscle weakness
• Shortness of breath, feeling faint, dizziness or headaches
• Vaginal bleeding or fluid loss
• Pain that presents in the lower back, pelvic/pubic area or abdomen as this may potentially indicate preterm labour
• Dizziness or breathlessness.

The bottom line
Exercising is safe to participate in during pregnancy and should be encouraged. However, specific changes and modifications should be made to exercise during the second and third trimester of pregnancy to avoid any concerns or complications. Not sure how to get started or where to get help from? Consult your nearest Accredited Exercise Physiologist today.

Written by Rebecca Dostan - AEP, AES, ESSAM

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 References  
Brown, WJ, Hayman, M, Haakstad, LAH, Lamerton, T, Mena, GP, Green, A, Keating, SE, Gomes, GAO, Coombes, JS, Mielke, GI 2022, ‘Australian Guidelines for physical activity in pregnancy and postpartum’, Journal of Science and Medicine in Sport, vol. 25, no. 6, pp 511-519.  

Dillard, DM 2016, ‘Exercise and pregnancy’, The International Journal of Childbirth Education, vol. 31, no. 1, pp. 8-.

Exercise is Medicine 2019, Being active during pregnancy, viewed 8 Octoboer 2024, < https://www.exerciseismedicine.org/assets/page_documents/EIM_Rx%20for%20Health_Pregnancy.pdf>.

Exercise is Medicine 2024, Pregnancy and exercise, Exercise is Medicine, viewed 9 Octover 2024, <http://exerciseismedicine.com.au/wp-content/uploads/2018/06/2014-Pregnancy-FULL.pdf>.
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Santos-Rocha, R (ed.) 2022, Exercise and physical activity during pregnancy and postpartum : evidence-based guidelines, 2nd ed., Springer, Cham, Switzerland.