Prenatal Pregnancy Exercises: guest post

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Dr. Mom blog explores Prenatal Pregnancy Exercises.

In so many ways, Motherhood starts in pregnancy. From the moment we learn about our pregnancies, we prioritize our own health for the benefit of our babies, such as taking prenatal vitamins, avoiding certain foods, and choosing an appropriate prenatal pregnancy exercise plan.

Because pregnancy is such a unique period in a woman’s life, with the health of two people to consider, there has been some hesitation in the past among Healthcare Providers about encouraging physical activity during pregnancy. We now know that regular prenatal exercise is associated with many benefits for the Mother and the baby such as a lower risk for all of the following: gestational diabetes, high blood pressure, pre-eclampsia, Cesarean section, use of forceps or vacuum during birth, urinary incontinence, pregnancy back pain, excessive pregnancy weight gain, and severity of postpartum depression symptoms.

How much prenatal exercise should women get during pregnancy?  

The most recent recommendation for prenatal exercise is that unless a woman has any health complications listed in the table below, she should get a minimum of 150 minutes of moderate-intensity exercise spread out over at least 5 days per week. That means that all women with uncomplicated pregnancies should be physically active for 30 minutes per day, 5 days per week, at an intensity that makes them breathe fast (but not become breathless) and sweat after about 10 minutes.

If you were not active prior to pregnancy, we recommend starting with 10-20 minutes of low-intensity exercise 3 times per week and increasing the intensity, frequency and duration gradually until you achieve the recommendations above. In this way, previously sedentary women and their babies can enjoy the health benefits of prenatal pregnancy exercise, without any additional risk. If you were already active, you may continue the types of exercise you did prior to becoming pregnant. This can include swimming, biking, jogging, strength training, dancing, and playing sports. Other examples of prenatal pregnancy exercise are yoga, Pilates, power walking, stair climbing, body weight exercises and weight training. There are some important considerations for prenatal exercise, which are: energy levels, comfort, risk of injury, and birth preparation/postpartum recovery.

Energy Levels for prenatal pregnancy exercise

When it comes to energy levels, the first trimester of pregnancy is unique in that the amount of cellular energy it takes to create another human being is enormous. During this time, respecting fatigue/nausea and getting lots of rest is a top priority. If there are days when exercise feels good, then we highly encourage it. However, we do not want women to feel guilty about not exercising when it would be further depleting her.

Physical Comfort During Pregnancy Exercise

In terms of comfort, although there is nothing dangerous about activities such as jogging during pregnancy, there may come a point when it stops being comfortable due to size and a change in a woman’s centre of gravity. There is no reason to continue to do prenatal pregnancy exercise that isn’t comfortable when there is so much variety available. Consider switching to power walking or stair climbing for an easy to do, solo, outdoor activity.

Risk of Injury during prenatal exercise

When it comes to risk of injury, pregnant women are at a slightly higher risk of ligament sprains. The pregnancy hormone relaxin, allows a woman’s belly to grow large and round. This same hormone allows other structures to stretch more than they normally would. Exercises that challenge maximal flexibility and strength (eg. Aggressive stretching and heavy weights) should only be performed with supervision and caution. Contact sports should be avoided

Contact sports (eg. Soccer) and activities with a higher risk of falls (eg. Skiing, horseback riding), should be avoided out of concern for fetal harm from accidental injury to the mother. SCUBA diving should also avoided because of the potential for fetal harm.

Another important consideration is how a woman’s abdominals and pelvic floor are responding to exercise. Both of these muscle groups work hard during pregnancy. Signs of Diastasis Recti (link – diastasis recti post) (such as doming above the belly button) or Pelvic Floor Dysfunction (link – effect of pregnancy on abd and PF) (such as urinary leakage, pain in the pelvis, or pressure vaginally) are a reason to modify activities.

Prenatal Exercise for Birth Preparation and Postpartum Recovery

Another thing to keep in mind is exercise for birth preparation and postpartumrecovery. Ideally, it is the same exercises that will help us to stay active in pregnancy, prepare for birth, and recover well after either vaginal or Cesarean birth. To do this, it is recommended that in addition to whole body exercise, women should perform pelvic floor exercises, or Kegels, daily to prevent pelvic floor dysfunction in the postpartum period (link – postpartum pelvic floor health post). Education on proper technique by a Doctor or Pelvic Physiotherapist, is essential for effectiveness.  Postpartum exercise can also help get you active and support your mood!  

If it’s hard to be motivated to exercise because of the benefits to yourself, try thinking about all of the benefits your baby gets from it! Creating a habit now may result in your whole family leading an active lifestyle in the long term.

Do Not Exercise if You Have: Talk to Your Doctor About
Exercise if You Have:
Ruptured membranes Recurrent pregnancy loss
Persistent vaginal bleeding History of pre-term birth
Placenta previa after 28 weeks Gestational hypertension
Pre-eclampsia Anemia
Incompetent cervix Eating Disorder
Triplets or more Twins after 28 weeks
Uncontrolled Type 1 diabetes
or hypertension
Other significant medical
conditions

This post was authored by Jillian Palmer is a Pelvic Physiotherapist and a Mom of four wonderful children. She is passionate about improving the quality of care for women in pregnancy and postpartum. Her Pelvic Physiotherapy practice in Edmonton, Alberta, serves women throughout the lifespan struggling with pelvic dysfunction. You can find her @yeg_pelvicphysio and @pine_health_yeg

Reference:

Mottola MF, Davenport MH, Ruchat S, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med 2018;52:1339-1346.

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