Myths and facts about exercising during pregnancy

You are pregnant. Time to pack away your tackies and put your feet up. Right? Wrong! According to Professor Hanlie Moss of North West University’s research focus area for Physical activity, Sport and Recreation and a member of the Biokinetics Association of South Africa (BASA) executive committee, if you have been exercising regularly prior to becoming pregnant, stopping simply because you are pregnant could be the worst thing you could do. Exercising during pregnancy has numerous benefits for you and baby.

“In addition, if you have never been particularly physically active, exercising during pregnancy could well be an excellent opportunity to change your lifestyle – and benefit both yourself and your baby,” she said. In addition, researchers in developed countries are currently investigating just how much the first nine months of your baby’s life – before birth – could influence the rest of his or her life.

Prof Moss pointed out that most women know that they should live a healthier lifestyle while pregnant. For many, that means stopping smoking and drinking alcohol, eating a healthy diet and “taking it easy” by either cutting back on exercise, or cutting it out altogether.
“It’s the ‘taking it easy’ part of the pregnancy lifestyle formula that causes so much confusion,” she said. “Women often receive mixed messages about exercising during pregnancy from friends, family, their own mothers, and even their doctors.

“The bottom line is that scientific data supports the fact that for normal, healthy women, exercising during pregnancy is not only safe, it is recommended. In fact, exercising during pregnancy can be extremely beneficial to both the mother and the baby. However, that does not mean that a pregnant woman should go out and run a marathon,” she added.

According to Prof Moss, a local South African study – the HAPPY-study – that she conducted in Potchefstroom, found that women tend to be less active than the recommended levels for health enhancement, during pregnancy. Physical activity decreases as pregnancy progresses and appears to drop off still further after the baby is born with women exercising even less three-months post pregnancy than during pregnancy.

Women often exercise less during pregnancy, or choose not to exercise at all because of some of the discomforts associated with pregnancy – leg cramps and swelling, tiredness and shortness of breath. It is also more difficult to move as your bump increases in size.

Very often, pregnant women just don’t feel like exercising. They feel tired all the time and develop a poor body image, perceiving themselves as fat and bloated. Not surprisingly, this can make them feel depressed. “Ironically, regular exercise can actually do wonders for one’s mood and tiredness,” Prof Moss said.

What if your doctor orders total physical inactivity such as bed rest? Bed rest is usually prescribed to prevent or treat several serious conditions including threatened miscarriage, early labour, slow foetal growth, swelling and pre-eclampsia.

According to Prof Moss, there is considerable debate about the merits of bed rest and whether it really is effective in treating these conditions or whether it actually does more harm. “However, there are no definitive answers and every woman must discuss her options with her doctor and follow his or her advice,” she stressed.

Benefits of exercise during pregnancy

  • Overall, exercise during pregnancy poses minimal risk to most women, actually offering many short- and long-term benefits for both mother and baby.
  • Maternal benefits are both physical and psychological.
  • Physical benefits include: shorter and easier labour and fewer delivery complications; improved cardiovascular function so you don’t feel as breathless; lower risk of muscle cramps and leg swelling; and reduced risk of suffering from gestational diabetes, pregnancy-related high blood pressure or pre-eclampsia.
  • In addition, women who exercise regularly during pregnancy are less likely to develop varicose veins or suffer from heartburn and lower back pain. They also often gain less weight but this does not significantly result in a lower birth weight of the baby.

The HAPPY-study found that the women retained on average 5kg weight after the birth of the baby. Should the woman on average have three children, after the birth of her three children, she will he left with an additional 15kg. Obesity then becomes a reality, increasing her risk of developing type 2 diabetes later in life.

“Regular exercise during and post childbirth will assist with weight management,” Prof Moss added. “From a psychological perspective, physical activity improves one’s mood and feeling of wellbeing. It also contributes to better sleep patterns which, in turn, makes one feel less tired.”

Studies have also shown that appropriate physical activity is beneficial to the baby – although prolonged, high-intensity levels of exercise could potentially be harmful to the supply of oxygen required for adequate growth of the foetus. Prolonged high intensity exercise could also challenge the regulation of the internal body temperature, which may compromise the health of the foetus.

On the other hand, women who exercise during pregnancy often have a larger placenta, resulting in a healthier blood exchange – and a potential supply of nutrients –  to the foetus. Another advantage is that there is generally less subcutaneous fat (fat under the skin) in the babies of exercising mothers.

Despite all the benefits of exercising while pregnant, Prof Moss warned, there are instances when a pregnant woman should not exercise at all. These include women who have been diagnosed with serious conditions such as haemodynamically significant heart disease, restrictive lung disease, and incompetent cervix. Women who are carrying three or more foetuses or have persistent second or third trimester bleeding; placenta praevia, particularly after 26 weeks gestation, premature labour, ruptured membranes or pre-eclampsia should also avoid exercise.

A pregnant woman should only be exercising during pregnancy under the supervision of a trained professional if she has acute anaemia, cardiac arrhythmia, poorly controlled Type I Diabetes or uncontrolled hypertension; or if she has a history of smoking and intrauterine growth restriction, is extremely obese or significantly underweight or leads an extremely sedentary lifestyle.

How much should you exercise?

  • The American College of Obstetricians and Gynaecologists (ACOG) recommends that healthy pregnant women should exercise at a moderate intensity for at least 30 minutes most days of the week.
  • The American College of Sports Medicine (ACSM) recommends an accumulation of 30 minutes or more of moderate physical exercise every day.
  • US Department of Health suggests that pregnancy women should engage in a minimum of 150 minutes of moderate-intensity aerobic activity a week, even if they were not physically active prior to pregnancy.
  • The Royal College of Gynaecologists (RCOG) says that exercise programmes should be individualised and based on the woman’s previous physical activity. If she was physically inactive, she should start with 15 minutes of continuous exercise three times a week and slowly increase that to 30 minutes four to five times a week.

What type of exercise?

  • Experts generally recommend that pregnant women participate in aerobic and strength-conditioning training at moderate intensity in a well-ventilated and temperature-controlled environment.
  • She should also take care. Prof Moss pointed out that hormonal changes during pregnancy lead to a softening of some joints which could potentially increase the woman’s risk for injury. In addition, her increased body weight as a result of carrying a foetus, could place additional stress on her hips and knees. And, of course, her centre of gravity shifts during pregnancy and could put strain on her spine and also affect her balance.

“To avoid unnecessary injuries – and potentially negatively affect the foetus – a woman who exercised regularly before falling pregnant should visit a Biokineticist, a professional who is registered with the Health Professions Council of South Africa, to help her adjust her programme to take account of her pregnancy. The Biokineticist will educate her about the complexities of hydration when exercising during pregnancy, as well as advise on the correct level of intensity at which to exercise to ensure the safety of both mother and baby.”

“Women who have not exercised regularly prior to falling pregnant should always consult a Biokineticist prior to starting an exercise programme. The Biokineticst is trained to develop a scientifically-based programme for her which takes account of her medical history.”

“Finally, ongoing supervision of the exercise programme is recommended to enable the Biokineticist to monitor the woman’s progress and made adaptations to the programme as the pregnancy progresses and the foetus grows,” Prof Moss concluded.

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