Pregnancy and exercise

Exercising during pregnancy has many potential health benefits. These include better weight control, an improved mood and the maintenance of fitness. Regular activity can also lower the risk of pregnancy-related complications such as pregnancy-induced high blood pressure (hypertension) and pre-eclampsia.

Before you start exercising in pregnancy, talk with your doctor, physiotherapist or another healthcare professional. If you did very little exercise before becoming pregnant, you may need to adapt your usual routine or choose a more suitable activity.

The benefits of exercise during pregnancy#

Physical activity can help you manage some of the symptoms of pregnancy and feel better, knowing you are doing something good for yourself and your baby. The benefits of regular exercise throughout pregnancy include:

• enjoyment and stress relief
• increased energy and improved fitness
• reduced back and pelvic pain
• a lower risk of complications such as pre-eclampsia and pregnancy-induced hypertension
• better preparation for the physical demands of labour
• fewer complications during delivery and a faster recovery afterwards
• prevention and management of urinary incontinence
• improved posture and circulation
• weight control
• a reduced risk of anxiety and depression
• better sleep and management of insomnia
• a greater ability to cope with the physical demands of being a parent

How pregnancy changes your body#

Your body goes through many changes during pregnancy. Some of these may affect your ability to exercise or mean you need to adjust your routine:

• Hormones such as relaxin loosen your ligaments, which can increase the risk of joint injuries such as sprains.
• As pregnancy progresses, your weight increases and your body shape and weight distribution change. This moves your centre of gravity forward and can affect your balance and coordination.
• Pregnancy raises your resting heart rate, so a target heart rate is not a reliable way to gauge exercise intensity. Instead, intensity can be monitored using a scale of perceived exertion, which measures how hard you feel your body is working.
• Your blood pressure drops in the second trimester, so avoid rapid changes of position, such as moving quickly from lying to standing, to prevent dizziness.

Pre-exercise screening helps identify medical conditions that could put you at higher risk during physical activity. It acts as a safety net to help decide whether the benefits of exercise outweigh the risks for you.

How much to exercise#

If you have been cleared to exercise and you were active before pregnancy, aim to do at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week.

If you have been cleared to exercise but were inactive before pregnancy, start with low-intensity exercise such as walking or swimming and build up gradually to moderate intensity. Aim for at least 30 minutes on most days. You can begin with separate sessions of about 15 minutes each and build up to longer durations.

Let your body be your guide#

You are at a good exercise intensity when you can talk normally (but not sing) and do not become exhausted too quickly.

If you are healthy and have no pregnancy complications, continue this level of activity throughout your pregnancy, or until it becomes uncomfortable to do so. Always be guided by your doctor, physiotherapist or healthcare professional.

Activities that are generally safe#

Many forms of exercise are safe and suitable during pregnancy, even for beginners, including:

• pregnancy exercise classes
• walking and swimming
• exercise in water (aquarobics)
• yoga, Pilates and other floor exercises
• pelvic floor exercises

While most exercise is safe, some positions and movements may be uncomfortable or harmful in pregnancy. Be guided by your doctor or physiotherapist, and keep these general cautions in mind:

• Avoid raising your body temperature too high. For example, do not soak in hot spas or exercise to the point of heavy sweating.
• Reduce your level of exercise on hot or humid days.
• Stay well hydrated.
• Do not exercise to the point of exhaustion.
• If you do weight training, choose lighter weights with medium to high repetitions and avoid lifting heavy weights.
• Perform controlled stretching and avoid over-extending your joints.

Avoid exercise if you are ill or feverish#

If you do not feel like exercising on a particular day, don’t. Listen to your body so you do not deplete your energy reserves. Do not increase the intensity of your routine while you are pregnant, and always work below 75 per cent of your maximum heart rate.

If you develop an illness or a complication of pregnancy, talk with your doctor or midwife before continuing or restarting your exercise program.

During pregnancy, avoid sports and activities that involve:

• exercising while lying flat on your back (supine position), as the weight of the baby can slow the return of blood to the heart; some of these exercises can be modified by lying on your side
• wide squats or lunges
• abdominal trauma or pressure, such as heavy weightlifting
• contact or collision, such as martial arts, soccer or basketball
• hard projectiles or striking implements, such as hockey, cricket or softball
• a risk of falling, such as downhill skiing, horse riding or skating
• extreme balance, coordination or agility, such as gymnastics
• significant changes in pressure, such as scuba diving
• heavy lifting
• high-altitude training above 2000 m

If you are not sure whether a particular activity is safe during pregnancy, check with your healthcare professional.

Pelvic floor exercises#

The pelvic floor muscles are weakened during pregnancy and birth (vaginal delivery), so it is important to begin conditioning them from the start of your pregnancy. Continue these exercises throughout pregnancy and resume them as soon as it is comfortable after the birth. A physiotherapist can prescribe appropriate exercises.

Strong abdominal muscles support your spine#

The internal core and pelvic floor muscles act as a natural corset that protects the pelvis and lower spine.

During pregnancy it is common to develop diastasis recti abdominis, a painless splitting of the abdominal muscle along the midline, also known as abdominal separation. Traditional sit-ups or crunches may worsen this and can be ineffective during pregnancy. Appropriate core stability exercises are recommended instead. For example:

• Concentrate on drawing your belly button towards your spine.
• Breathe out while pulling in your belly.
• Hold the position and count to 10.
• Relax and breathe in.
• Repeat 10 times, as many times a day as you are able.

You can do this exercise sitting, standing or on your hands and knees.

Warning signs when exercising#

If you experience any of the following during or after physical activity, stop exercising immediately and see your doctor:

• muscle weakness
• headache, dizziness or feeling faint
• heart palpitations or chest pain
• swelling of the face, hands or feet
• calf pain or swelling
• vaginal bleeding
• contractions
• deep back pain

Key points#

• Women with uncomplicated pregnancies are encouraged to do aerobic and strength exercise as part of a healthy lifestyle.
• Aim to maintain fitness rather than reach peak fitness.
• Check with your doctor, physiotherapist or midwife before starting, and adapt your routine as your body changes.
• Stay hydrated, avoid overheating and exhaustion, and stop and seek help if warning signs appear.