Pre/Post Natal Exercise

Pregnancy means your body will undergo some amazing changes, which will affect you physically, psychologically, and emotionally. You may feel nauseous, tired, achy, crampy, excited, anxious, out of control, even tearful at times. After the birth, tiredness, neck and back tension, concerns about your body, emotional highs and lows, and a constant test of your stamina are just some of the aspects you may find yourself having to cope with. This is all worth it of course, because your new family member is likely to bring you endless joy. However, your ability to cope with the challenges of pregnancy and motherhood could receive an enormous boost if regular exercise is a part of your life. This is true whether or not you were physically active prior to becoming pregnant.

The safest way forward is to seek professional advice from a personal trainer with experience of exercise prescription for pre- and post-natal women. You should feel comfortable to discuss any concerns you may have about exercising. With so many physical changes happening to you, you are likely to have an enhanced awareness of your body and it is important to be guided by how you feel. As long as the exercises you do are appropriate for you at each stage of your pregnancy and after you’ve given birth, you will benefit from increased levels of energy, confidence, and psychologically, because you will be regaining control over your body. Furthermore, you will be less likely to suffer muscular tension, aches, poor posture, and circulatory problems.

It is important to remember that pregnancy is not an illness. It is a natural stage that millions of women successfully experience worldwide every year. If you are sensible and realistic, then both you and your baby are likely to benefit from moderate exercise. There are certain contra-indications to exercise for the pregnant woman. Your GP and all professional exercise instructors should be aware of these. If you are in any doubt about whether exercise is appropriate for you whilst you are pregnant, then check first with your GP.

I have included below a set of guidelines from the American College of Gynaecologists as of 1994, (sourced from the American College of Sports Medicine’s “Guidelines for Exercise Testing and Prescription, 5th Edition (1995)”:

  • During pregnancy, women can continue to exercise and derive health benefits even from mild to moderate exercise routines. Regular exercise (at least 3 times per week) is preferable to intermittent activity.
  • Women should avoid exercise in the supine position after the first trimester. Such a position is associated with decreased cardiac output in most pregnant women. Because the remaining cardiac output will be preferentially distributed away from splanchnic beds (including the uterus) during vigorous exercise, such regimes are best avoided during pregnancy. Prolonged periods of motionless standing should also be avoided.
  • Women should be made aware of the decreased oxygen available for aerobic exercise during pregnancy. They should be encouraged to modify the intensity of their exercise according to maternal symptoms. Pregnant women should stop exercising when fatigued and not exercise to exhaustion. Weightbearing exercises may under some circumstances be continued at intensities similar to those prior to pregnancy throughout pregnancy. Non-weightbearing exercises, such as cycling or swimming, will minimize the risk of injury and facilitate the continuation of exercise during pregnancy.
  • Morphologic changes in pregnancy should serve as a relative contraindication to types of exercise in which loss of balance could be detrimental to maternal or foetal well-being, especially in the third trimester. Further, any type of exercise involving the potential for even mild abdominal trauma should be avoided.
  • Pregnancy requires an additional 300 kcal/day in order to maintain metabolic homeostasis. Thus, women who exercise during pregnancy should be particularly careful to ensure an adequate diet.
  • Pregnant women who exercise in the first trimester should augment heat dissipation by ensuring adequate hydration, appropriate clothing, and optimal environmental surroundings during exercise.
  • Many of the physiological and morphological changes of pregnancy persist four to six weeks postpartum. Thus, prepregnancy exercise routines should be resumed gradually based upon a woman’s physical capability.

ACSM also lists several reasons to discontinue exercise and seek medical advice during pregnancy:

  • Any signs of bloody discharge from the vagina.
  • Any “gush” of fluid from the vagina (premature rupture of membranes).
  • Sudden swelling of the ankles, face, or hands.
  • Persistent, severe headaches and/or visual disturbance; unexplained spell of faintness or dizziness.
  • Swelling, pain, and redness in the calf of one leg (phlebitis).
  • Elevation of pulse rate or blood pressure that persists after exercise.
  • Excessive fatigue, palpitations, chest pain.
  • Persistent contractions (>6 to 8/hour) that may suggest onset of premature labour.
  • Unexplained abdominal pain.
  • Insufficient weight gain (<1.0 kg/month) during the last two trimesters.