Exercise In Pregnancy

Exercising in pregnancy is sometimes a slightly contentious topic – with some being advised to put their feet up or stop running in early pregnancy and others being told they aren’t doing enough! Worry not – we are here to help demystify exercise in pregnancy and share advice that is safe, evidence based and suitable for everyone regardless of your fitness level.

The main message is that being active in pregnancy is safe, good and healthy for you and your baby.  There are a host of benefits to gentle exercise in pregnancy for your physical and mental health and the great thing is that it’s very much guided by you and what you feel up to doing.

Why exercise during pregnancy? 

Exercising in pregnancy is beneficial for you and your baby. Research highlights that for most women and birthing people, the more fit and active you are in pregnancy, the better you and your body will adapt to the changes that pregnancy brings – both physical, such as your changing shape and emotional, such as adapting to these changes. 

Exercise is also known to help you prepare and cope better with the labouring and birthing process, and your recovery after baby has arrived is also quicker if you have been active in pregnancy.

Exercising throughout your pregnancy helps to:

• Reduce common pregnancy related complaints such constipation and backaches, heartburn and constipation
• Maintain a healthy weight
• Help fight pregnancy insomnia and promote better sleep
• Increase your energy levels
• Boost your emotional wellbeing 
• Increase your strength and endurance 

How much and what exercises you do will depend on your fitness levels before pregnancy and of course how well you are in your pregnancy too.

If you are someone who exercises regularly, then it’s great to try and keep up what you can do, whilst making sure that you pace yourself and feel comfortable at all times.

If you are new to exercising and starting off in pregnancy or haven’t been active for a while – it is important to start off gently, pace yourself and listen to your body. Exercise doesn’t need to be vigorous or fast paced to be beneficial and building up gently is essential.

It is also important that you check with your midwife before starting exercise if you are new to it, if you have any underlying health conditions or any pregnancy related complications.

Remember, exercise is safe for most but it is sensible to check with your midwife or doctor if you have any:

• Underlying health conditions such as heart or lung issues, diabetes or thyroid issues
• There is concern about your cervix or you may need or have had a cervical stitch
• You are pregnant with more than one baby 
• There is a risk of premature labour or birth, or if your waters have broken prematurely 
• There is concern about where the placenta is – such as Placenta previa
• You are anaemic 
• You have any bleeding from the vagina in your pregnancy
• You have any conditions that affect your mobility
• You have pregnancy related conditions such as Pre-eclampsia.

Considerations before exercising:

Whether you have been exercising before pregnancy or not, it is important to pay close attention to your body and its changing needs and listen to the signals it gives you.

Exercising in pregnancy is about finding the right balance that works for you in keeping you healthy and doesn’t exhaust you.

There are two keys points to always near in mind when exercising in pregnancy:

Intensity of exercise and pacing yourself in pregnancy

This will vary from person to person depending on your fitness and activity levels. How much you can do will also change as your pregnancy progresses – you may need to swap to another form of exercise or slow down as your body changes or if your midwife/doctor advises you to. 

Pacing yourself is key – build up your stamina gently. The general rule of exercising applies in pregnancy too – exercise should not make you feel breathless and that whilst exercising you should be able to hold a conversation. 

It is important to not suddenly take up strenuous exercise if you haven’t exercised before pregnancy. Start off gently ideally with 10 minutes of daily exercise such as walking at a brisk pace and build up gently to around 150 minutes of weekly exercise even in short bursts of 10 minutes.

Listen to your body  

Alongside pacing yourself and building up activity, it is important to also listen to your body regardless of your fitness levels. Always make sure you warm up before exercising, and cool down afterwards, keep yourself well hydrated with water and avoid getting too hot.

It is also important that when pregnant you avoid strenuous exercise in hot weather. If you are attending exercise classes, it is important that your instructor is aware that you are pregnant and aware of any pregnancy related issues, as well as being qualified to advise you about exercise in pregnancy.

Types of exercising to consider during pregnancy:

• Pelvic tilt exercises help with reducing pain and stiffness in the pelvic area, whilst also strengthening your core. This video explains how to do pelvic tilt exercises in more detail: https://www.youtube.com/watch?v=vgIIrBxblTg
• Pelvic floor exercises help strengthen your pelvic floor muscles. They are important in pregnancy as due to hormonal changes and your growing baby; your pelvic floor muscles loosen and can lead to the leakage of urine (incontinence) in pregnancy or after the birth of your baby. Pelvic floor exercises are discussed in detail during our live antenatal classes both before the birth of your baby and after the baby has arrived.
• Yoga in pregnancy can be a great way to help you relax and ease the tension that you may feel all over your body. Yoga uses gentle stretching and breathing techniques and can be done at home watching a video or as part of an instructor led class.  It is important if you do join a class that your instructor knows you are pregnant.
• Weight lifting in pregnancy can help with strengthening core muscles such as back and stomach muscles. However, it is vital that you check with your doctor/midwife if weightlifting is safe for you and then ensure you are guided by a professional trainer before starting any weight lifting routine.
• Aerobic exercise in pregnancy refers to exercise that combines the use of stretching and training that improves your muscle strength. Most Aerobic exercise is safe to do in pregnancy, but it is always best to ensure your trainer or instructor is aware you are pregnant.
• Dancing is great, easy and safe for getting active in pregnancy. If you aren’t much of a dancer and only trying out in pregnancy, it is sensible to start with gentle dances that don’t involve anything too strenuous such as jumping. If you decide to join a dance class, it is important your instructor is aware of your pregnancy.
• Walking is an easy, safe, free and fantastic way of exercising in pregnancy. If you are new to exercising or haven’t been very active before pregnancy, it’s the best way of getting your activity levels up. Up to 30 mins of walking a day is ideal but do what you can, even if it is 5-10 mins a day and aim to build up to the 30 minutes.
• Running in pregnancy is an ideal way of doing some aerobic exercise if you are someone who is used to running or jogging regularly before pregnancy. If you haven’t run before or had a long break from it, it is best to start off with walking instead of running.
• Cycling is another brilliant way of exercising whilst pregnant. It is an ideal,  low-impact aerobic exercise and can be really practical too! It’s important to be aware that your balance will change as your body changes and bump grows, as you may be more prone to falls. It may be best to then look into using a stationary or gym bike.
• Pilates helps to improve your posture, balance, flexibility, and strength which is great in pregnancy in supporting you in carrying the growing weight of your baby and preparing for birth and life with a new baby.
• Aquanatal classes are specialised exercise classes in water designed for pregnancy and led by a qualified instructor. They are ideal in pregnancy as the water allows you to move freely due to the buoyancy whilst also helping to strengthen the supporting muscles mainly around your pelvis.
• Swimming in pregnancy is another form of exercise that works well throughout your pregnancy and can help you feel lighter in the water in the third trimester when your bump has really grown. Swimming is great for improving your circulation, muscle tone and endurance.

Exercises to avoid in pregnancy

Whilst exercising in pregnancy is great, there are some exercises that may not be suitable in pregnancy as they may cause injury or problems for you or your baby. The exercise and activities that should be avoided are:

Contact sports such as rugby or martial arts as there is a risk of your bump being hit.

Any activities that have a risk of falling such as horse riding or skiing.

Exercising at high altitudes as altitudes above 2,500 metres reduces oxygen supply to you and your baby.

Scuba diving as nitrogen gas bubbles can cross the placenta.

Any exercises on your back in pregnancy from 16 weeks of pregnancy as this can cause low blood pressure and dizziness due to the baby’s weight on a major blood vessel and reduce blood flow to your heart. This is also why you should never go to sleep on your back from 24 weeks onwards.

Where can I find pregnancy exercise classes?

Ask your midwife about any classes that the hospital or maternity services may be offering – some hospitals offer short courses for free or a small fee.  It’s also worth having a look online for classes near you – such as your local leisure centre or gym.  If you are joining any classes just ensure that they are suitable for pregnancy.

Exercise tips for pregnancy

• Start off gently and build up – don’t attempt to run 5k if you haven’t been running or jogging that distance before pregnancy.
• Little and often is great when starting out – so a short daily walk is better than trying to walk for an hour and then being too exhausted.
• Make sure you warm up before you start any exercise and to cool down as well after.
• Keep yourself well hydrated when exercising with a lot of water or other suitable fluids.
• Avoid exercise listed above.
• Listen to your body and pace yourself – as your pregnancy progresses you may find exercise that you enjoyed and were comfortable with may no longer suit you.
• Make sure any classes you join are suitable for pregnancy and if you have an instructor ensure they know how many weeks pregnant you are and are qualified to instruct you.

Sources

• https://www.nhs.uk/pregnancy/keeping-well/exercise/ 
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622376/ 
• https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-04257-8 
• https://bmjopen.bmj.com/content/9/9/e030162 
• https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period 
• https://www.britishjournalofmidwifery.com/content/midwife-blog/exercise-during-pregnancy/ 
• https://www.sciencedirect.com/science/article/abs/pii/S2210778914000270 
• https://www.rcm.org.uk/media/2307/rcmcsp-joint-statement-on-pelvic-floor-muscle-exercises_4.pdf