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What are the guidelines for safe exercise during pregnancy and the postnatal period?

It can be daunting. You want to protect your baby so wrapping yourself in a duvet or the sofa for the next nine months seems like a plan. You may not be feeling full of energy or you may be getting advised by family or friends that you shouldn’t be continuing your pre-pregnancy fitness routine that you love.


But think about it. Why wouldn’t you be able to stay active during pregnancy? We’re not talking, risky activities that could cause a serious injury like jumping out of planes, horse-riding, skiing or scuba diving. You also don’t want to intentionally put your body in a situation that could get your bump knocked, like contact sports, but most types of physical exercise, especially if you have been exercising pre-pregnancy, are activities that you can continue to enjoy, even if there are some considerations and modifications to be made as you progress through the trimesters and into the postnatal period.


Can you get fit in pregnancy?


The answer is yes! There are of course safety guidelines to consider when starting exercise during pregnancy depending on if you have previously been regularly exercising or are new to exercise.

In the absence of obstetric or medical complications or contraindications, physical activity in pregnancy is safe and desirable, and pregnant women should be encouraged to continue or to initiate safe physical activities.” Physical Activity and Exercise During Pregnancy and the Postpartum Period | ACOG

There are also some health conditions that may need monitoring or may stop you from exercising so you should always consult a healthcare provider first. 

“Women who habitually engaged in vigorous-intensity aerobic activity or who were physically active before pregnancy can continue these activities during pregnancy and the postpartum period.” Physical Activity and Exercise During Pregnancy and the Postpartum Period | ACOG

 

How much exercise is safe during pregnancy?


The recommendation is 150 minutes of cardiovascular exercise a week (American College of Sports Medicine). This can be spread over the week in 30 minute sessions or, if you are new to exercise, built up in 10-15 minute windows of activity. If just starting out, you can gradually increase the duration of your workout at your own pace. But don't feel discouraged if you can't hit the full 150 minutes per week; any activity and movement is better than none, especially during pregnancy.

 

By the third trimester, as you start to feel slower and fatigued, you may feel the need to reduce the duration of your workouts, which is completely understandable! The warm up and cool down elements either side of your workout could be extended to replace some of the aerobic workout, and could provide opportunity for additional stretching and relaxation, beneficial to a positive pregnancy and labour.


Consider attending a fitness class with a trained prenatal fitness instructor who will know how to modify exercises and ensure that you are doing exercises safely and with correct form. Ensure you cooperate with procedures to keep you safe by filling out health screening forms and informing your instructor if you are feeling unwell.


Safe exercise guidelines for pregnant and postnatal women


Listening to your body is your best guide when exercising. You should still be able to talk whilst working out, so not exercising to exhaustion. Your pregnant body will be producing the hormone relaxin which loosens your muscles and allows your body to accommodate your growing uterus and baby. This can make joints unsteady and at risk of injury if over stretched. Stretches are essential before and after any exercise and amazing for easing pregnancy aches and pains but should be controlled at comfort levels.


Before and during your pre or postnatal workout:


  • Consume a snack before exercise, to reduce the risk of hypoglycaemia

  • Prioritise warming up before exercising and cooling down afterwards to help prevent injury and promote overall fitness.

  • Stay well-hydrated by drinking plenty of water and other fluids.

  • Reduce impact on the joints and twisting and pulling of the abdominals

  • Stay at a comfortable temperature and do not exercise in hot temperatures or if feeling unwell.


Pay attention to your bodies warning signs which mean you must stop activity and seek medical attention if you notice:


  • Vaginal bleeding

  • Abdominal pain

  • Regular painful contractions

  • Amniotic fluid leakage

  • Dyspnea before exertion

  • Dizziness

  • Headache

  • Chest pain

  • Muscle weakness affecting balance

  • Calf pain or swelling


What kind of exercise can I do in Pregnancy?

 

You can do most forms of exercise in pregnancy – including: walking, running, stationary cycling, swimming, water aerobics, dancing, circuit training, strength and resistance training, cross-training, prenatal yoga and pilates. General housework such as hoovering, dusting and cleaning up or gardening are other daily activities you can do to contribute to your exercise routine.


There are a few exercises that are best avoided during pregnancy:


  • Anything with rapid twisting and jumping movements, such as high-intensity aerobics.

  • Contact sports, or anything where you might get hit, so no judo, boxing, hockey, squash or similar.

  • Any exercises involving lying flat on your back should be avoided after about 16 weeks. The weight of your uterus can put pressure on your blood vessels, particularly the major blood vessel called the vena cava, which can disrupt blood flow to your baby and leave you feeling nauseas, short of breath and dizzy.

  • Sit-ups are a no-no after the first trimester, as well as any abdominal exercises that pull on your tummy or put pressure on your lower back.

  • Exercises where there's a high risk of falling, such as ice skating, skiing or horse riding.

  • No scuba diving as your baby has no protection against decompression sickness and gas embolism.

  • Mountain climbing above 2,500 metres is out due to the risk of altitude sickness.


How can I modify my existing exercise routine for pregnancy?


In a pregnancy fitness class environment, the instructor will modify your routine if needed as you progress through your pregnancy. For example; slowing the pace and reducing quick changes of direction, reducing the number of repetitions, shortening the main aerobic part of the workout, and modifying/replacing equipment.


In the second trimester it is advised that pregnant ladies should not lie flat on their backs because the weight of the baby can start to restrict circulation, therefore exercises can be modified or replaced with alternatives which are side-lying, reclined, seated or even standing.


How to return to exercise safely after giving birth


As long as there are no complications, you can return to your formal exercise classes or routine following your 6-8 week postnatal check-up, or 10-12 weeks following a caesarean birth. It’s essential to listen to your body and gradually ease back into exercise. A qualified pre and postnatal fitness instructor will be able to provide you with the correct workout for your body and support you safely with your recovery.


Until you are ready to return to formal exercise, a gentle stroll with the pram and some pelvic floor exercises along with gentle core strengthening exercises are normally appropriate and can be started as soon as you ae able.


Modifying your postnatal workout


Some tips for modifying your postnatal exercise sessions:


  • Focus on rebuilding core strength with exercises like pelvic tilts, gentle abdominal contractions, and modified planks.

  • Avoid activities that place stress on the pelvic floor or hip joints until joint strength and stability has improved.

  • Begin with low impact activities and gradually increase intensity as your body heals

  • Abdominal crunches, oblique rotations and planks should be modified or replaced by alternative exercises to avoid further injury to the abdominal muscles.

  • If you are breastfeeding, consider feeding your baby or expressing milk before exercising to avoid discomfort of engorged breasts.

  • Ensure adequate hydration before commencing physical activity.

  • Ensure not to overstretch muscles as the levels of hormones in the body remain high for several months in the postnatal period, and even longer if you are breastfeeding.


What if my baby wont let me put her down?


Remember, you may also have a baby present whilst you are exercising postnatally, especially if you are attending a mum and baby postnatal class such as mine, so it’s important to be guided by your baby aswell. If your baby needs cuddles, feeding or changing, go with the flow! Enjoy the quick break and pick up your workout where you left off when you are both settled again.


Don’t worry if you miss parts of the class or it seems to take forever to get to the end of your workout due to lots of stops and starts. This is all part of your postnatal journey. In the early days and months, you have a tiny human being who depends on you for everything and you are doing an amazing job by getting active again. Your body needs time to recover and adjust and all these little ways of making you stop are its way of keeping you from doing too much, too soon.

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