Pregnancy | Clinical Guidelines for physical activity while pregnant.

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Can you do physical exercise during pregnancy? 

Guidelines to exercise during pregnancy:

Exercise, we all know we feel better when we do it, but sometimes we need a little reminding of why it is so good for us. Regular physical activity across our lives is associated with many impressive health benefits such as; improved mental health, physical fitness and a decrease in the risk of chronic disease and mortality (1). Pregnancy is an extra great time to get out there and get moving! There is a growing body of evidence on how it can significantly affect the health of the mother and her child.

Although guidelines around the world recommend women without contraindications engage in prenatal physical activity, fewer than 15% of women will actually achieve the minimum recommendation of 150 minutes per week of moderate intensity physical activity during their pregnancy (2).

 This may be occurring due to some uncertainty among some pregnant women and obstetric care providers as to whether prenatal physical activity may increase the risk of complications to the pregnancy, however there is no research to support this and there is a lot of research that highlights the risk of not engaging in prenatal physical activity.

Over the last 3 decades the rates of pregnancy complications such as gestational diabetes mellitus, pre-eclampsia, gestational hypertension and newborn macrosomia have risen dramatically and are likely due to rising rates of maternal obesity (3,4). Physical activity has been proposed as a preventative or therapeutic way of reducing pregnancy complications and optimising maternal and foetal health.

In the absence of contraindications, following these guidelines is associated with fewer newborn complications (ie, large for gestational age) and maternal health benefits (ie, decreased risk of pre-eclampsia, gestational hypertension, gestational diabetes, caesarian section, instrumental delivery, urinary incontinence, excessive gestational weight gain and depression; improved blood glucose; decreased total gestational weight gain; and decreased severity of depressive symptoms and lumbopelvic pain). That is a long and impressive list of the benefits of maintaining regular exercise throughout pregnancy, don’t you think?

For pregnant women not currently meeting these guidelines, a progressive adjustment towards them is recommended. Previously active women may continue physical activity throughout pregnancy. Women may find they need to modify their physical activity to make it more manageable as the pregnancy progresses. There may also be periods of time when following the guidelines is not possible due to fatigue and/or discomforts of pregnancy; however women are encouraged to do what they can and return to following the recommendations when they are able (5).

Recommendations for exercise while pregnant:

  • All women without contraindications should be physically active throughout pregnancy.
  • Pregnant women should accumulate at least 150 minutes of moderate intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications.
  • Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged
  • Pregnant women should incorporate a variety of aerobic and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial
  • Pelvic floor muscle training (PFMT) (e.g. Kegel exercises) may be performed on a daily basis to reduce the risk of urinary incontinence. Instruction on the proper technique is recommended to obtain optimal benefits,
  • Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position.

Contraindications:

All pregnant women can participate in physical activity throughout pregnancy with the exception of those who have contraindications (listed below). Women with absolute contraindications may be able to continue their usual activities of daily living but should not participate in more strenuous activities. Women with relative contraindications should discuss the advantages and disadvantages of moderate-to-vigorous intensity physical activity with their obstetric care provider prior to participation.

The following are absolute contraindications to exercise:

  • Ruptured membranes.
  • Premature labour.
  • Unexplained persistent vaginal bleeding.
  • Placenta praevia after 28 weeks’ gestation.
  • Pre-eclampsia.
  • Incompetent cervix.
  • Intrauterine growth restriction.
  • High-order multiple pregnancy (eg, triplets).
  • Uncontrolled type I diabetes.
  • Uncontrolled hypertension.
  • Uncontrolled thyroid disease.
  • Other serious cardiovascular, respiratory or systemic disorder.

For a full list of contraindications as to why it may not be advisable for you to partake in exercise during your pregnancy, please check out the full article at https://bjsm.bmj.com/content/52/21/1339 (5). Alternatively, please seek advice from your health provider and/or medical team. 

Safety precautions for prenatal physical activity:
  • Avoid physical activity in excessive heat, especially with high humidity.
  • Avoid activities which involve physical contact or danger of falling.
  • Avoid scuba diving.
  • Lowlander women (ie, living below 2500 m) should avoid physical activity at high altitude (>2500 m). Those considering physical activity above those altitudes should seek supervision from an obstetric care provider with knowledge of the impact of high altitude on maternal and fetal outcomes.
  • Those considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and fetal outcomes.
  • Maintain adequate nutrition and hydration—drink water before, during and after physical activity.
  • Know the reasons to stop physical activity and consult a qualified healthcare provider immediately if they occur (see Box 2).
Reasons to stop physical activity and consult a healthcare provider:
  • Persistent excessive shortness of breath that does not resolve on rest.
  • Severe chest pain.
  • Regular and painful uterine contractions.
  • Vaginal bleeding.
  • Persistent loss of fluid from the vagina indicating rupture of the membranes.
  • Persistent dizziness or faintness that does not resolve on rest.

We hope that these recommendations help to motivate you to keep healthy and moving throughout your pregnancy. If you have any questions or concerns, as always, don’t hesitate to contact one of our friendly team members at the clinic on (03) 9570 9061 so that we can help you Move, Grow and Thrive!

Want to make an appointment? – Book Online Today!

(03) 9570 9061

www.valuedhealth.com.au

Massage, Osteopathy, Clinical Pilates, Rehabilitation, Relaxation massage, Pregnancy massage, Sports massage, Valued Health Osteopathy, Bentleigh East, Osteopath Bentleigh East, Pregnancy, Osteopathy and pregnancy

You do not need a referral to see one of our friendly Osteopaths at Valued Health Osteopathy. We have a very good relationship with many surrounding doctors, other health practitioners and personal trainers in the local community of Bentleigh East , Bentleigh, Ormond, McKinnon, Oakleigh, Carnegie, Caulfield, Moorabbin, Murrumbeena, Brighton, Clayton and Clarinda.

Valued Health Osteopathy offers:

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Valued Health Osteopathy is open 6 days a week with early morning and evening appointments. Move better with Osteopathy!

Valued Health Osteopathy is located at 3/658 Centre Road, Bentleigh East, Melbourne, Victoria, 3165.

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References:

  1. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia: Wolters Kluwer/Lippincott, Williams & Wilkins, 2013
  2. Evenson KR ,  Barakat R ,  Brown WJ , et al  . Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med 2014;8:102–21.doi:10.1177/1559827613498204
  3. Lavery JA ,  Friedman AM ,  Keyes KM , et al  . Gestational diabetes in the United States: temporal changes in prevalence rates between 1979 and 2010. BJOG 2017;124:804–13.doi:10.1111/1471-0528.14236
  4. Anne B. Wallis, Audrey F. Saftlas, Jason Hsia, Hani K. Atrash, Secular Trends in the Rates of Preeclampsia, Eclampsia, and Gestational Hypertension, United States, 1987–2004, American Journal of Hypertension, Volume 21, Issue 5, May 2008, Pages 521–526, https://doi.org/10.1038/ajh.2008.20
  5. Mottola MF, Davenport MH, Ruchat S, et al 2019 Canadian guideline for physical activity throughout pregnancy British Journal of Sports Medicine 2018;52:1339-1346
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About Tom McCormick

Dr. Tom McCormick (Osteopath) is the Director and Principal Osteopath at Valued Health Osteopathy in Bentleigh East. Tom is a qualified Osteopath and Dry needling practitioner and is also a Level 1 Strength and Conditioning Coach. Tom has also completed further studies in optimal movement patterns with the FMS (Functional Movement Systems).Tom believes it is important to address the immediate issues causing pain, however feels it is equally important to improve his patient’s ongoing movement, tissue quality, muscle activation and muscle strength in order to optimize injury recovery and reduce the chance of re-aggravation. Since Tom graduated as an Osteopath he has had the opportunity to work both in Queensland and Victoria within private practice and has worked closely with sporting teams. Tom has suffered many injuries and complaints over the years due to his heavy interest in sport. From broken bones, torn cartilage, tendon and muscle injuries to even a double hernia repair, this is ultimately what led Tom into the health field. Tom has a hands on approach to healthcare by utilizing a broad range of techniques that are tailored specifically to each patient. Such techniques include mobilization, soft tissue massage, stretching, trigger point therapy, dry needling and exercise rehabilitation. Although Tom enjoys treating athletes, he also thrives on the sense of enjoyment that comes with helping his patients of all ages with many other injuries. Tom also has experience in treating headaches, back and neck pain, hip, knee and ankle injuries and shoulder and elbow pain. Here at Valued Health Osteopathy Tom will use his Osteopathic experience, coupled with his further training to assess, diagnose, rehabilitate and treat in order to get you moving better with less pain. Outside of work Tom loves to travel, watch plenty of sport, exercise and loves a good coffee.