Exercise

During

Pregnancy

By. Guthe Mahaedhie

Exercise is defined as regular, leisure-time physical activities to improve physical condition, ability or health. Previous studies indicate that women with uncomplicated pregnancies are fit for exercise with few restrictions, without any risk of harm to the mother or fetus.

A myth prevails that athletes, gymnasts and horsewomen may experience difficult labors due to strong pelvic floor muscles, and these questions are frequently discussed on chatting websites for pregnant women.

However, training of the pelvic floor muscles may produce strong and well controlled muscles that will facilitate labor, and one randomized controlled trial has demonstrated that intensive pelvic floor muscle training in pregnancy prevented a prolonged second stage of labor in about one in eight women.

Improved aerobic capacity and general muscular strength may also be beneficial and facilitate labor, but this has been sparsely studied in randomized controlled trials.

Salvesen, K. Å., Stafne, S. N., Eggebø, T. M., & Mørkved, S. (2014). Does regular exercise in pregnancy influence duration of

labor? A secondary analysis of a randomized controlled trial. Acta Obstetricia Et Gynecologica Scandinavica, 93(1), 73-79.

doi:10.1111/aogs.12260

Moyer, C., Livingston, J., Xiangming, F., & May, L. E. (2015). Influence of exercise mode on pregnancy outcomes: ENHANCED

by Mom project. BMC Pregnancy & Childbirth, 15(1), 1-7. doi:10.1186/s12884-015-0556-6

Understanding the effects of exercise during pregnancy on the

fetus and neonate is just beginning to be explored. The effects

of aerobic exercise on maternal health have been long

understood, with the body of research indicating the safety and

efficacy of maternal exercise training regarding fetal and

neonatal health is growing .

The fetus is not at risk of hypoxia or significant bradycardia

during maternal exercise. The neonate of exercising women is

also not at risk of being born disproportionately or underweight,

but is similar to women who have not exercised.

Moreover, fetuses of exercising women have decreased body

fat mass compared to fetuses of non exercising mothers.

Based on socio-cultural reasons, pregnant women

are encouraged to reduce physical activity during

pregnancy because of worries about potential

harms such as early pregnancy loss or reduced

placental circulation.

In 1985, the American College of Obstetricians and

Gynecologists (ACOG) published a guideline for the safe

physical activities during pregnancy. According to ACOG

recommendation, pregnant women are encouraged to do

low-impact, moderate-intensity and regular exercises during

this period.

They also were told to avoid intense activities (such as

jogging or cycling) for more than 15 minutes per session.

ACOG recommended doing low-intensity exercises every

day more than or equal to thirty minutes. They also

suggested high intensity exercises to be done three times a

week with twenty minutes or more duration.

Since then there has been a dramatic change in how doctors

and scientists perceive exercise during pregnancy.

Exercise is now thought to be great for the mother and the

unborn child.

Researchers are also now starting to look even more closely at

how exercise can influence a baby’s health in the womb and

how these effects might translate into protection from future

health problems.

Domingues, M. R., Matijasevich, A., Barros, A. D., Santos, I. S., Horta, B. L., & Hallal, P. C. (2014). Physical Activity during

Pregnancy and Offspring Neurodevelopment and IQ in the First 4 Years of Life. Plos ONE, 9(10), 1-8.

doi:10.1371/journal.pone.0110050

Physical activity during pregnancy is known to result in health

benefits as much as among non-pregnant individuals.

For example, women who exercise while pregnant experience

less muscular discomforts and depressive symptoms, keep their

weight gain within normal ranges and present lower blood

pressure and blood sugar levels.

Evidence also shows that children may benefit from maternal

exercise, as preterm birth is less frequent among exercisers.

Besides, active mothers are more likely to present healthier

lifestyles that may influence future health outcomes such as

future diabetes and hypertension.

There is no debt about benefits of physical activity among the

general populations. Recommendations are available about

benefits of physical activity during pregnancy.

Similar to other periods, physical activity will be valuable for

reducing cardiovascular problems, limiting weight gain,

decreasing musculoskeletal discomfort, reducing lower limb

edema and pregnancy specific benefits such as reducing risk of

developing gestational hypertension and diabetes.

Most women are concerned about effects of physical activity

on their own health and fetus health

Tanha, F. D., Ghajarzadeh, M., Mohseni, M., Shariat, M., & Ranjbar, M. (2014). Is ACOG Guideline Helpful for Encouraging

Pregnant Women to Do Exercise During Pregnancy?. Acta Medica Iranica, 52(6), 458-461.

Reason # 1

Why women should exercise during pregnancy :

This is due to hearth health.

It’s been known that those who exercise—including

pregnant women—tend to have lower resting heart

rates than those who don’t.

Lower heart rates can be a sign of an efficient heart;

high heart rates have been linked to greater risk of

cardiovascular disease.

Reason # 2

Why women should exercise during pregnancy :

The benefits of exercising while pregnant also last into a

child’s life after birth

higher heart rate variability if they had exercised along

with their moms in utero(Walker). These benefits can lead

into healthier childhood years, in which they have more efficiently pumping hearts.

Reason # 3

Why women should exercise during pregnancy :

Prepare women and her body for birth

Strong muscles and a fit heart can greatly ease labor and

delivery. Gaining control over your breathing can help

you manage pain. And in the event of a lengthy labor,

increased endurance can be a real help.

Reason # 4

Why women should exercise during pregnancy:

Regain pre-pregnancy body more quickly

Woman will gain less fat weight during her pregnancy if

you continue to exercise (assuming she exercised before

becoming pregnant). But don't expect or try to lose

weight by exercising during pregnancy. For most women, the goal is to maintain their fitness level throughout

pregnancy

May’s Study

Linda May, now at East Carolina University in North Carolina,

has long been interested whether benefits like this extended

to baby.

In a 2010 study, she and her colleagues collected a group of

26 pregnant women who reported that they’d been

exercising three times a week for more than 30 minutes per

session.

When researchers brought the moms into the lab at 36 weeks,

they found that the babies in their bellies, too, had lower heart

rates than those carried by the moms they studied who

weren’t regular exercisers.

May’s Study

In another study, May recruited 60 women at 13 weeks of

pregnancy and brought them into the gym three times a week

for either aerobic or mixed aerobic and weight training exercise.

A control group of women came in to stretch and chat with

researchers, keeping their heart rates low.

At 34 weeks—about six weeks before the babies’ due dates—the

researchers checked in with the hearts within the wombs.

Whether their moms were pumping iron or spinning, the babies in

the bellies of exercising moms played along—their heart rates

were lower and more variable, another sign of heart health, and

pumped more blood with each beat than the tiny hearts inside

moms in the control group.

May’s Study

The results indicate that exercise during pregnancy, far from

harming the fetus, can be incredibly beneficial for both mom

and baby. And timing matters: exercise during pregnancy, as

opposed to pre-pregnancy fitness, seems to be doing

something extra-special, May says.

In this most recent study, about half of the group hadn’t

exercised previously, and still saw similar effects on their babies’

hearts. In some of May’s past work, she collected data on

moms’ pre-pregnancy body mass index and their resting heart

rates, ages, and how much weight they gained in pregnancy.

But these things didn’t explain the link between the fetus’s heart

health and the exercise done in pregnancy.

Benefits at Birth, and Beyond

Such benefits to the heart may last into a child’s early life. Earlier this year, May and colleagues found that

month-old infants still had higher heart rate variability if they had exercised along with their moms in utero.

Another set of results from May’s group, not yet published, suggests that kids up to six years old still

carry some of these early workouts with them: youngsters whose moms exercised while pregnant

have higher “ejection fractions,” which indicates their hearts are pumping blood more efficiently.

As for what types of exercise bring the most

benefit, May has found that aerobic

exercise is great for the mom—lowering her

heart rate and helping her gain less fat—but

a mix of aerobics and strength training may

be even better for the baby.

Precautions:

Avoid aerobic exercise during pregnancy if you have:

Hemodynamically significant heart disease

Restrictive lung disease

Incompetent cervix/cerclage

Multiple gestation at risk for premature labor

Persistent second- or third-trimester bleeding

Placenta previa after 26 weeks of gestation

Premature labor during the current pregnancy

Ruptured membranes

Preeclampsia/pregnancy-induced hypertension

Take precautions with aerobic exercise during

pregnancy if you have:

Severe anemia

Unevaluated maternal cardiac arrhythmia

Chronic bronchitis

Poorly controlled type 1 diabetes

Extreme morbid obesity

Extreme underweight (BMI <12)

History of extremely sedentary lifestyle

Intrauterine growth restriction in current pregnancy

Poorly controlled hypertension

Orthopedic limitations

Poorly controlled seizure disorder

Poorly controlled hyperthyroidism

Heavy smoker

There are certain exercises and activities that can be harmful

if performed during pregnancy. Avoid:

Holding your breath during any activity

Activities where falling is likely (such as skiing and horseback riding)

Contact sports such as softball, football, basketball and volleyball

Any exercise that may cause even mild abdominal trauma, including activities that include jarring motions or rapid changes in direction

Activities that require extensive jumping, hopping, skipping, or bouncing

Deep knee bends, full sit-ups, double leg raises and straight-leg toe touches

Bouncing while stretching

Exercises that require lying on your back or right side for more than three minutes. (especially after your third month of pregnancy)

Heavy exercise spurts followed by long periods of no activity

Exercise in hot, humid weather

Scuba diving

Thank You