Pregnancy: A Guide to Exercise

The information in this guide relates to a single foetus uncomplicated pregnancy. If you are carrying more than one baby or have any complications related to either your health or your pregnancy it is important to consult with your doctor.

Can I Exercise during pregnancy?

Pregnancy is normal! You are not ill and there is no reason not to exercise (except if there is a health or pregnancy complication see above). In fact, appropriate adapted exercise during pregnancy can deliver benefits.

During pregnancy you will be going through physical, hormonal and emotional changes and any exercise you do needs to recognize these changes.

If you are accustomed to doing a high level of exercise, now is the time to reduce exercise intensity, duration and frequency and ensure that your exercise choices prepare you for motherhood rather than prepare you for competition or high performance.

If you have not been doing regular exercise before your pregnancy, you can start, it is best to join a beginners class or where possible an exercise class specifically for pregnant women or a personal session with an instructor who has specific training, skills and knowledge in working with pregnant women.

What type of exercise is suitable during pregnancy?

Contact and competitive sports (e.g. martial arts, football) are best avoided whilst pregnant and during the post-natal period. Sport or exercise that involves any risk of falling (e.g. skiing, horse riding) and any extreme sport or extreme exercise is also best avoided (e.g. white water rafting!!). There should be no risk of trauma to the abdomen.

If you are used to impact exercise such as running or aerobics, you can continue. However the hormonal changes in your body will make your ligaments more lax and your body will be less able to support and protect your joints especially when bearing the increasing weight. So there is an increased risk of injury. Listen to your own body and don’t expect it to do what it has done previously. If you feel any discomfort in your back, pelvis, feet, or knees then your body is telling you to reduce the intensity of the exercise and to adapt. So for example, if you are a jogger you could swap to water jogging or Aqua exercise in a swimming pool where the water will support your body.

What type of exercise is best?

Pregnancy Pilates and Aqua Natal are excellent exercise programmes during pregnancy. Pilates and yoga classes specifically for pregnancy are a mind body type of training. You learn to move correctly, thoughtfully and mindfully. The slow moves are controlled, involve no impact and do not stress your joints. Pilates is especially helpful as there is a lot of emphasis on good posture and during pregnancy posture can change both dramatically and cause problems during and after pregnancy. Aqua natal exercise classes allows the body to move through movements more slowly (the water slows everything down), and supports the weight of the body.

How long and how frequently should I exercise for whilst pregnant?

Most exercise classes last one hour. During pregnancy it is better do an exercise class of around 45 mins, the remainder of your class might be an opportunity to relax or make friends with other mothers and mothers to be. The social aspect of an exercise class can be as beneficial as the physical aspect. Do not feel you have to “work out” for a whole hour. Most exercise guidelines suggest exercising 3 times a week for a minimum of 20 minutes, but this can be a combination of different types of exercise and not necessarily 3 specific classes or sessions, you might include walking.

Doing just a few basic exercises at home and pelvic floor contraction exercises (Kegel exercises) daily for a few minutes will be effective combined with one or two exercise sessions a week. Ask your instructor to give you a few simple exercises to practice at home between sessions.

I am used to doing intense work outs and like to feel “the burn”, what should I do in pregnancy?

One of the first changes in pregnancy is a small increase in core body temperature. It is very important during pregnancy to regulate your core temperature, and especially in the first trimester. High intensity exercise, and overheating can potentially raise the core temperature and damage your baby. It is generally recommended to also avoid saunas, Jacuzzis or exercising in a pool which is warmer than 32 degrees Celsius or 89.6 Fahrenheit. Women who are regularly active during pregnancy, and stay hydrated are better to adjusting to the rise in core temperature during pregnancy. Exercise in loose fitting clothing, check you can hold a conversation whilst you are exercising (e.g. you are not straining or out of breath), and exercise in a cool environment.

Can I do stretching exercises during pregnancy?

From approximately the second week of the pregnancy to up six months following pregnancy the body significantly increases its levels of the hormone relaxin. Relaxin is responsible for literally “relaxing” the ligaments and fibrous tissue during pregnancy so the body can prepare for giving birth. Your ligaments and tendons will become more elastic and in particular the abdominal muscles and pelvic floor muscles will be able to stretch in order to make room for the growing baby and to give birth. The presence of relaxin is one of the main reasons exercise needs to be adjusted during and after pregnancy. You will become less stable around joints so consequently excessive stretching or dynamic full range movements need to be avoided to prevent any increased risk to separation of the symphis pubis and injury to joints. If you are used to doing a lot of stretching, or if you have a physical training background such as a professional dancer or gymnast, you should stop your normal exercise routine. Avoid any overstretching or limbering of muscles, and full range movements. In general, keep your limbs close to your body, bend your knees rather than extend your knees, limit the range of movement so exercise moves are smaller. In particular, avoid hamstring and adductor stretches, strengthen these muscles rather than stretch them.

What happens to posture during pregnancy?

As your breasts grow and become heavier there is an increased strain in the upper back, neck and shoulders. With Pilates scapular stability exercises you can learn how to release the tension, strengthen the mid back muscles to support upper body movement and improve your awareness of how to move your upper body. You will also strengthen the upper body muscles which will help you with carrying the baby, the buggy, and carrying and lifting.

As the pregnancy develops it is likely the natural lordosis of the spine will increase and so your lumbar spine is at an increased risk of becoming excessively curved. Pilates exercises are especially helpful and will teach you how to recruit the muscles correctly to support your spine and help prevent the problems associated with the increased curvature of the spine. Some of the extensive number of exercises in the Pilates repertoire will not be suitable and it is important that your instructor provides the correct exercises and adapts exercises for your stage of pregnancy.

I want to get my flat stomach back as quickly as possible, what can I do?

During pregnancy the rectus abdominis separate, at this stage of the pregnancy (mostly around 12 to 14 weeks) the worst exercise you can do is the traditional abdominal curl up or sit up (lifting the head and upper chest off the floor) and performing these type of exercises could lead to making it more difficult to closing the separation post pregnancy. The best exercises are to focus on a combination of exercises that engage the transversus abdominis muscle, and to avoid lying on your back or standing still on your legs for longer than 3 mins. Exercises should involve slow changes of position, use variations of abdominal exercises that avoid the head and upper chest curling up.

Lying on the back for any length of time after the first trimester is not recommended due to the pressure of the baby on the inferior vena cava, being in this position for any long period can lead to dizziness. Advanced Pilates exercises are not suitable and if you are used to doing advanced abdominal type exercises you should drop your exercise level to beginners. Concentration and accuracy becomes more important and Pilates has many exercises that will not only help when it comes to the important task of giving birth, but will also help the body to return to a fit state following the birth.

Exercise in pregnancy

You are an individual and your pregnancy is unique, so how you exercise during and after pregnancy needs to be tailored to how you feel and what is working for you. For a normal healthy pregnancy some benefits include:

Reduction and prevention of back pain
Improved strength to carry the additional weight of your baby
Improved posture
Improved circulation and blood flow
Increase in calcium absorption prevention future osteoporosis (weight bearing exercise)
Increased self-esteem and confidence
Better ability to cope with labour
Reduced chance of high blood pressure
Faster recovery time following the birth
Limiting excessive weight gain
Better sleep and relaxation
Increased social contact
Reduction of gestational diabetes
Alleviation of minor physical discomforts (leg cramps, swelling, constipation etc.)
Better body awareness
Strong foundation to commitment to exercise to help you get your figure back, and to encourage your family to exercise

Every individual has a different experience during pregnancy, and whilst exercise cannot provide guarantees, it can help you manage and enjoy this very special time.

Blog article by Celia Carron. Celia is a Pilates instructor living and working in Basel, Switzerland and previously director of Little Venice Pilates, London.