Physical Activity Throughout Pregnancy

Regular physical activity throughout life is associated with substantial health benefits, including improvements in physical fitness and mental health, as well as decreased risk of chronic diseases such as diabetes and hypertension.

Pregnancy is a unique period of a woman’s life where lifestyle including physical activity can significantly affect her health as well as that of her baby. Fewer than 15% of women actually meet the recommended physical activity of 150 exercise minutes per week. Unfortunately, it is a widespread misconception that physical activity during pregnancy may increase the risk of miscarriage, growth restrictions, preterm birth, fatigue or harm to the baby. However, over the last three decades there have been significant progress in the area of physical activity and pregnancy research which has found that these misconceptions are not substantiated and in fact, it is safe for most women to stay active while pregnant!

Women who should continue with their activities of daily living but who should not participate in more strenuous activities include women with:

• Ruptured membranes

• Premature labour

• Unexplained vaginal bleeding

• Placenta previa after 28 weeks

• Incompetent cervix

• Uncontrolled hypertension, thyroid disease, type I diabetes

• Multiple pregnancies (triplets)

• Pre-eclampsia

• Intrauterine growth restrictions

• Other serious cardiovascular, respiratory or systemic disorders

Women with the following conditions should discuss the advantages and disadvantages of physical activity with their obstetric care provider prior to starting.

• Recurrent pregnancy loss

• Gestational hypertension

• A history of spontaneous preterm birth

• Mild/moderate cardiovascular or respiratory disease

• Twin pregnancy after the 28th week

• Other significant medical conditions

For all other women, prenatal physical activity should be considered the front-line therapy for reducing risk of pregnancy complications and enhancing maternal and mental health. For pregnant woman not currently meeting the recommended 150 minutes, a slow and progressive lifestyle change towards them is suggested. Pregnant woman who were previously active may continue to be physical active throughout their pregnancy, however, there may need to be some modifications as the pregnancy progresses.

The 2019 Canadian Guidelines are as follows:

1. All women without any of the above conditions should be active throughout pregnancy.

2. Pregnant women should get at least 150 minutes of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications.

3. Physical activity should be performed over a minimum of 3 days per week; however, being active every day is recommended.

4. Pregnant women should incorporate a variety of aerobic and strength training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also provide benefit.

5. Pelvic floor muscle training (ex: Kegal exercises) may be performed on a daily basis to reduce risk of urinary incontinence. Please ask your health care provider on proper instruction in order to attain optimal benefits.

6. 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.

Even though exercising while pregnant is safe, precautions still need to taken. These include:

• Avoid physical activity in excessive heat, especially with high humidity.

• Avoid activities which involve physical contact or danger of falling. This includes sports like ice hockey, downhill skiing, non-stationary cycling and Olympic lifting.

• Avoid scuba diving.

• Avoid physical activity at high altitudes if not accustomed.

• Those considering athletic competitions or exercising significantly above the recommended 150 minutes per week should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and fetal health.

• Maintain adequate nutrition and hydration- drink water before, during and after exercise.

• Know the reasons to stop physical activity and consult a health care provider immediately if they occur. See below.

-Persistent excessive shortness of breath that does not resolve with rest

-Severe chest pain

-Regular and painful uterine contractions

-Vaginal bleeding

-Rupture of membranes

-Persistent dizziness or faintness that does not resolve with rest

Meeting these Guidelines may be difficult and some may need additional support or advice. I would be happy to provide you with the support, guidance and expertise to help your reach your health goals during pregnancy!

Source:

Mottola MF, Davenport MH, Ruchat S-M, et al. Br J Sports Med 2018;52:1339–1346.