Most women are concerned about exercise during pregnancy. Physical activity and exercise in the absence of any contraindication during pregnancy are safe and have been shown to benefit __ most women. Studies have found that women who exercise during pregnancy have a lower incidence of gestational diabetes, cesarean birth, excessive weight gain, pre-term birth, and higher incidence of vaginal birth, faster recovery post-delivery.
According to recent research, one in every seven women will develop postpartum depression within a year of giving a child. Physical exercise plays an important role in the prevention of depressive disorders in postpartum women.
Women can continue doing any activity that they performed before conception
as long as the intensity and frequency are moderate. Although because of morphological, anatomical, and physiological changes during pregnancy, certain modifications are necessary.
Before making any changes in the exercise pattern and physical activity routine, do refer to gynecologists for their consent.
Types of activities that are considered safe during pregnancy:
- Walking
- Stationary cycling
- Aerobic exercises
- Pelvic floor strengthening exercises
- Stretching
- Resistance training
- Water aerobics
Types of activities that need to be avoided during pregnancy:
- Contact sports or sports that involve falling on the stomach should be avoided as it involves significant risk of abdominal trauma or imbalance.
- Scuba-diving: It should be avoided as the fetus is at a higher risk of developing decompression sickness.
- Hiking and Sky diving : Women living at sea level were able to withstand physical activity up to 6,000 feet, suggesting that this altitude is safe for pregnant women. Women already living in certain climatic conditions and on hills may be able to withstand the physical activity.
- High-impact Activities: Repetitive high-impact activity, such as twisting and turning, high stepping, or abrupt pauses, can induce joint pain and should be avoided.
ACOG recommends at least 150 minutes of moderate-intensity physical activity per week for pregnant women. It can be divided into 30 mins of 5 days or start with 10 mins in case of an absolute beginner and increase up to at least 30 minutes gradually.
Before implementing an exercise program, a complete clinical examination should be performed to ensure that the female does not have any contraindication to avoid it.
Sedentary:
Females who are sedentary before conception should follow a more gradual progression of exercise. Avoid taking strenuous exercise. This is not the time to experiment.
Start with low-impact exercises like walking, bicycling, resistance training, swimming, etc.
Frequency: Minimum of 3 times a week
Duration: Start with 15-20 mins and gradually increase up to 30 minutes.
Intensity: Low to Moderate. Heart rate 65%–75% maximum
Recreational Athlete:
Females who are into physical activity before conceiving and have no contraindications can continue to participate in high-intensity exercise regimens like running and aerobics without experiencing any negative side effects. High intensity for a long duration can lead to fatigue and hypoglycemia as well. In that case, females should take care of proper hydration and calories prior to exercise or reduce the length/ intensity of the activity.
Frequency: 3–5 times per week
Intensity: perceived exertion = Moderately hard to hard, Heart rate 65%–80% maximum
Type: same as above plus prior activities such as running/ jogging, tennis, cross country, etc
(Adapted from Joy EA: Exercise and pregnancy. In Family Practice Obstetrics, edn 2.)
Tip: Conduct a talk test method to measure intensity. Try to hold a conversation. If females get breathless while talking that means the intensity is high. Low to moderate intensity is when a female is able to strike a conversation but not able to sing.
Conclusion
Physical exercise in pregnancy is safe and desirable in the absence of obstetric or medical difficulties or contraindications, and pregnant women should be encouraged to continue or begin safe physical activities.
Note : __ Exercise regimes should be tailored to the needs of women with obstetric or medical comorbidities. Obstetrician–gynecologists and other health care professionals should carefully assess women who have medical or obstetric difficulties before recommending physical exercise during pregnancy.
References:
- Dye, T.D., Knox, K.L., Artal, R., Aubry, R.H. and Wojtowycz, M.A., 1997. Physical activity, obesity, and diabetes in pregnancy. American journal of epidemiology, 146 (11), pp.961-965.
- Di Mascio, D., Magro-Malosso, E.R., Saccone, G., Marhefka, G.D. and Berghella, V., 2016. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. American journal of obstetrics and gynecology, 215 (5), pp.561-571.
- Bauman, B.L., Ko, J.Y., Cox, S., D’Angelo, D.V., Warner, L., Folger, S., Tevendale, H.D., Coy, K.C., Harrison, L. and Barfield, W.D., 2020. Vital signs: postpartum depressive symptoms and provider discussions about perinatal depression—United States, 2018. Morbidity and Mortality Weekly Report, 69 (19), p.575.
- Kołomańska-Bogucka, D. and Mazur-Bialy, A.I., 2019. Physical activity and the occurrence of postnatal depression—a systematic review. Medicina, 55 (9), p.560.
- Michalek, I.M., Comte, C. and Desseauve, D., 2020. Impact of maternal physical activity during an uncomplicated pregnancy on fetal and neonatal well-being parameters: a systematic review of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology, 252 , pp.265-272.
- ACOG Committee on Obstetric Practice, 2002. Committee opinion# 267: exercise during pregnancy and the postpartum period. Obstetrics & Gynecology, 99 (1), pp.171-173.
- Soultanakis, H.N., Artal, R. and Wiswell, R.A., 1996, August. Prolonged exercise in pregnancy: glucose homeostasis, ventilatory and cardiovascular responses. In Seminars in perinatology (Vol. 20, No. 4, pp. 315-327). WB Saunders.
