This post is written by Baraa Sabbagh, Dietitian, Sports Nutritionist, and Personal Trainer at Healthy Happy Us Nutrition and Sports Diet Center in Beirut, Verdun, Lebanon.
A historical perspective of exercise during pregnancy
Several reasons have piled up over the years that caused women to be seriously hesitant towards exercise during pregnancy. Many suggest that this hesitation has been due to the vague recommendation published by the American College of Obstetricians and Gynecologists on exercise during pregnancy in 2002. The recommendations stated the following:
“In the absence of medical or obstetric complications, 30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.”
The recommendation caused enthusiasm towards exercise. However, it did not mention how to exercise safely, for how long, and what type of exercise should a pregnant woman engage in. If I were pregnant back in the day when the recommendation was published I would have probably just walked around leisurely for 30 minutes, sat on the couch and called it a day.Since 2002, many research studies and reviews have been developed to better understand exercise and pregnancy and that’s what I am going to tap into: the “why,”“what,” “how,” and “how long?”
is it Safe of exercise during pregnancy?
Before getting into the spectacular benefits and details. Let us first establish safety. In healthy women, exercise during pregnancy has been deemed as safe for the mother and the baby (Clapp, 2010). This is because the human body works in mysterious ways, the mother’s body does its own self-regulation during exercise as to secure the most benefits for herself and her baby. For example:
So, why not look at what exercise has to offer?
“Why” exercise? What are the Benefits of exercise during pregnancy to the mother?
- Exercise during pregnancy can significantly reduce the risk of developing gestational diabetes (diabetes during pregnancy) and preeclampsia (high blood pressure during pregnancy). It can also improve cardiovascular function (Zavorsky, 2011) (Prather 2012) (Duckkit, 2011).
- Clinical trials showed positive effects of physical exercise on depression, anxiety, self-esteem, quality of life, pain components and maternal perception of health status during pregnancy and postpartum (Prather, 2012).
- It has also been shown to decrease the duration and coping skills during labor, backaches and discomfort (Zavorsky, 2011). It helps reduce constipation, nausea and bloating (Duckitt, 2011). It could help improve lean muscle mass, cause less alteration to posture and enhance sleep during pregnancy (Prather, 2012) (Clapp, 2010).
- In addition, exercise will help pregnant mothers gain less weight, deposit less fat and have an increased fitness profile (Zavorsky, 2011). The fitness profile is improved due to the effect of exercise on blood volume, blood pressure, cardiac output and flow redistribution requirements (Clapp, 2010). These will lead to higher chances for the previously sedentary and active mommies to exercise after birth, have an improved exercise capacity and attain the pre-pregnancy shape back (Duckitt, 2011) (Clapp, 2010).
On the other hand, if a mother is not exercising while carrying the baby weight, she is increasing her chances of developing a large baby, cesarean delivery, preeclampsia, impaired glucose tolerance, and gestational diabetes (Heidi, 2012) (Jones, 2010) (Stamness, 2012).
“Why” exercise? Benefits of exercise during pregnancy to the fetus?
- A study done on ~ 80,000 infants showed that women who exercised during pregnancy had a lower risk of developing a baby that is small or large for gestational age (Zavorsky, 2011).
- Other benefits for the fetus, infant and child include a decrease in the rate of fat development on organs (Zavorsky, 2011).
- Infants of exercising women also have normal to superior cognitive and neurodevelopment which persists for the first 5 years of life (Zavorsky, 2011).
- There is also evidence that babies of exercising women experience less behavioral and biochemical stress during late pregnancy and labor (Micheli, 2010).
“What” types of exercises are okay and what types of exercises are not?
*Before beginning your exercise routine, make sure you to get clearance from your doctor as these recommendations follow through for women who are healthy without pregnancy complications.
Green light: Aerobic exercise such as swimming, stationary cycling, jogging, walking, treadmill use, stair climbing, and aerobic dance classes have gotten the green light. In addition, progressive resistive training, yoga, Pilates, and stretching exercises have also gotten the approval (Plather, 2012). Exercise in water provides a good workout for pregnant women which can reduce pressure on joints (Jones, 2010). Walking also provides a total body workout, has minimal impact on joints and muscles, and is a great way to begin an exercise program (Jones, 2010). Kegal exercises are also recommended during pregnancy (Jones, 2010). You can engage in these activities as long as you maintain your balance and effort levels are within range. Strength training can help improve muscle tone and reduce some of the aches and pains of pregnancy (Jones, 2010).
Orange light: Running could also be acceptable for women who were runners prior to pregnancy (Jones, 2010).
Red light: The exercises that should be avoided include those that increase the risk of falling (ice skating, gymnastics, horseback riding, downhill skiing etc.), injury to the stomach and contact sports (basketball, soccer, and hockey) and finally scuba diving is strictly prohibited during pregnancy (Clapp, 2010).
“How long” should a pregnant woman exercise for?
Your exercise plan can be maintained throughout your entire pregnancy as long as you’re following the approved exercise plans.
If you were sedentary (not physically active) before pregnancy: An exercise prescription for you, is to start at 15-30 minutes per day, 3 times a week. You can gradually increase to 30-45 minutes, 4 times a week at low-to-moderate intensity (Plather, 2012).
If you were active before pregnancy: You can maintain your previous exercise routine or engage in at least 30 minutes of moderate-to-vigorous exercise 3-5 times per week, this has been deemed as safe for the mother, fetus and infant.
“How” to safely exercise during pregnancy
- Exercise 2 hours after having a snack or meal: it is also crucial to have a planned snack/meal directly after the exercise session (Clapp, 2010). Why? To ensure your blood sugar stays within the normal range. The possibility of low blood sugar increases with the late months of pregnancy as well as if you exercise within the first 2 hours after having a meal.
- Stay hydrated: You should maintain proper hydration before, during and after the exercise session.
- Do the “talk test” while exercising: Moderate exertion can be explained with the “talk test” which means you are able to talk comfortably during exercise (to keep your heart rate in an acceptable range).
- Keep your heart rate within range: The mother’s heart rate should be in the following target zones according to her age (<20 = 140–155; 20–29 = 135–150; 30–39 = 130–145; >=40 = 125–140 beats/min) which corresponds to around 60–80% of aerobic capacity (Plather, 2012).
- Start with warm up and end with cool down: all exercise programs should start with a warm up and end with a cool down without a sudden end to exercise and standing or sitting (Clapp, 2010)(Jones, 2010).
- Keep an eye on warning signs: Even though most women can successfully exercise throughout their pregnancy, you should still be cautious in case of any warning signs and stop immediately if you experience chest pain, dizziness, shortness of breath, muscle weakness, vaginal bleeding, calf pain or swelling, amniotic fluid leakage, preterm labor, or decreased fetal movement (Clapp, 2010) (Jones, 2010).
You can book private one on one nutrition or personal training sessions with Baraa Sabbagh, Dietitian, Sports Nutritionist, and Personal Trainer at Healthy Happy Us Nutrition and Sports Diet Center in Beirut, Verdun, Lebanon. You won’t regret it.