Not so long ago a myth existed that exercise before and during pregnancy made childbirth more difficult. Thankfully nowadays most medical practitioners recommend exercise as part of a plan for fostering a healthy pregnancy and a healthy mom. In this article we will look at the three phases of pregnancy, i.e. before, during and after, and shed some light on what you should be doing as a pregnant exerciser.
Before we get into ‘when’ and ‘how’, it’s even more important to understand ‘why’. Studies have shown that women who exercise before and during pregnancy generally have easier births than those who don’t.1 Try to tell that to a pregnant woman as she’s going through childbirth and she might beg to differ!
Realistically, many women are most concerned with factors such as looking good, feeling good and of course ensuring that the growing baby is healthy. We also don’t need a scientist to prove that keeping in reasonable shape during and after pregnancy boosts self-esteem and self-image. The stats do, however, prove that women who exercise during pregnancy gain less weight than those who don’t, not to mention benefits such as increased joint strength, improved circulation, as well as the reduced likelihood of anaemia which is more likely to occur during pregnancy. Exercise has also been proven to decrease mood swings associated with pregnancy, and to increase energy levels.2
HOW MUCH IS ENOUGH?
A general recommendation is that pregnant women should exercise 2 to 3 times per week for 25 to 30 minutes. The cardiovascular section of training should not last more than 15 minutes. I say ‘generally’ due to the fact that not only will exercisers have different fitness levels, but the pregnant woman will go through changes during the 9 months that affect her ability to exercise. Pregnancy can be divided into trimesters (3-month periods) during which the effects of exercise can be summarised as follows:
Fitness levels decrease, so decrease your effort during this phase.
Fitness levels increase (not to pre-pregnancy levels) and the pregnant exerciser can therefore increase efforts (within recommended guidelines).
Fitness levels decrease, mostly associated with weight gain, therefore effort should be decreased again.
Exercise to exhaustion or avoid breaking a sweat?
Exercise professionals use heart rate monitors to measure exercise intensity. It is recommended that you exercise at 50 to 60% of maximum heart rate. In practice that probably doesn’t mean much to most people and heart rate monitors are also quite expensive. For most people it is more practical to exercise according to your perceived exertion, i.e. how you feel when you are exercising. If you were to use a scale out of 10, with 1 meaning at rest and 10 equal to your maximum effort, you should be exercising at an effort level of around 5 or 6.
I met a woman who worked as a spinning instructor – she had continued to teach classes throughout her pregnancy and had a very successful childbirth. There are always exceptions to rules, and everyone is different. However, one should always bear in mind that when exercising and pregnant, you are exercising for two! The question is not only how you are doing, but how the fetus is coping. There is scientific evidence to show that increases above 38 ̊C in core temperature of the mother (normal body temperature is around 36.9 ̊C) can result in spinal cord and brain damage.1 Personally I don’t think it’s worth taking the risk!
Remember, conditioned athletes are not only conditioned to perform, but also to meet the demands placed on the body during stress. Heat is one such stress, which in the case of the spinning instructor was a variable her body could cope with. The importance of adequate hydration and exercising in a cool environment cannot be overemphasised.
Other than monitoring exercise intensity, bear in mind the following precautions when exercising:
- Avoid lying on your stomach during exercise – that goes without saying!
- Avoid doing exercises lying on your back after the fourth month.
- Be aware of body temperature and signs of heat intolerance. Adequate hydration is paramount.
- Avoid movements that put stress on joints. During pregnancy hormones are released that increase joint laxity, putting them at risk of injury. This isn’t the time to try that new funky dance class!
So now that we’ve looked at some of the benefits of exercising, here is a summary of some common exercises you could consider, their benefits, as well as precautions in specific cases:
- Walking: This is great and is preferable to jogging at this time. Wear comfortable, supportive clothing.
- Weight training: Breathing is important while lifting. Don’t lift heavy weights during this time! Exercise programmes should be designed to strengthen joints in preparation for weight gain, as well as to address postural stresses placed on the body during pregnancy. Ask your instructor for a programme that strengthens the legs and postural muscles of the upper body.
- Swimming: This is a good form of exercise, especially during the later stages of pregnancy as it is less stressful on the joints.
- Aerobics: Be careful and avoid high-intensity exercise that involves fast changes of direction.
- Pilates: This is good in the first trimester. Be careful in the second trimester, with particular respect to exercises on the floor.
- Yoga: Be careful of over-stretching joints or any postures that involve the upside-down position.
Remember to always eat an adequate amount of carbohydrates when exercising so as to prevent hypoglycaemia (low blood sugar).
EXERCISE AFTER PREGNANCY
There is some debate as to exactly when one should begin exercising after pregnancy. Some moms exercise within a few weeks of birth. It is generally recommended that exercise begin within six weeks of delivery. It is vital to consult your doctor, however, before undertaking any exercise programme. Women who have had a caesarean section generally start exercise slightly later and need to be careful that exercises are not too stressful around the abdominal area. There’s always someone everyone knows who is permanently in good shape, even after pregnancy. Remember that weight loss in particular differs from person to person, so don’t base your goals on the experience of others.
- Aim to start with abdominal and Kegel exercises. Kegel exercises involve contracting the muscles of the pelvic floor. Practise the action of stopping the flow of urine, and hold for 5 to 10 seconds. Repeat 10 to 20 times, twice per day as you become stronger.
- Abdominal exercise does not refer to sit-ups! ‘Belly exercise’ as it is commonly called involves lying on your back and ‘pulling’ the navel in towards the spine, as if to flatten the back against the floor. Perform the same number of repetitions as for the Kegel exercises. This isn’t going to give you an immediate six-pack, but it will firm up the pelvic floor and abdominal area.
- Walking is the best form of exercise to get you started. Aim to build up to 30 to 45 minutes, pushing a pram once you are fit! Your aim should be to eventually be fit enough to attend classes.
- As a reminder, drink lots of water while exercising, especially while you are breastfeeding. Just as importantly, exercise within your personal comfort levels. If you notice any signs of discomfort during exercise or of fluid loss/ bleeding, be sure to stop exercising and consult your physician.
The question is no longer whether to exercise during and after pregnancy, but rather how much. The guidelines provided should give you some direction and insight in this regard. More importantly, much as science provides us with answers and suggestions, you need to know your own body and listen to it!
- Watermeyer A. Health and Fitness Professionals Association Manual, Exercise and Pregnancy. 10th ed. Johannesburg, 2008.
- Berk B. Motherwell. Maternity Fitness Plan. USA: Human Kinetics, 2005.