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Article originally written for pop’d 

The top three types of exercise that you should prioritise in pregnancy for a better pregnancy, birth and recovery.

It is now very well proven from research that keeping physically active during pregnancy is not only safe, but it’s associated with numerous benefits to both the mother and the unborn baby.

There is good evidence to show that those who participate in exercise regularly from the first trimester have less risk of complications. Those who meet the recommended guidelines for exercise through their pregnancy are less likely to experience gestational diabetes, high blood pressure, depression, anxiety and back pain.

Importantly, there is also a huge amount of evidence that for uncomplicated pregnancies, exercise DOES NOT increase the risk of miscarriage, birth defects, or going into early labour.

So it’s official – we know for sure that if you have been given the medical all clear to keep active in your pregnancy, you should!

But in our busy lifestyles, how do we know which types of exercise we should focus on in pregnancy to pack the biggest punch and give us the best outcomes?

I would recommend focusing in on three areas of exercise that we know from research and experience can have the biggest benefits:

  1. Workouts with a mix of moderate intensity cardio and resistance
  2. Pelvic Floor exercises
  3. Stretches

The following information will summarise how you can incorporate these into your week and how you might need to modify them for safety and comfort as your pregnancy progresses.

Workouts with a mix of moderate intensity cardio and resistance

International guidelines for exercise in pregnancy outline that pregnant women should be aiming for at least 150 minutes per week of moderate intensity cardiovascular exercise, and they recommend that this should be done over at least 3 occasions.

Interestingly, research has also shown that doing resistance work and cardio work together, for example a fast paced circuit workout with bands or light weights, is likely to be more effective and have more pregnancy-related benefits than doing cardio alone (such as going for a brisk walk).

So in a nutshell, you are aiming to exercise for at least 30 minutes on most days, ideally a mix of cardio and resistance training, in a manner that gets you a bit breathless and sweaty.

This is the similar to the guidelines for the non-pregnant population. So how do we ensure that we modify our cardio and resistance training for the safety and comfort of the pregnant woman?

Here are some points of difference:

  • When it comes to intensity, for non-pregnant people, the recommendation is moderate or high intensity. In pregnancy, it is recommended to keep to moderate intensity exercise, which is a rate where you could talk but not sing. You want to get a bit breathless and sweaty to get the benefits of moderate intensity exercise, without overheating or taking blood flow away from the baby.
  • Resistance exercises need to be done in a way that there is no risk of falling, of a weight hitting the abdomen, and without lying flat on your back. Lying flat on your back in the second half of pregnancy could decrease the blood flow to the baby due to the weight of the pregnant uterus, and so exercises in this position are advised to be avoided or modified to be on an incline.
  • Choosing low impact versions of cardio exercise, such as walking, swimming, stationary cycling or aqua aerobic, may decrease the pressure on your pelvic floor muscles, pelvic joints and leg joints compared to activities like jogging and skipping. Joints and pelvic floor muscles can be a bit more prone to injury during pregnancy due to the softening nature of the pregnancy hormones and the increasing weight of the baby through that area.
  • Abdominal muscle exercises are likely to need to be modified in the second half of pregnancy when the six pack muscles have started to stretch apart from each other to allow to baby to grow. Watching out for ‘doming’ and avoiding exercises that cause this (such as sit ups, planks, and Russian twists) will put less pressure on the stretched midline and may allow for an easier recovery for your abs after birth. Get an experienced professional to show you alternative forms of abdominal muscle exercises that don’t cause ‘doming’. 

It is always recommended to seek guidance from your medical team with regards to exercise safety, and ideally also having guidance from a Women’s Health Physiotherapist, who can assess you and put in place an indvidualised exercise program to suit you.

Pelvic Floor Exercises

There is a huge amount of research that has shown that it is beneficial to do pelvic floor exercises in pregnancy!

It has been shown to decrease the risk during and after pregnancy of bladder and bowel leakage, and has been shown to decrease the amount of intervention needed in a vaginal birth.

But – the very important thing to note is that this research is not based on pelvic floor exercises learnt from a brochure or the internet.

This research has shown that the benefits are gained when pelvic floor exercises are individually assessed and prescribed to suit that particular pregnant woman.

Women’s Health Physiotherapists in your community can do an assessment via an abdominal ultrasound, or via a digital vaginal examination, and determine how many repetitions, how long you should hold for, how often you should do them, whether you need to focus more on the letting go aspect of the exercise (particularly important in a vaginal birth) and how you should incorporate this into your daily tasks or exercise.

Stretching

Pregnancy is a time of life when your posture changes quite rapidly, and muscles have to lengthen or shorten to accommodate.

It is also a time when weight gain occurs relatively rapidly, and your muscles and joints can get more tired and overworked than usual with the extra load.

A regular stretching routine, done at various intervals in the day, can help to reduce discomforts associated with this changing posture and increased load.

Most women find that stretching before bedtime, or first thing in the morning, helps them to have a better night sleep or a more comfortable day. 

The particular areas that are often tight are the glute (buttock) muscles, the lower and middle back muscles, and the muscles around the shoulder blades and neck. Learning a stretching routine that you can do on your bedroom floor, at your office chair, by the kitchen bench etc can help to make this a part of daily life.

The only thing to note with stretching in pregnancy is that you are likely to have more joint mobility than usual, due to the softening effect of pregnancy hormones. Take care not to push too far into a stretch, especially one against your body weight such as ‘pigeon pose’ in yoga.