KEY POINTS
Recreational exercise refers here to any kind of energetic (aerobic) exercise (such as swimming or running) and/or strength conditioning exercise.
- During pregnancy, aerobic and strength conditioning exercise is considered to be safe and beneficial.
- The aim of recreational exercise during pregnancy is to stay fit, rather than to reach peak fitness.
- You should take extra care when doing exercises where there is a possibility of losing your balance, such as horse riding or downhill skiing
You should avoid contact sports where there is a risk of being hit in the abdomen, such as kickboxing, judo or squash.
- If you experience any unusual symptoms, you should not continue to exercise. You should contact your healthcare professional immediately.
- If you have a medical condition, you should discuss this with your healthcare professional before doing recreational exercise.
- Pelvic floor exercises during pregnancy and immediately after birth may reduce the risk of urinary and faecal incontinence in the future.
- For most women, it is safe to exercise as soon after the birth as they feel ready.
- Recreational exercise does not affect the amount of milk you produce or its quality.
What is recreational exercise?
Exercise forms a part of our daily lives, whether we realise it or not. Actions such as climbing stairs, walking to the shops or running for a train all involve some form of exercise. Recreational exercise refers here to any planned regular exercise that a woman takes during her pregnancy, which involves energetic (aerobic) exercise (such as swimming or running) and/or strength conditioning exercise. The aim of recreational exercise during pregnancy is for a woman to stay fit rather than to reach peak fitness.
What are the benefits of recreational exercise during pregnancy?
Benefits for you
Many women find that recreational exercise helps them to adjust to the physical changes that occur during pregnancy. It may help relieve tiredness, lower back pain and reduce varicose veins and swelling of the feet and ankles. Recreational exercise improves muscle tone, strength and endurance. It makes it easier to carry the weight you gain during pregnancy and helps prepare you for the physical challenge of labour. Recreational exercise promotes a sense of wellbeing. Staying fit during pregnancy may help to reduce feelings of stress, anxiety and depression. Recreational exercise also improves sleep.
Recreational exercise during pregnancy may help to prevent medical conditions such as:
- Gestational diabetes mellitus (diabetes that develops during pregnancy)
- Hypertension (high blood pressure).
Recreational exercise also reduces the risk of developing colon cancer and may reduce the risk of developing breast cancer later in life. If you have gestational diabetes mellitus (diabetes that develops during pregnancy), exercise can help to improve your blood sugar levels. Women who do not do recreational exercise during pregnancy may become unfit.
Benefits for your baby
Women who do strength conditioning exercise during pregnancy tend to have a shorter labour time and fewer delivery complications.
Are there any risks?
Although recreational exercise can be beneficial during pregnancy, there may also be certain risks. These are related to the physical changes that occur as your body adapts to pregnancy. The risks are more likely to occur when you do inappropriate kinds of exercise and when you overexert yourself. By making appropriate adjustments to your exercise routine, you can reduce the likelihood of harm to you and the baby.
The risks include:
Getting too hot (hyperthermia)
When you exercise during pregnancy, your overall body temperature increases more than it would do normally. If your body temperature rises above 39.2°C in the first 12 weeks, this may affect the baby’s development leading to disability at birth.
To reduce the risk of getting too hot, you should:
- ensure that you drink lots of water before and during exercise
- avoid over-exerting yourself, particularly in the first 12 weeks of pregnancy
- avoid exercising in a very hot and humid climate until you have acclimatised – this will take a few days.
Low blood pressure (hypotension)
When you lie flat on your back, the growing baby presses on the main blood vessels. The effect is that less blood is pumped around your body and this may lead to low blood pressure (hypotension). This is more likely after 16 weeks of pregnancy.
To reduce the risk of low blood pressure, you should:
- avoid exercises which involve lying flat on your back, particularly after 16 weeks.
Physical injury
During pregnancy you may notice that your joints become loser. You may also notice that you can flex and extend particular parts of your body more than usual, such as your elbows, wrists, fingers, and knees. This is often referred to as hypermobility. It occurs because hormonal changes affect the ligaments that normally support your joints, which in turn make the joints loose in preparation for birth. When your joints and ligaments are less stable, you are at increased risk of injuring yourself.
To reduce the risk of physical injury, you should:
- make sure that you do warm-up and cool-down exercises
- avoid sudden changes of direction, if you are doing aerobic exercise
- consider wearing pelvic support belts during exercise.
Insufficient oxygen in the baby (hypoxia)
At high altitudes, the flow of blood to the womb is decreased and so the baby receives less oxygen. If a woman exercises at high altitudes, the amount of blood flowing to the womb is decreased even further. This leads to insufficient oxygen for the baby.
Blood sugar level
Blood glucose is a source of energy for both you and the baby.
It is important that you:
- eat well during pregnancy
- Exercise for no more than 45 minutes at a time.
If you have pre-existing or gestational diabetes mellitus, then you should take particular care when exercising. You should have your blood glucose monitored, eat at regular times, take rest at specific times, and ensure that your baby is carefully monitored. Your healthcare professional should provide you with further information.
Why aerobic and strength conditioning exercise?
The best forms of recreational exercise during pregnancy are:
Aerobic exercise, also known as cardiovascular (heart and lungs) exercise. When you do aerobic exercise your heart rate raises. This causes blood to circulate more quickly around the body and as a result more oxygen reaches the muscles. Swimming, running, fast walking, aqua aerobics and dancing are examples of aerobic exercises.
Strength conditioning exercise. This form of exercise helps to increase your overall fitness and involves slow, controlled movements such as weight bearing exercises.
If you do not exercise routinely and you are starting an aerobic exercise programme, you should be advised to begin with no more than 15 minutes continuous exercise three times per week, increasing gradually to a maximum of 30 minute sessions four times a week to daily.
What kind of recreational exercise should I avoid?
You should avoid exercises which involve lying flat on your back, particularly after 16 weeks.
You should avoid contact sports where there is a risk of being hit in the abdomen, such as kickboxing, judo or squash.
How can I be sure not to over-exert myself?
To ensure that you do not over-exert yourself, you should always have a warm-up and a cool-down period.
The ‘talk test’
During recreational exercise, you should be able to hold a conversation. If you become breathless as you talk, then you are probably exercising too strenuously.
When should I stop exercising?
If you have any unusual symptoms, you should not continue to exercise.
Unusual symptoms may include any of the following:
- dizziness or feeling faint
- headache
- shortness of breath before exertion
- difficulty getting your breath whilst exercising
- pain or palpitations in your chest
- pain in your abdomen, back or pubic area
- pain in your pelvic girdle
- weakness in your muscles
- pain or swelling in your leg/legs
- painful uterine contractions or preterm labour
- fewer movements from baby
- leakage of your ‘waters’ (amniotic fluid)
- bleeding.
Can I exercise if I have a medical condition?
If you have a medical condition such as heart disease or high blood pressure, or develop this during pregnancy, then you should talk with your healthcare professionals (such as cardiologist and obstetrician) before doing any recreational exercise.
Can I exercise immediately after birth?
If you have had an uncomplicated pregnancy and delivery, then you should be able to do mild recreational exercise such as walking and stretching immediately after birth.
You should be advised to do pelvic floor exercises after the birth, as this reduces the risk of urinary and faecal incontinence.
Women, who do recreational exercise during pregnancy, tend to continue to exercise after birth.
The benefits of exercising at this time are that you:
- feel better
- feel less anxious and depressed
- have more energy
- lose weight
- feel fitter (improved cardiovascular fitness).
Sources and acknowledgements: This information is based on the Royal College of Obstetricians and Gynaecologists (RCOG) Statement Exercise in Pregnancy
For more information contact:Dr.Sandeep Singh Sarpal Clinic