Exercise in pregnancy
Just how much exercise do you need to do in pregnancy? Recommendations from the UK's Chief Medical Officers might surprise you.
Guidelines suggest that pregnant women should carry out around 150 minutes of “moderate intensity” activity every week. But what is “moderate intensity” activity? Sadly, walking to the kitchen to satisfy cravings doesn't quite count. Rather, moderate activity is described as “activity that makes you breathe faster” while still being able to hold a conversation. The recommendations aim to reduce issues such as obesity, diabetes and other health concerns during pregnancy.
Here are just a few of the benefits of exercising during pregnancy:
- Helps you sleep
- If you get gestational diabetes it can help control your blood sugar
- You may well have a shorter labour
- You have a higher chance of having a vaginal birth and less intervention
How can I exercise safely during pregnancy?
While pregnancy is no time to take up steeplechasing or iron man competitions, particularly if you weren't big on feeling the burn previously, exercise plays a crucial role in keeping you fit and healthy for labour.
There are just a few health and safety things to remember before you get started:
- Do a good warm-up and cool-down whenever you exercise
- If you go to a class, tell the instructor you are pregnant. They may be able to advise you on any modifications you can do if the exercises prove too strenuous
- Be active each day, even if it's just a walk
- Stay hydrated by drinking plenty of water
- Eat three or four hours before exercising, and again straight after
- Pregnancy hormones make your ligaments a bit floppy, so take care
- Stop immediately if you feel unwell, short of breath, experience deep pelvic pain, dizziness, loss of fluid from the vagina, spotting or Braxton Hicks contractions
- Always check with your GP or midwife before starting an exercise regime as some women (for example those with certain conditions such as placenta praevia or very high blood pressure) are not advised to exercise in pregnancy
What exercise is OK to do in pregnancy?
Most forms of exercise are fine, but do listen to cues from your body – and don't be surprised if you find things a little harder than they were before you had a bump to contend with. NHS Choices advises that you should be able to keep up a conversation when you are exercising during pregnancy, so don't go at it full pelt.
It's worth remembering that three 10-minute sessions are as beneficial as a half-hour block. What's more, everything – from a brisk walk to the bus stop to a pilates class – counts as exercise, so you can adapt your routine to fit around your lifestyle.
What are the best dedicated antenatal exercise classes to do?
Exercise classes specifically designed for doing during pregnancy are a good option – and there's so much choice available now, with classes in everything from aquanatal fitness to prenatal ballet. You can sometimes access these through your antenatal classes, or look to local gyms and pools which may run set sessions for pregnant women.
Can I carry on with yoga or pilates in pregnancy?I'm 30 weeks and still doing Bodypump and Pilates – although I'm finding that it does get harder the bigger you get, simply because your range of movements decreases and you get out of breath a lot quicker!
Yes, there are lots of benefits to yoga and pilates. Yoga is great as it will teach you breathing techniques that can be used during labour and you'll also learn how to use positive visualisations, which can help you relax during pregnancy and birth.
Pilates is good in pregnancy as it focuses on the muscles in the abdomen and your pelvic floor, so can help you prepare and strengthen those muscles for birth.
Check that your instructor is qualified to teach pregnant women or, better yet, find a dedicated class for pregnancy which will focus on the areas of the body most affected, and may also include preparation for birth.
Is swimming safe in pregnancy?
Absolutely. Swimming is great exercise as you get bigger because the water supports your body weight and there is less pressure on the back. It improves circulation which can reduce any swelling in your extremities. Water also offers some resistance, which helps you tone muscles.
The only thing to know is that you should avoid butterfly stroke (unlikely, we know). And if you're suffering from any pelvic pain, avoid 'frog leg' movements, like you do for breaststroke. It's also worth taking a pair of goggles with you so you can put your face in the water rather than struggling to hold your head up, which can cause you to curve your spine a bit too much.
Is running safe in pregnancy?I run and continued until 35+ weeks with my pregnancies. This included races until 26 weeks (although at a toned-down pace). Basically, don't overheat and keep yourself hydrated. Your body will naturally slow you down as your pregnancy progresses.
If you were a runner pre-pregnancy, it's fine to carry on, but it's not a good idea to take running up in pregnancy if you're new to it.
In early pregnancy you just need to make sure you don't get too tired or overheat while running, and that you're wearing supportive shoes and a good sports bra – but you may need to modify your routine as you get bigger. Aim for a gentle pace where you are not so out of breath that you couldn't still hold a conversation.
Once in the third trimester, many women dial their runs down to brisk walking instead, but it's fine to carry on as long as you are listening to your body and taking it slowly. The key safety message is a common sense “don’t bump the bump”, referring to all activities which place you at an increased risk of injury through physical contact.
If you experience breathlessness before or following minimal exertion, headaches, dizziness, chest pain, muscle weakness affecting balance and calf pain or swelling, seek medical advice. Women may also be advised to reduce/stop physical activity following pregnancy complications such as vaginal bleeding, regular painful contractions or amniotic fluid leakage.
Can I still go to the gym when I'm pregnant?
Going to the gym is fine – in fact, cardio activity increases blood flow to the placenta as well as reducing your risk of varicose veins, cramps and high blood pressure.
The step machine is to be avoided, however, and you'll need to change your gym routine as you get bigger. Speak to an instructor for advice on how to do that as you move through pregnancy.
Is it safe to ride a bike during pregnancy?
You need to be VERY careful if you're undertaking exercise where there's a risk of falling, such as cycling or horse riding. Some doctors and midwives advise against it completely and many women choose to get off the saddle, but if you don't want to stop then do take more care than you usually would and don't go too fast or take any risks. Exercising on a static bike is absolutely fine.
Do I need to modify my exercise in pregnancy?My goal is being strong for the birth, rather than a PB on my 5k or whatever it might have been before. It's a great motivator.
Some forms of exercise can still be undertaken – but do make allowances for being pregnant and perhaps change your routine slightly to accommodate your changing body. If you're attending a regular exercise class, let the teacher know you're pregnant and they can advise you on modifications to suit at different stages.
Which activities are not safe in pregnancy?
There are a few exercises on the dos and don'ts of pregnancy list that are best avoided:
- Anything with rapid twisting and jumping movements, such as high-intensity aerobics
- Contact sports, or anything where you might get hit – so no judo, boxing, squash or similar
- Any exercises lying on your back after about 16 weeks. The weight of your baby can put pressure on your blood vessels and make you faint
- Sit-ups are a no-no after the first trimester
- Exercises where there's a high risk of falling, such as ice skating or skiing
- Scuba diving, because the baby has no protection against decompression sickness and gas embolism
- Mountain climbing above 2,500m is out due to the risk of altitude sickness.
What kinds of exercise are best for each trimester?
You should do what you enjoy and what suits you, but here are some ideas to get you started – or to help you shake up your routine with different things at different stages of pregnancy.
Pregnancy exercise in the first trimester
Keep up running if you were already a reasonably proficient runner – until you grow a bump, you won't notice too much difference. But make sure you don't overheat – very easily done in the first trimester as your body adjusts to new hormone levels, sending your thermostat slightly haywire – and dial down your expectations a bit. You're looking to maintain a steady pace, not beat any personal bests now.
A gentle cardio workout is good, too, so head to the gym and find out from the instructors how you can modify your exercise regime for pregnancy and what classes are available. Although you may feel wiped out by pregnancy tiredness, this sort of exercise will energise you and help you sleep better at night.
Pregnancy exercise in the second trimester
During the second trimester you should find you get some energy back, so it's a good time to join an antenatal exercise class you can do in the evenings. Aquanatal is a good all-round workout with cardio and strength-building aspects to it. You should avoid exercise that involves lying flat on your back now that your first trimester has ended.
If you're running regularly you should be fine to keep this up, but do make sure you're wearing supportive clothes and shoes and take care when out running as your centre of balance is beginning to shift now.
Pregnancy exercise in the third trimester
Towards the end of pregnancy, you may well find exercise harder. It sounds contradictory, but your fitness levels drop more dramatically the fitter you were before pregnancy. Listen to your body and slow down. A gentle swim is a good way to get some exercise now and the feeling of weightlessness can be a real relief if you're feeling heavy and lethargic. You might also think about a pregnancy yoga class, which is a great way to relax as well as exercise.
Useful exercises to do at home during pregnancy
There are lots of DVDs and online videos suitable for pregnancy that you can do in the comfort of your home. Yoga is particularly good, and there are strengthening exercises you can do any time, to keep you fit and prepare you for childbirth.
If you are finding floor exercises difficult, try doing them sitting on a gym ball. This supports your pelvic floor nicely and gives you a solid base to do upper body movements.
Don't forget to do your pelvic floor exercises whenever you can, too, as they will help you to avoid continence problems both in pregnancy and after the birth.
For more antenatal exercise inspiration, have a look at the tips Olympic gold medallist Jessica Ennis-Hill gave us when she visited MNHQ.