Dr Danie Schneider
Obstetrician and Gynaecologist, Somerset West

Exercise during Pregnancy

Is it safe to exercise in pregnancy?

Current recommendations advise physical activity for most women.  Exercise has minimal risk and will benefit most women.  Researchers like Dr James Clapp have over the last few years provided reassuring data of countless studies done on pregnant women and have not been able to show identifiable maternal ill effects.  International guidelines now uniformly advise physical activity in pregnancy.  Discuss this during your antenatal consultations and together we can address your individual needs and concerns.

What are the advantages of exercise in pregnancy?

Less maternal weight gain
Women who stay active will deposit and retain less fat
Lower incidence of Diabetes in pregnancy
Less Hypertension/ High blood pressure
Rapid recovery after birth
Feel better during pregnancy
Shorter, less complicated labours
Likely to adopt long-term healthy lifestyle

What are the benefits for the baby?

No short or long-term problems
Lower, more efficient heart rate
Healthier weight
Less obesity
Stable blood sugar
Larger, more efficient placenta
More active brain

What are safe exercises?

Stationary cycling
Low- impact aerobics (water aerobics and aerobic dance)
Yoga (modified)
Pilates (modified)
Strength training

What should I be aware of when exercising during pregnancy?

Thorough clinical evaluation is advised before starting an exercise program.
Discuss what level you want to exercise at during the consultation.
There is no one size fits all!
Different guidelines apply to the fit and the unfit as far as type, frequency and level of intensity of exercise is concerned.
Aerobic exercise as well as strength conditioning is advised for uncomplicated pregnancies.
Stay well hydrated while exercising.
Do not exercise according to heart rate, as it is inaccurate in pregnancy.
Take enough time to cool down and recover after exercise. This should be longer than what you are used to before pregnancy.
Be aware of the contra-indications as well as warning signs to stop exercising.

What are the absolute contraindications?

Ruptured membranes
Persistent bleeding (from the womb)
Incompetent cervix
Multiple gestations at risk of premature labour
Structurally abnormal womb
Placenta praevia
Pre -eclampsia, severe anemia or heart problems

What are warning signs to discontinue?

Vaginal bleeding
Regular, painful contractions
Amniotic fluid leakage
Shortness of breath before exertion
Chest pain
Muscle weakness affecting balance
Calf pain or swelling

How will I know at what level to exercise?

Note that your set point for your normal body temperature, as well as your set point for sweating is lower in pregnancy. It is therefore easier for your body to dissipate heat through your skin and get rid of heat through expiration. Research shows that your body has inbuilt protection against thermal injury during pregnancy!
Do not exercise according to heart rate, but focus on the level of exertion. If you feel okay during exercise, it is the right level! You should be able to talk while exercising.

What can I do if I am unfit and want to exercise during pregnancy?

Contrary to previous opinions, pregnancy is now considered an ideal time, not only for continuing, but also for initiating an active lifestyle.
Gradual progression is advised.
The goal is 150 min of exercise a week at the level of “ a brisk walk”.
Build up to moderate intensity exercise for 20 minutes on most days of the week.
Break your days exercise into shorter periods if pressed for time or unfit.
Count distance, rather than minutes, eg walk 1-2 km three times per day.
Aim to walk 3-4 km on most days.
Use a fitness app! Walking around the Mall does count as exercise…

What about exercise for the fit?

Remember that the placenta stops growing at around 20 weeks. Do not start your program or increase aerobic capacity after 20 weeks.
Exercise in the “somewhat difficult to difficult” range at the beginning of the pregnancy.
Scale down to the “somewhat difficult” range from 20 weeks.
Lengthen your cool-down phase.
Mentally downshift in the last half of the pregnancy and do not push through the pain barrier or exert yourself.
Cross train after 20 weeks.

Can I do strength training?

All women will benefit from strength training and strengthening your core muscles.
Your transvers abdominus muscle is of key importance.
Be aware of the alignment changes your body goes through during pregnancy and counterbalance those.
Always maintain a neutral spine.
Form during exercise is more important than ever. Use a mirror or get help from a trainer.
Avoid exercises that make your stomach muscles form a “cone shape”.
Continue flexibility exercises!
Remember to do Kegel exercises regularly.

Are there guidelines for strength training in pregnancy?

There are no established strength training guidelines for pregnancy or weight limits for exercises. First of all discuss this in the consultation and get the all clear before starting out. It is important to use your common sense and monitor your physical responses to specific exercise to ensure that your routine is safe. It’s important to listen to your body and employ modifications to exercises that become uncomfortable. It is vital to ensure that the exercises continue to feel comfortable and aren’t causing any strain or pain. Examples of exercises that have been used in research include resistance bands, dumbbells and body weight exercises of 15-20 min duration 3-5 times a week, with effort at a light to moderate intensity lasting 1-2 sets.

What about aerobic exercise during pregnancy?

Examples of low impact aerobic exercises that have been tested through research include walking, aerobic dancing, stationary cycling, swimming and running (in previously active women). The optimal intensity is at the level of the “talk test”. The duration should be for 20-30 min 3-5 times a week. The combination of low impact aerobic and strength training combined e.g. aerobic dancing followed by the use of dumbbells could be time efficient…