Exercise and pregnancy: Is it safe?

Exercise is vital for a healthy life, pregnancy is no exception. Exercise can help maintain or improve your body’s strength, flexibility, and even boost your mood (which might be a little sensitive during pregnancy). But the age-old question remains: is exercise safe during pregnancy?

In this article, we will explore the safety of exercise during pregnancy, the benefits of exercise during pregnancy, pregnancy-safe exercises, and exercises that encourage an easy birth.

Is exercise safe during pregnancy?

In short, it depends. There are various factors that may prevent some women from safely exercising during pregnancy, which include:

• Vaginal bleeding: vaginal bleeding is not considered normal during pregnancy (although it may be frequently encountered especially during the first trimester). Vaginal bleeding may be a sign of a threatened miscarriage, cervical/placental issues, preterm labour, etc. One should stop exercising when they encounter vaginal bleeding and consult their obstetrician at the soonest.
• Placenta problems: low-lying placenta, also known as placenta previa, is a condition during pregnancy where the placenta is found to be either near or overlying the cervical OS (aka the womb neck opening or opening of the cervix); women with this condition are at an increased risk of vaginal bleeding and preterm labour and should hence avoid strenuous exercise so as to minimise the risk of triggering the fore-mentioned.

  

• Pre-eclampsia during the second or third trimester: pre-eclampsia (PE) is a condition involving high blood pressure and proteinuria (protein found in the urine) that is typically diagnosed in the second or third trimester; uncontrolled hypertension in pregnancy can result in liver/kidney/blood dysfunction and even seizures in the pregnant mother; women with PE typically need close monitoring with medications and should avoid strenuous exercise to maintain a normal blood pressure range as far as possible.
• Cervical problems: a short cervix, also known as cervix insufficiency or an incompetent cervix increases the risk of preterm labour. If you have been told that you have a short cervix, either due to previous cervical operations or on the ultrasound scan, you should avoid strenuous exercise lest you trigger premature contractions.

  

• Anaemia: having a low blood count, particularly during pregnancy when you need to provide for both yourself and your foetus, can put extra strain on your vital organs and result in a higher risk of you feeling faint/light-headed/dizzy during exercise. In general, try to get your anaemia under control through appropriate supplements before engaging in strenuous exercises.
• Preterm labour: if you are at risk of going into preterm labour e.g., you have a history of preterm deliveries, a short cervix from previous surgery, repeated bleeding episodes throughout your pregnancy etc, it is generally not a good idea to engage in strenuous exercise.
• Pregnant with multiple babies: having twins (or higher order pregnancies) means that your womb is heavier, your joints/ligaments are under greater strain, and you are also overall at a higher risk of going into labour early (preterm labour); excessive exercise may put you at increased risk of ending up with premature babies.

With these in mind, it is essential to check with your obstetrician and obtain clearance before you commence exercising.

For most women however, exercise during pregnancy is safe; the bottom line is – if you are healthy and your pregnancy is normal/low risk, it is safe to exercise and you should exercise to maintain your physical stamina throughout your pregnancy journey [1-4].

Benefits of exercise during pregnancy

During pregnancy, your body goes through a plethora of changes such as a change in the centre of gravity, backaches, bloating, constipation, and weight gain. Exercise has been shown to be incredibly beneficial during pregnancy [5].

Exercise during pregnancy has been found [3] to promote the following:

• Increase energy levels: regular exercise can help combat fatigue and boost energy levels during pregnancy, making it easier to cope with the physical demands that pregnancy puts on your body.
• Improve mood and mental well-being: pregnancy or not, exercise is well known for stimulating the release of endorphins, which are natural mood-boosting chemicals. Pregnancy can be stressful and anxiety-inducing, exercise can help negate this by boosting one’s mental health overall.
• Reduce pregnancy aches and pains: pregnancy can bring about many physiological changes in one’s body, including lower backaches, bloating, water retention, and constipation; exercise serves to alleviate these symptoms.
• Regulate weight gain and reduce risk of pregnancy complications: such as gestational diabetes mellitus (GDM) and pregnancy-induced hypertension, 1 in 5 pregnant women in Singapore is afflicted with GDM; exercise can help regulate blood sugar, blood pressure, and optimise gestational weight gain during pregnancy. Exercise also allows an easier return to pre-pregnancy weight following delivery.
• Enhance overall fitness, strength, and endurance: maintaining these through exercise during pregnancy is essential as the pregnancy journey is a physically demanding one and so is the process of childbirth.
• Improve sleep quality: exercise promotes better sleep and relaxation during pregnancy.

Which month of pregnancy can I start exercising?

Once you have gotten the go-ahead from your obstetrician, you can start exercising in any month of your pregnancy. How to kick start exercising during pregnancy depends on your fitness level prior to pregnancy; if you led a largely sedentary lifestyle prior to pregnancy, start low and go slow – begin by incorporating just 10 minutes of light exercise a day, this may include walking, yoga, stretching, or swimming.

If you were generally fit and exercised regularly before conceiving, you will be able to keep to your usual exercise routine barring physical impediments e.g., as your belly grows bigger. Ultimately, you know your body best and it is important to listen to your body and the advice of your doctor.

Pregnancy-safe exercises

Depending on your fitness level, the following low-impact exercises are considered safe for pregnancy:

• Swimming
• Walking/hiking
• Jogging
• Yoga
• Pilates
• Body-weight exercises
• Light weight exercises

Exercises not considered safe for pregnancy are:

• Kick-boxing
• Hockey
• Soccer
• Volleyball
• Basketball
• Hot yoga
• Hot pilates
• Gymnastics

High-impact exercises with risks of direct or indirect trauma to your belly are a definite no-no during pregnancy. Additionally, exercises or activities that involve exposure to high temperatures like hot yoga, hot pilates, sauna, and hot tubs are also generally not advisable during pregnancy [6].

Exercises that encourage an easy birth

An easy birth or delivery is one of the most important aspects of giving birth. Fortunately, there are several types of exercises that encourage an easy birth, these include:

• Kegel exercises: otherwise known as pelvic floor exercises. Pelvic floor muscles play an important role in supporting the pelvic organs (bladder, uterus, and bowel); strengthening them during the antenatal and postpartum period can help improve your control over them as well as facilitate a smoother postpartum recovery.
• Squats: these help open up the pelvis and also strengthen and tone the hip, buttock, and thigh muscles, all of which are actively engaged during labour and childbirth.
• Stretching exercises: commonly adopted in pregnancy modified pilates/yoga, gentle stretching, maintaining core muscle strength, improving posture, and stabilising the pelvis are beneficial in improving flexibility, balance, and overall strength.
• Walking/swimming: these low-impact and easily available exercises are gentle on the joints, promote cardiovascular fitness, and can serve to increase endurance.
• Deep breathing exercises: these can help with relaxation and form part of coping techniques during labour.

In conclusion, for most women, exercise during pregnancy is safe and beneficial. Consult with your obstetrician to find out what is suitable for you, listen to your body, and listen to your doctor.

References

1. Simony L Nascimento, F. G. (2012). Physical exercise during pregnancy: a systematic review. Current Opinion in Obstetrics and Gynecology, 387-394.
2. Maria Perales, A. S.-L. (2016). Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Human Development, 43-48.
3. Maria Margarida Ribeiro, A. A. (2021). Physical exercise in pregnancy: benefits, risks and prescription. Journal of Perinatal Medicine, 4-17.
4. Loretta Dipietro, K. R.-B., & COMMITTEE, 2. P. (2019). Benefits of Physical Activity during Pregnancy and Postpartum: An Umbrella Review. Medicine and Science in Sports Exercise, 1292-1302.
5. Lingdi Wang, L. Z. (2022). Exercise during pregnancy may have more benefits than we thought. eBioMedicine, doi: 10.1016/j.ebiom.2022.103889.
6. Justin Chan, A. N. (2014). Hot yoga and pregnancy. Canadian Family Physician, 41-42.