LIGHT EXERCISE GOOD FOR MOMS-TO-BE
But higher-risk activities like surfing and water-skiing should be avoided
Despite plenty of research suggesting exercise is safe for moms-to-be and their babies-onboard, eyebrows still raise when a visibly pregnant woman pulls on her workout wear. And while a few laps of the pool or a prenatal fitness class are generally well received, there’s no shortage of opinions shared if a woman with a baby bump jogs by.
Yet the benefits of exercise should negate the idea that the gym is no place for pregnant women. Reduced risk of gestational diabetes, depression, low back and pelvic pain, high blood pressure and excessive weight gain are just a few of the pregnancy-related complications exercise can help alleviate. And there’s evidence suggesting that working up a sweat on a regular basis can make mom happier, delivery easier and contribute toward a healthy birth weight.
Still, most exercise guidelines geared for pregnant women contain a mixture of encouragement and caution. The Society of Obstetrics and Gynecologists of Canada, who last updated their guidelines in 2003, recommend an active lifestyle, but suggest keeping exercise intensity at a moderate level and limit the options to brisk walking, stationary cycling, cross-country skiing, swimming and aquafit. As for exercises to avoid, horseback riding, downhill skiing, ice hockey, gymnastics and cycling are considered too high-risk. Women are also warned to avoid exercising in extreme heat and from performing exercises while lying on their backs.
American guidelines, updated in 2015, offer similar recommendations, but include lowimpact aerobics, yoga and Pilates (provided positions performed while lying on the back are avoided as much as possible), racket sports, strength training, jogging and running on their list of “safe” forms of exercise. As for activities they don’t recommend, water-skiing, surfing, off-road cycling, gymnastics, skydiving, hot yoga and hot Pilates are considered “unsafe.”
For many mothers-to-be, a moderate-intensity workout performed a few times a week doesn’t differ much from their pre-pregnancy routine. But there are some active women who don’t want to give up their favourite workout or dial down their intensity in favour of a brisk walk or a few laps of the pool. Instead, they aspire to maintain their regular workout routine for as long as possible during their pregnancy.
Understanding that many of the world’s elite athletes are competing in their prime childbearing years and may one day be faced with the dilemma of how much of their workout regimen they need to change and which, if any, activities they need to discontinue, the International Olympic Committee gathered a committee of experts to review the current scientific literature on exercise and pregnancy. The goal was to evaluate the risk factors and “provide recommendations for exercise training during pregnancy and after childbirth for high-level regular exercisers and elite athletes.” Their consensus statement, Exercise and Pregnancy in Recreational and Elite Athletes, was published in the British Journal of Sports Medicine in 2016.
The committee outlined the many physiological and anatomical changes associated with pregnancy and their potential to affect the ability of athletes to maintain their pre-pregnancy training regimens. Step length and width, balance and gait are altered as the pregnancy progresses. So is heart rate, with an increase of 15-20 beats per minute over pre-pregnancy levels. Blood volume also increases, as does the need for additional calories, nutrients and fluids. And let’s not forget the other changes to the body, including increased breast size and additional weight.
But they also mention that many of the recommendations for exercise during pregnancy are based on presumption rather than science, largely because of the limited number of studies using pregnant women and the ethics of exposing women to experimental conditions that have the potential to harm them and/or their fetuses.
As for what activities are considered safe during pregnancy, the consensus statement commissioned by the IOC left a lot more choices on the table, only listing those that pose potential abdominal trauma or physiological danger as contraindicated, like bobsledding, luge, equestrian, pole vaulting, ice hockey, downhill ski racing and scuba diving.
The bottom line is exercise should be considered as vital a part of a healthy pregnancy as diet, and doctors should work with active moms-to-be to maintain as much of their prepregnancy workout routine as possible.