Exercise in Pregnancy and the Postnatal Period
Exercise in pregnancy is associated with improved health and better outcomes for birth and recovery. It is also helpful to promote mood, increase strength and stamina, and prevent the development of gestational diabetes and hypertension in pregnancy. Antenatal exercise is also associated with positive impacts on foetal development and pregnancy term, reducing the risk of premature labour.
The benefits of prenatal exercise for the foetus are higher when exercise is performed under the guidance of a trained professional. Self-guided programmes are safe and effective for the mothers' health, but it appears that the outcomes for delivery and foetal health are magnified when prenatal exercise is conducted under supervision, at the correct intensity, frequency and volume throughout the pregnancy.
Training with free weights or machines can help to support posture and may help to prevent lower back pain associated with pregnancy. Weight-bearing exercises, such as walking and jogging, have been shown to promote healthy placenta development and so benefit the foetus.
Pregnancy can be challenging as the body changes throughout the trimesters, and so it is important that we listen to our bodies and adjust exercise intensity accordingly.
In the third trimester we can feel very tired and balance can become difficult, we may also have other uncomfortable things to deal with such as swollen legs and feet as well as managing an ever-increasing bump! So if we choose to continue to exercise in the last trimester of pregnancy, it's really important that we go at a pace that suits us, regress exercises as much as possible, and perform reps seated if necessary to mitigate the aches in the lower body.
It is possible to continue to exercise safely throughout pregnancy, once we have no complications and exercise isn't contraindicated on health grounds. A few rules of thumb include:
heart rate monitoring - ensuring we don't cross 140 beats per minute
avoiding crunches after the first trimester
adjusting exercises to avoid being in supine positions
Be mindful not to bump the bump and ensure the exercise area is clear, clutter-free and safe as our vision will be blocked by the bump as it grows, so gym etiquette becomes even more important! It is advisable to link with a gym instructor or personal trainer who is qualified in pre and post-natal exercise to guide you on the do’s and don'ts of exercise during pregnancy.
The focus during pregnancy and beyond is promoting pelvic floor health and keeping active for our mental and physical health.
Ensure an adequate intake of healthy dietary choices. Remember to eat before training and soon afterwards. In pregnancy our energy needs are increased, and we should aim to consume 2,300 Kcal per day. We also have increased blood flowing, and so preventing dehydration is a vital consideration to ensure we are well fuelled and hydrated throughout the day.
Healthy active ladies should aim to maintain pre-pregnancy activity levels as much as possible throughout the pregnancy, but at least 3 times per week at moderate activity levels. For those who wish to begin taking part in exercise during pregnancy, they should consult with their GP or other healthcare professional to ensure safety.
Post Natal Exercise
In the postnatal period rest and recovery is so important for the first 8 weeks, this time is for you to bond with baby and allow time for your body to heal. Once birth was uncomplicated, a gentle return to pelvic floor exercises, stretching and gentle walking can begin almost immediately. However, if birth was complicated, then it is safer to consult with a GP at the first 6-week postpartum check up.
A gentle return to exercise is advisable once you feel ready, bleeding has stopped and you have been cleared as being fit to return to exercise by your GP. At 8 weeks postpartum, Mum can begin to progress to pelvic floor exercises and low impact aerobic activities.
In weeks 8-12, new mums can continue to develop and progress with these exercise foundations.
During weeks 12-16, core strength and pelvic floor should be returning to normal strength, once regular exercises have been completed.
At 16 weeks+ normal activities can resume once the pelvic floor and core strength levels are back to normal. In the postnatal period, RPE charts and talk-tests are important tools to monitor fitness levels and exercise intensity.
In the post-natal period (12 months), following birth the primary focus is to be gentle and develop endurance, building a strong foundation for your return to exercise. The benefits affect both the body and the mind, and post-natal classes provide an opportunity to meet other new mums in a supportive environment.
Exercise classes can be a fun and accessible means to develop social connections. Research has shown that relationships can be in flux as we enter parenthood. Post-natal fitness classes can provide an informal social outlet for mothers. This can have a positive impact on mental health and connectivity within the community, as well as the physical benefits of regular exercise. Social connections have been shown to promote child health outcomes, as parents with strong social connections experience reduced stress levels.
Exercise at this period should be supported by a good dietary quality, and ladies who are breastfeeding should be mindful that their calorie intake should rise to 2,500 Kcal per day to support optimal milk production.
Exercise has so many benefits from boosting our mood, building connections through classes, reduces stress and anxiety, builds strong healthy muscles and bones, releases endorphins and reduces the risks of developing a number of chronic illnesses.
After pregnancy, we should focus on building a strong foundation to prevent injury. Investing this time focusing on movement quality and addressing any muscular imbalances caused during pregnancy, can help to protect against injury into the future.
Returning to exercise in a controlled manner and taking your time will benefit you and ensure you are equipped with the fundamental movement patterns to exercise safely.
Postnatal exercise will also help to ensure better pelvic floor health, increased core strength and increased mobility following pregnancy.
Bibliography
Bennett C.T at Al. (2017) A realist synthesis of social connectivity interventions during transition to parenthood: The value of relationships Applied Nursing Research 34. http://dx.doi.org/10.1016/j.apnr.2016.11.004
Berghella V & Saccone G (2017) Exercise in Pregnancy! American Jornal of Obstetrics and Gynaecology Editorial 216(4)
Olson D et al. (2009) Exercise in Pregnancy Current Sports medicine Reports 8(3) DOI: 10.1249/JSR.0b013e3181a61d51
Perales M et al. (2020) Gestational Exercise and Maternal and Child health: Effects Until Delivery and Post Natal Follow up. Journal of Clinical Medicine 9(2). https://doi.org/10.3390/jcm9020379
Szumilewicz A (2018) Who and How Should Prescribe and Conduct Exercise Programmes for Pregnant Women? Recommendations Based on the European Educational Standards for Pregnancy and Post Natal Exercise Specialists. Developmental Period Medicine DOI:10.34763/devperiodmed.20182202.107112
