Exercise During Pregnancy – Dr Donald Angstetra, Obstetrician & Gynaecologist


How to stay fit and healthy? – A Guide to Pregnant Women


The benefits of exercise during pregnancy

Exercise during pregnancy lifts your well-being and prepares you for labour and childbirth. According to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), a routine sensible exercise is safe and beneficial during pregnancy. Exercise can help to relieve some aches and pains and also pregnancy-related symptoms such as tiredness, leg cramps, constipation and weight gain.  Exercise during pregnancy boosts mood and improves sleep. It also prepares you for childbirth by strengthening muscles and building endurance, making easier to get back in shape after you give birth. Research suggests that prenatal exercise may also lower the risk of developing gestational diabetes and preeclampsia. If you have been diagnosed with gestational diabetes, exercise can help you manage to control your sugar levels.


Changes during pregnancy

The body undergoes some physical changes during pregnancy which may affect the response to physical activity such as

•  Pregnancy increases weight and change in body shape; hence it alters body balance and co-ordination.

•   During pregnancy, the body releases hormones called Progesterone and Relaxin. It softens the ligaments, allowing the pelvis to expand in preparation for childbirth. All joints become less stable hence the risk of injury increases

•   Pregnancy increases demands on cardiovascular system. The heart has to pump more blood and the heart rates increases in order to adequately supply Oxygen to the baby.

•   Pregnancy hormones and gravid uterus that pushes the diaphragm (muscle between chest wall and abdomen) upwards can make breathing more difficult.

•   Core temperature rises about 1oC during pregnancy. Coupled with an increased in core temperature during exercise, means pregnant lady must be careful not to overheat as prolonged overheating can be harmful to the baby.


Exercise activities that are safe for expectant mother

•   Walking : Routine walking will keep you fit. It is safe to do throughout pregnancy.

•   Swimming : Swimming is the best and safest exercise for pregnant women. Swimming is ideal because it exercises both arms and legs, provides cardiovascular benefits, reduces swelling and allows you to feel weightless despite all the extra pounds you’re carrying. It can be helpful for low back pain.

•   Aerobics : Aerobic exercise strengthens your heart and tones your body. Many centers offer aerobics classes designed specifically for pregnant women and have instructors who can offer expert guidance on safe exercise.

•   Dancing : Get your heart pumping by dancing to your favourite music. Avoid routines that call for leaps, jumps or twirls.

•   Running : Going for a jog is an excellent way to exercise your heart and build endurance during pregnancy. It is better to start at a slow pace on shorter routes before gradually building up to 30-minute runs.

•   Yoga : Yoga can maintain muscle tone and keep you flexible with minimal impact on your joints. Yoga gives your heart a workout. Prenatal yoga can help to stay in shape and practice important breathing techniques for labour and birth.

•   Cycling : Cycling early in your pregnancy is safe if you are already comfortable on a bike. However, it is probably best to stick to stationary bikes later in pregnancy.

•   Stretching : Stretching is a great way to keep your body relaxed and prevent muscle strain. Add stretching to your cardiovascular exercises to get a complete workout.


Things you should NOT DO…

1.      Lie on your back

 As your pregnancy advanced, the weight of your uterus puts pressure on a major vein called inferior vena cava. It can reduce blood flow to your heart and may reduce blood flow to your brain and uterus. This can make you dizzy or short of breath. You can avoid this by putting pillows or a foam wedge behind your back to lift your body while you exercise.

2.      Overdo it

You should feel like you are working with your body, not punishing it. If you feel completely drained instead of invigorated after a workout, you are probably overdoing it. Don’t exercise until you are exhausted. In general, the best guideline is to listen to your body. Always stop if something hurts.

3.      Exercise in high heat or humidity

Avoid exercising in hot or humid conditions during pregnancy. Avoid activities such as doing Bikram yoga or “hot Pilates”.  Increased blood flow and a higher metabolic rate during pregnancy can make your body harder to regulate the core temperature. As a result, you may get overheated much faster than you normally would.

It is important to watch symptoms such as excessive sweating, feel uncomfortably warm, nauseated, dizziness or short of breath. To cool off quickly, stop exercising, take off layers and go someplace with air-conditioning or step into a cool shower. Hydrating is important so drink plenty water.

4.      Dangerous sports

Avoid contact sports or some other activities that might throw you off balance and cause a fall (such horse riding, surfing or skiing). All pregnant women should avoid scuba diving – babies in the womb aren’t protected from the effects of pressure changes.


Things you should DO…

1.      Eat enough calories

Exercise burns calories, so be sure to eat well to nourish and strengthen your body. When you are pregnant, you naturally gain weight as your baby grows. The amount you need to gain varies based on your pre-pregnancy weight.

If your body mass index (BMI) is in a healthy range (20-25), you will need to eat about 340 calories/day more in the second trimester than before you were pregnant and 450 calories/day more in the third trimester. If you’re underweight or overweight, you may need to gain a little more or less than someone with a healthy BMI and adjust your calorie intake accordingly.

2.      Wear the right clothes

Wear loose-fitting, breathable clothing. Make sure your maternity bra is supportive enough and choose athletic shoes that fit properly. You may need to get a new pair as your feet have changed because of mild swelling.

3.       Warm up

Warming up prepares your muscles and joints for exercise and increases your heart rate slowly. If you skip the warm-up and jump into strenuous activity before your body is ready, you could strain your muscles and ligaments and have more aches and pains after your workout.

A good way to warm up is to go slowly with your chosen activity and gradually increase its intensity after the first five to eight minutes. This prepares the muscles you will be using for more vigorous movement.

4.       Drink plenty of water

Drink water before, during, and after exercise to prevent dehydration. Dehydration can reduce blood flow reaching the placenta. Dehydration can also increase your risk of overheating or even trigger contractions.

There is no guideline on how much water pregnant women should drink while exercising, but many experts recommend a simple technique by checking the colour of urine to determine you are well hydrated. Dark yellow urine is a sign of dehydration.

5.      Get up from the floor slowly

Your centre of gravity shifts as your belly grows. It is important to take extra care when you change positions. Getting up too quickly can make you dizzy and may cause you to lose your balance.

6.       Make it a habit

Make a commitment to exercise regularly. Keeping up a routine is easier on your body than long periods of inertia interrupted by spurts of activity.


It is important to be cautious throughout your exercise. You should learn which activities to avoid during your pregnancy so that it can keep you – and your baby – healthy and safe.

Always check with your obstetrician, GP or midwife about your exercise routine to make sure your activities don’t put you or your baby at risk. If you exercised regularly before getting pregnant and your pregnancy is uncomplicated, you can probably continue with a few modifications.


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