It may sound like a cliché, but it is none-the-less true that pregnancy is a time of tremendous change for expectant mothers. With many conflicting priorities and much to get done before baby’s arrival it is easy to understand how exercise may fall to the wayside, even among women who were regular exercisers before becoming pregnant. There’s also the common idea that pregnancy is a time for women to “put their feet up and take things easy.”
Myth 1: Pregnant women should not exercise.
Fact: The majority of pregnant women will benefit from being physically active.
**There are some medical conditions that would prevent a woman from participating in exercise. All pregnant women are encouraged to speak with their physician or other obstetrical care provider about their specific situation.1,2
Myth 2: Exercise will harm baby.
Fact: Exercise is safe.
Among healthy pregnant women, exercise has been found to be safe. Studies have shown that there is no increase in complications, no negative impact on baby’s growth, no change in miscarriage rates or other negative outcomes associated with regular, moderate intensity aerobic and/or strength exercises.2
To gauge how hard to workout, use the Talk Test or Borg’s Rating of Perceived Exertion (see box).3 If you can carry out a conversation while exercising you are working at an appropriate intensity (the Talk Test).2 If using the Borg Scale, aim to be within the 12-14, or “somewhat hard” range.2
Level of Exertion
No exertion at all
Myth 3: My mother had gestational diabetes and varicose veins, so I’ll get them too no matter what I do.
Fact: Exercise helps prevent many complications of pregnancy.
Regular exercise doesn’t guarantee that you won’t get gestational diabetes or varicose veins, but it is a known preventive measure that works. A lack of exercise during pregnancy is associated with excess weight gain, increasing the risk of gestational diabetes, and high blood pressure. The combination of being overweight and inactive also increases the risk of preeclampsia and caesarian section delivery. Exercise also helps to prevent varicose veins and blood clots, shortness of breath, and a decline in general fitness that develops due to inactivity.4
Myth 4: I used to be really active, now that I’m pregnant all I can safely do is walk.
False: There are many forms of exercise that previously active pregnant women can do.
If you exercised regularly before you became pregnant, you can continue your exercise programs with few modifications. Aerobic activities such as stationary cycling, cross-country skiing, swimming and aquafit are considered safe forms of exercise that are low impact and pose a lower risk of loss of balance and potential injury.2 However, provided that the intensity is within the moderate range outlined above, there’s no evidence to suggest that you can’t continue to jog, road cycle, dance or hike, though these activities may pose a greater risk of injury.1 The limited research available also suggests that strength training during pregnancy using low resistance and multiple repetitions is a safe form of exercise.1
The take home message is that while it’s probably not the right time to aim for your personal best in competitive sport, continuing to exercise at a moderate intensity is a good idea.
That risk of injury with activity is generally thought to relate to two factors: balance and hormone-related changes to ligaments that come with pregnancy. As pregnancy progresses, a woman’s center of gravity changes, which in theory may make them more prone to loss of balance and falling.1 Changes in hormones can also lead to increased flexibility or laxity of the ligaments that support the joints of the body.1 While these hormonal changes are important when it’s time to deliver baby, they impact on all of the joints of the body not just the pelvis, making you more at risk for a sprain of other injury.
You need to weigh the risks and benefits of being active when deciding what activities to participate in. There are a few types of exercise to avoid. They include contact sports and scuba diving, due to risks of fetal injury.2
Myth 5: Now that I’m pregnant, it’s not a good time to start exercising.
Fact: Women who were not exercising before pregnancy are encouraged to start.
Only approximately one-third of pregnant women meet published exercise recommendations, despite the multiple benefits of exercise during pregnancy.4,5 Pregnancy may in fact be an optimal time to make healthy lifestyle changes, including taking up exercise. If you haven’t been physically active before, start with 15 minutes of continuous exercise three times a week and gradually increase to 30 minute sessions 5-7 days per week.1 If you are not sure where to start with an exercise program, or if you have another condition that make exercise difficult, a physiotherapist can provide you with recommendations for how to start. Click here to find a physiotherapist.
Myth 6: I’m pregnant, so I’m guaranteed to have incontinence.
Fact: While incontinence is a common problem during and after pregnancy, it is not inevitable.
Exercise to strengthen the pelvic floor can decrease symptoms of incontinence and improve long term outcomes.6 Incontinence and pelvic organ prolapse are two common side-effects of pregnancy and delivery.7 Regular exercise to strengthen your pelvic floor can help to reduce or eliminate incontinence, and help prevent prolapse.6 Many people talk about Kegel exercises, but pelvic floor exercise is more than just Kegels. Click here to find a physiotherapist to help strengthen your pelvic floor or treat incontinence.
Myth 7: I’m guaranteed to develop back pain as I get closer to my due date.
Fact: About half of pregnant women develop low back pain.1
Due to the normal changes that occur throughout pregnancy as baby grows and nears delivery, women often develop an increased curve or “lordosis” of the lower back. The increased curvature can contribute to or exacerbate low back pain.1 This is especially true if you have poor posture or an increased curve to begin with. Taking steps to maintain good posture can help to manage or prevent the development of back pain. If you do develop low back pain, a physiotherapist can help you to manage the discomfort and provide you with suggestions for how to modify your posture and work and home environments to support your back and reduce your discomfort.
Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British Journal of Sports Medicine 2003; 37:6-12.
Davies GAL, Wolfe LA, Mottola MF, MacKinnon C, et al. Joint SOGC/CSEP Clinical Practice Guideline: Exercise in pregnancy and the postpartum period. Canadian Journal of Applied Physiology 2003; 28(3):329-341.
Borg GAV. Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise 1982; 14(5):377-381.
Broberg L, Ersboll AS, Backhausen MG, Damm P, Tabor A, Hegaard HK. Compliance with national recommendations for exercise during early pregnancy in a Danish cohort. BioMed Central 2015: 317.
Hesketh, KR. Evenson KR. Prevalence of US pregnant women meeting 2015 ACOG Physical Activity Guidelines. American Journal of Preventive Medicine 2016; 51(3):e87-e89.
Dumoulin C, Hay-Smith EJC, Mac Habée-Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews 2014; 5. Art. No.: CD005654. DOI:10.1002/14651858.CD005654.pub3. Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005654.pub3/epdf/standard Accessed on February 15, 2017.
Gyhagen M, Bullarbo M, Nielsen TF, Milsom I. The prevalence of urinary incontinence 20 years after childbirth: A national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG: An international Journal of Obstetrics and Gynaecology 2013; 20(2):144-151. Available at: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2012.03301.x/full Accessed on February 15, 2017.