Healthy Practices for Exercising While Pregnant
Healthy Practices for Exercising While Pregnant
By Evan Penrose
Prenatal exercise has been shown to be highly effective in supporting the health of pregnant women. Historically, there have been conflicting answers on who should exercise while pregnant and what conditions can be adversely affected by exercise in the prenatal period. Previously, a variety of medical conditions were outlined where there was uncertainty if exercise would have a negative impact on pregnancy health. However, recent findings identified no evidence to quit prenatal exercise due to 11 common pregnancy conditions (chronic or gestational hypertension; overweight/obesity; recurrent miscarriage; shortened cervix; multiple pregnancies; epilepsy and anemia; orthopedic limitations; history of extremely sedentary lifestyle; history of spontaneous preterm labor; or fetal growth restriction; Meah et al., 2020). In fact, within those findings, it was shown that prenatal exercise can be beneficial to those with the aforementioned conditions.
This same study, however, found that certain conditions were adversely associated with prenatal exercise. An extensive review of dozens of studies found that prenatal exercise should not be practiced with the following conditions: severe cardiorespiratory disease, placental separation, vasa previa (blood vessel rupture by the umbilical cord), uncontrolled type 1 diabetes, intrauterine growth restriction, active preterm labor, severe pre-eclampsia and cervical insufficiency (cervical weakness/dilation prior to delivery) (Meah et al., 2020). With any one of these conditions, the risk of health complications from prenatal exercise was much higher, and that exercise was discouraged. While prenatal exercise is discouraged while having one of these conditions, you should not modify your daily living activities.
Women who have eating disorders should also not be discouraged from exercising during pregnancy (unless medically-advised to do so). Exercising regularly during pregnancy has been linked to a 67% decrease in the odds of prenatal depression occurring in women (Meah et al., 2020). Prenatal exercise can be useful for improving overall mental health and can potentially mitigate psychological factors associated with eating disorders. In situations where eating disorders are more severe, moderate to intense levels of activity should be avoided. Those with severe symptoms or those who are symptomatic are advised to practice low-intensity workouts provided they have regular guidelines given by their healthcare provider.
Women who have experienced miscarriages or reoccurring pregnancy loss should also know that there is no data that links prenatal exercise and reoccurring pregnancy loss (Meah et al., 2020). While there are few studies on the two items specifically, the underlying pathophysiology shows that is unlikely that prenatal exercise and spontaneous pregnancy loss are related. Prenatal exercise may actually be beneficial to those who have experienced spontaneous pregnancy loss, as prenatal exercise can improve general maternal health. Prenatal exercise can specifically help to mitigate factors attributed to pregnancy loss such as insulin resistance and obesity.
Moving forward, for those who are able to engage in prenatal exercise, the activity is beneficial to both the developing fetus and the woman exercising. Moreover, evidence supports that exercise can be done at varying levels such as high or moderate-intensity while still being safe. Research has shown that blood flow to the fetus was not significantly affected by moderate level exercise routines, as well as birth weight (Bakarat et al., 2010). While there is still more research to do in this area of study, so far, the information shows that exercise does not pose any adverse effects on the health of developing fetuses.
Women with no preexisting health contradictions should still be aware of some caveats that are associated with prenatal exercise. Generally, women with no preexisting conditions should still avoid exercise relating to the following situations: exercising while lying flat after the first trimester; prolonged standing; high risk of contact, falling, or abdominal trauma; altitudes greater than 5250 feet; and scuba diving (Hinman et al., 2015). Women should also be aware that they should stop exercising if they experience any of the following symptoms: vaginal bleeding, dizziness, calf pain or swelling, chest pain, preterm labor, decreased fetal movement, leakage of amniotic fluid, or hyperventilation prior to physical activity.
Overall, prenatal exercise can contribute to a variety of positive factors in general maternal health. Those without restrictions are encouraged to participate in prenatal exercise under the guidance of their healthcare provider. Prenatal exercise can improve health conditions for a woman physically and psychologically, while also being safe for the developing fetus. On the other hand, those with contraindications should avoid exercise unless advised differently by a healthcare provider.
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Hinman SK, Smith KB, Quillen DM, Smith MS. Exercise in Pregnancy: A Clinical Review. Sports Health. 2015;7(6):527-531.
Meah VL, Davies GA, Davenport MH. Br J Sports Med 2020;54:1395–1404.