Being pregnant in a pandemic can be worrying, so at APPI we want to support you through your pregnancy safely. Following current medical guidelines, we can help you stay fit and active so you’re well prepared for birth.
In this blog post we’ll take you through:
- what the current exercise guidelines are during pregnancy
- contra-indications to exercise in pregnancy
- signs to slow down or seek help
- the services we offer to keep you active
Exercise guidelines during pregnancy
Being fit, active and maintaining strength and mobility is key in pregnancy – helping you to prepare for birth, supporting your mental health and adapting to the demands of your changing shape and weight. It also helps to support your body through these changes, reducing the risk of:
- pelvic girdle pain
- mechanical lower back pain
- gestational hypertension
- gestational diabetes
- c-section delivery (emergency)
- urinary incontinence
- excessive gestational weight gain
While your GP, obstetrician or midwife may advise that exercise during pregnancy isn’t safe if you have any contra-indications – the 2019 Canadian guideline for physical activity throughout pregnancy states pregnant women without any contra-indications should be physically active during pregnancy. This includes women who were previously inactive before falling pregnant. Or if you’re overweight or obese, it’s recommended you progress slowly towards the guideline aims.
Aim for 150 mins of moderate intensity exercise a week
Moderate exercise means you can still talk while exercising. We use the BORG scale to monitor this – which you can use too. Moderate exercise falls under 13-16 on the Borg scale, where you’ll still be able to talk, though your heart rate and breathing rate will have increased.
|How you describe your exertion||Borg rating of your exertion||Examples for most adults
under 65 years of age
|None||6||Reading a book, watching TV|
|Very very light||7-8||Tying shoes|
|Very light||9-10||Chores like folding clothes, light effort|
|Fairly light||11-12||Walking, but not enough effort to speed up your heart rate or breath|
|Somewhat hard||13-14||A brisk walk or moderate effort – slight increase in heart rate and breathing, but not out of breath and you can still talk|
|Hard||15-16||Cycling, swimming – vigorous effort, increase in heart rate, faster breathing, can speak in broken sentences|
|Very hard||17-18||The highest level of activity you can sustain, – increased heart rate and breathing, and unable to maintain conversation or talk|
|Very very hard||19-20||A burst of activity you can’t sustain for long sprinting – at maximum heart rate, rapid breathing and unable to talk|
Source: BORG G.A. Psychophysical bases of perceived exertion. Medicine and science in sports and exercise. 1982 14:377-381.
You can also use a Fitbit to monitor your heart rate during pregnancy, as below. This is key if you’re taking part in more cardiovascular, strenuous exercise such as running, spinning or aerobic classes. (Please bear in mind if you’re overweight or unfit, your resting heart rate will be higher so it’s recommended that you start gently.)
|Maternal age||Intensity||Heart rate range (beats per min)|
|29 years or less||Light
Source: Mottola M.F. et al. 2019 Canadian guideline for physical activity throughout pregnancy. British journal sports medicine 2018;52:1339-1346.
Spread your 150 mins of exercise over a minimum of 3 days
Exercise should include a range of aerobic and resistance training, with some gentle stretching and mobility work too. More focused pelvic floor exercises (also known as Kegels) are recommended on a daily basis to reduce the risk of urinary stress incontinence. The pelvic floor muscles support your pelvic organs – your bladder, uterus, lower bowel and rectum – and keeping them strong through pregnancy can reduce post-natal pelvic floor dysfunction. Correct technique is key, so if you aren’t sure you’re doing Kegels correctly, speak to a pelvic health Physio for further support. (We can offer virtual appointments!)
Contra-indications to exercise in pregnancy
Generally exercise in pregnancy is safe and a key part of your preparations for birth. However, for some ladies who have ‘absolute’ or ‘relative’ contra-indications in the lists below, exercise may not be recommended.
If you have any of these, exercise isn’t recommended:
- ruptured membranes
- premature labour
- unexplained persistent vaginal bleeding
- placenta previa 28 weeks onwards
- incompetent cervix
- intrauterine growth restriction
- high-order multiple pregnancy (triplets)
- uncontrolled type 1 diabetes
- uncontrolled hypertension
- uncontrolled thyroid disease
- other serious cardiovascular, respiratory or systemic disorders
If you have any of the ‘relative’ contra-indications below, speak to your consultant obstetrician and midwife to discuss the risks, advantages and disadvantages of moderate exercise:
- recurrent pregnancy loss
- gestational hypertension
- history of spontaneous preterm birth
- mild/moderate cardiovascular or respiratory disease
- symptomatic anaemia
- malnutrition / eating disorder
- twin pregnancy after 28 weeks onwards
- other significant medical conditions
In some instances, they may be happy for you to exercise under 1 to 1 supervised guidance, but perhaps not part of a larger class. Your care provider will also ask you to document this in your ante-natal notes.
It’s vital you fill in and return the pregnancy screening questionnaire before attending any classes or 1 to 1s at APPI. You’ll also need to update your instructor if your health changes in the course of the pregnancy – so they can adapt to your needs to make sure your safety comes first.
Signs of when to stop exercising
If you experience any of the following your should consult with your midwife and obstetrician:
- excessive shortness of breath that does not resolve with rest
- severe chest pain
- regular and painful uterine contractions (more than 6-8 per hour)
- vaginal bleeding
- any ‘gush’ or persistent loss of fluid from the vagina (suggesting premature rupture of the membranes)
- persistent dizziness and fainting that does not resolve with rest
Safety precautions you can take for pre-natal physical activity:
- avoid physical activity in excessive heat especially with high humidity
- avoid contact sports or activities with risk of falling
- avoid isometric exercises with breath-holding and bracing techniques (which may weaken your pelvic floor)
- avoid scuba diving
- avoid changing the altitude of your training
- if you’re considering athletic competition or exercising significantly above the recommended guidelines, get the supervision of an obstetric care provider with knowledge of high-intensity physical activity on maternal and foetal outcomes
- stay well hydrated before, during and after exercise
- know when to slow down, stop exercise and seek immediate help from your healthcare provider
How can we support your pregnancy?
Our current online services for pregnant mums-to-be include:
- Physiotherapy assessment, treatment and support of pelvic girdle pain, back pain and pelvic floor dysfunction – plus aid in birth planning and preparation
- Pregnancy group matwork classes
- 1 to 1 Pilates
We’re offering high quality care, assessment, education, reassurance and rehab programmes from the safety of your own home. Our classes and 1 to 1 Pilates are led by expert Pilates instructors who understand the physiological changes during and after pregnancy.
Let us know if you’d like our help – we’d be happy to safely support and guide you!