Pro-tip Series: Exercising during Pregnancy

Baby let's move! Or shall we? It is natural for women to question the safety of exercise during pregnancy. In this post from our Pro-tip Series, MyMama midwife Ms Catriona Grech discusses the ins and outs of staying active while growing a baby.

Ms Catriona Grech - Exercising during Pregnancy

For a long time, pregnant women have been considered too delicate for even the mildest of strenuous efforts. They have been excluded not only from contact sports, but even from many party activities - including dancing or blowing balloons! Luckily, the idea of pregnancy being considered as a weakness is finally being challenged. I believe that it is actually really important, that women realize what a time of great strength and vitality pregnancy can be!

All of the current advice on exercise during pregnancy offer the same message: LISTEN TO YOUR BODY! If you did already exercise regularly before you got pregnant, you can carry on with the same routine, but always listen to what your body is telling you to do, and always consult a professional if you have any concerns. On the other hand, if you have never exercised before or you are relatively unfit, don’t launch into a hardcore fitness program in the first trimester. Build up slowly and if you find yourself breathless or experiencing any discomfort, stop. As your bump grows, you will probably find that you tend to slow down naturally !

What are some benefits of physical activity during pregnancy?

• It helps you sleep better.
• It reduces your chances of suffering from the common complaints of pregnancy, such as swollen feet and tiredness.
• It reduces your anxiety and stress levels.

What does ‘being active’ in pregnancy mean?

Any activity that makes you feel warm and a little bit out of breath counts towards your exercise goals. Walking briskly, going up and down stairs and putting a bit more energy into doing the housework all count.

The main rule is to be as active as possible – how you do it is totally up to you. As well as being more active in the things you do every day, you can also try swimming, dancing, light jogging and suitable exercise classes. It is important to note that you should be able to hold a conversation as you exercise when pregnant. So if you become breathless as you talk, you're probably exercising too strenuously!

Why is exercise good for me and my baby?

• Being active makes you feel good, reduces stress and gives you more energy.
• If you’re active, it’s easier to manage your weight during pregnancy and lose any extra weight once your baby is born.
• You are less likely to suffer from the common aches and pains of pregnancy.
• Being active helps reduce constipation, which is a common pregnancy problem.
• Exercise may help you cope better with labour and birth.
• Being active will reduce your likelihood of having pregnancy problems such as high blood pressure or diabetes, which means less risk for your baby.
• Women who do weight-bearing exercise (exercise where your feet and legs support your weight) during pregnancy can have a shorter labour time with fewer complications.

How can exercise improve my mood?

When you’re active, your body produces hormones called endorphins. These endorphins make you less anxious and depressed. When you’re pregnant, your body is more sensitive to these endorphins, so activity can boost your mood for longer.

What are the main exercise tips for pregnancy?

• It is important to warm up before exercising, and allow time to cool down afterwards.
• Try to keep active on a daily basis - 30 minutes of walking each day can be enough (don’t worry if you cannot manage that, as any amount is better than nothing).
• Avoid any strenuous exercise in hot weather.
• Make sure you keep yourself hydrated - drink plenty of water and other fluids.
• If you are attending exercise classes, make sure your teacher/instructor is properly qualified and knows that you're pregnant and how many weeks pregnant you are.
• You might want to consider swimming - water will support your increased weight. Locally, aquanatal classes are being offered by qualified midwives. Some benefits of aquanatal classes include increased resistance by ensuring little or no muscle soreness after exercising,  the strengthening of the core by increasing muscle tone, the prevention or reduction of back pain and reduction of risks of postnatal urinary incontinence as well as helping with flexibility. Aquanatal classes are also offered in the postnatal period, when they help to regain muscle tone, act as a full body workout and help with general physiological well being.

What exercises should be avoided in pregnancy?

• Avoid sports that have a risk of falling, such as horse riding, skiing and cycling - as falls might carry a risk of damage to your baby. Contact sports where there's a risk of being hit, such as kickboxing or judo should also be avoided.
• Avoid lying flat on your back for long periods because the weight of your baby presses on the main blood vessel and can make you feel faint.
• Avoid scuba diving, because the baby has no protection against decompression sickness and gas embolism (gas bubbles in the bloodstream).

Below, I'm sharing some photos that you can use as a reference for some exercises/positions you can use throughout your pregnancy. These will strengthen your muscles to help you carry the extra weight of pregnancy. They'll also help to make your joints stronger, improve circulation, ease backache, and generally  help you feel well.

As your baby gets bigger, you may find that the hollow in your lower back increases and this can give you backache. Strengthening abdominal muscles, may ease backache. In addition, improving body balance improves physiological functions – even the birth process! A balance in tone and alignment may increase your chance of an easier birth and better sleep while you are pregnant.

 1. Maternal positioning:  Make sure that your knees are lower than the level of your hips.  When using an exercise ball make sure your hips are not lower than your knees and keep a straight back.

The forward-leaning inversion: is a technique that creates room in the lower uterus. The baby can then use that space (with the natural pull of gravity) to position itself into a more ideal position for birth.

Pelvic Tilts: Loosens the hips and sacrum. Relaxes the lower back and soothes an achy back. You can do pelvic tilts at the end of each day for comfort and to enhance flexibility. Pelvic tilts (aka pelvic rocking) are to keep the spine flexible and help prevent the muscles and membranous attachments from back to pelvis from stiffening or resisting free range of motion.

Forward lunges: free the sacrum by lengthening hamstrings. These are important for preparing the pelvis to avoid tension that may, in some cases, delay fetal rotation during labour.

Squatting: It is important to go down only as far as you can, whilst keeping your heels down. Squats will help to prepare the pelvic floor muscles for birth. It also prevents lower back and pelvic pain – Strong gluteal muscles help to stabilise your pelvis by supporting your sacroiliac joint. This prevents pain which is often caused by ligaments loosening due to the pregnancy hormones relaxin and progesterone - “Squat 300 times a day and you are going to give birth quicker” – Ina May Gaskin (an American midwife, described as "the mother of authentic midwifery").

Staying active during the Coronavirus pandemic

The majority of us are trying hard to cope with changes to our routine amidst the current situation with Covid-19, including looking after ourselves to boost our immunity by taking care of what we eat and exercising. The most important thing is to try and be as active as you can, without comparing yourself to others. This might mean getting active in your living room, taking some time to go for a walk, or trying a pregnancy-safe indoor stretch. Keep in mind that things like housework, running around after little ones and being on your feet are all ways to keep yourself moving whilst at home.

My personal views

I have danced ballet since I was a little kid, three to four times a week. When I got pregnant, I was determined to stick to my dancing practice routine. I kept attending classes till I was about 12 weeks, until my leotard and tights didn't fit. Throughout my pregnancy I made sure I walked for at least one hour daily, to stretch regularly and I followed a fitness program at home. I worked full-time until I was 35 weeks pregnant, so walking and exercising was a huge contributor to my personal, emotional and physical resilience, keeping me fit as well helping me sleep better at night. I opted for natural labour and definitely felt that my physical and emotional strength were of incredible benefit in the hour of need! I felt that exercise had a huge impact on my mental well being - it helped me build up the necessary strength, positive mindset and resilience, so that wherever my childbirth journey would take me, I knew I would be prepared.️

References

• Hill, M. (2017). The Positive Birth Book. Pinter & Martin: London.
• NHS (2020). Exercise in pregnancy. Retrieved October 2, 2020 from https://www.nhs.uk/conditions/pregnancy-and-baby/pregnancy-exercise/?tabname=labour-and-birth
• Spinning Babies (2020). Pregnancy and birth - Daily activities. Retrieved October 2, 2020 from https://www.spinningbabies.com/pregnancy-birth/daily-activities/

Ms Catriona Grech is offering online consultations to pregnant women and new mums via this platform. Book an appointment with her should you need expert support and information relating to pregnancy, birth and parenthood preparation (nutrition, pain relief, infant care, infant feeding, self-care, local services) and any specific questions that you might have.