Exercise and Pregnancy: Can I Exercise While Pregnant?
I don’t know about other cultures but if you have an Arab background you’ll have every grandmother, mother, auntie and everyone else under the sun telling you not to lift, bend or do anything physical. As a Physio, I would just smile say I’m alright and walk away while internally rolling my eyes. I know my body and I know my limits. I’m also a Physio who works with prenatal, postnatal women and women’s health sooooo I think it’s safe to say I know what to do. Don’t get me wrong, I’m all for resting and relaxing. The mother’s emotions do have an effect on the baby, but that doesn’t mean I can’t physically do my everyday things.
Being pregnant is a roller coaster filled with beautiful moments and scary moments. I’ll be addressing some common questions and concerns as follows:
Firstly, a little prelude before going into exercise recommendations. Remember to be kind to yourself and show yourself some grace. Your body is working hard every minute to grow a human being! Despite the recommendations, there will be days that are harder than others and days you may feel sick. If you cannot be physically active during those times, that's ok. Please don’t be hard on yourself.
Being a Physiotherapist I thought I was going to continue to be active and motivated to keep my body healthy for my little jellybean. NOPE! Nausea, acid reflux, vomiting and fatigue hit me hard for about the first 5 months. All I could focus on was getting something to eat that my body would hold down, sitting on a couch and resting while trying to run my business. I needed to listen to my body and help it the best I could. On good days I would add my walks and movement in. No matter what, you are doing great!
Now let’s get into all the juicy information!
Can I exercise when pregnant? Is it safe?
Short answer: YESSSS! Pregnant women without medical restrictions can exercise when pregnant. You should be physically active! (2019 Canadian Guidelines for Physical Activity)
Being physically active is important and provides many health benefits. Physical activity during pregnancy reduces risk of:
pregnancy related illnesses (i.e. depression) by 25%
gestational diabetes, preeclampsia and high blood pressure by 40%
It’s also associated with fewer newborn risks, caesarean sections, urinary incontinence, instrumental delivery and excessive weight gain during pregnancy.
If you have no medical complications then it is safe to exercise when pregnant! I always advise you to get clearance from your appropriate healthcare provider especially if you are hesitant for whatever reason. Although I knew I’d be ok to exercise, I still double-checked with my doctor. I was also lowkey testing her to ensure her decisions were evidence-based. Knowing that I was healthy enough to exercise, if my doctor told me no without any reasonable scientific explanation, I was going to find a new OBGYN. I’ve had family members whose doctors told them not to exercise and that left me very puzzled. Ultimately exercise provides health benefits to the mom and baby as mentioned above.
Prenatal exercise would NOT be safe if you have any absolute contraindications such as:
(Note: the following chart was taken from the 2019 Canadian Guidelines for Physical Activity https://csepguidelines.ca/guidelines/pregnancy/)
ruptured membranes,
premature labour,
unexplained persistent vaginal bleeding,
placenta previa after 28 weeks gestation,
preeclampsia,
incompetent cervix,
intrauterine growth restriction,
high-order multiple pregnancy (e.g., triplets),
uncontrolled Type I diabetes,
uncontrolled hypertension,
uncontrolled thyroid disease,
other serious cardiovascular, respiratory or systemic disorder.
Proceed with caution under guided medical advise for the following relative contraindications:
recurrent pregnancy loss,
gestational hypertension,
a history of spontaneous preterm birth,
mild/moderate cardiovascular or respiratory disease,
symptomatic anemia,
malnutrition,
eating disorder,
twin pregnancy after the 28th week,
other significant medical conditions.
6 Recommendations by the 2019 Canadian Guidelines for Prenatal Physical Activity:
The 2019 Canadian Guidelines for Physical Activity makes 6 recommendations for exercising when pregnant.
Recommendation #1: pregnant women free of contraindications should be physically active.
Despite this recommendation please remember to be kind to yourself. You may be feeling nauseous, sick or have really bad acid reflux like me. These things make it hard to exercise and that’s ok.
Recommendation #2: 150 minutes of moderate intensity exercise per week will help contribute to a decrease in labour complications and provide health benefits to baby and pregnant person.
Recommendation #3: It’s beneficial to accumulate 150 minutes of physical activity over a minimum of 3 days per week. You can divide that 150 minutes over 5-7 days as well! The 3 days minimum is just advising the prenatal population to be active at least 3 days per week.
Recommendation #4: Ideally you want to include a mix of aerobic and resistance training. They also mention that yoga may be beneficial. As a Physiotherapist, I think yoga is very beneficial as it can be used to help relax the pelvic floor muscles and help maintain mobility to aid in labour and delivery.
Recommendation #5: Pelvic Floor muscle training is important to help reduce risk of pelvic floor issues such as urinary incontience. Being assessed and guided by a Pelvic Floor Physiotherapist is recommended.
Recommendation #6: Do not exercise while laying on your back if it causes nausea, light-headedness or dizziness or causes you to feel unwell.
With the above recommendations, I have seen the following question “does performing more exercise than the guidelines have additional benefits?”
No. There isn’t really any evidence that shows increased benefits so definitely don’t over do it especially if that wasn’t your normal routine pre-pregnancy.
Do you want to know a secret? I, as a Physiotherapist, haven’t even achieved this outcome throughout my whole pregnancy. I’ve been dealing with really bad acid reflux where additional pressure causes me to throw up. So had I been doing a mixture of resistance and cardiovascular training? Nope. I did walk as much as I could though! Got any kind of movement opportunity in which is much better than nothing. However now that I am in my third trimester, I am able to manage much better and have begun my birth prep and strengthening for my back, glutes and hips. I also attended prenatal yoga classes which I really enjoyed. You just have to roll with the punches and go with the flow.
What are the Best Prenatal Exercises? What Should I Avoid?
Ultimately the best type of exercise is the exercise program you will do and is safe for mama and baby. If a particular workout makes you lightheaded, dizzy and sick then you shouldn’t be doing it. Also, I’d obviously avoid contact sports and extreme sports as well (i.e. soccer, football, rugby, water-skiing etc).
Everyone thinks you need to be doing hit workouts. No. Everyone’s pregnancy is different and everyone’s fitness levels pre-pregnancy differs. Therefore, everyone’s prenatal exercise routine will be different.
I uploaded a video with some basic mobility exercises on Instagram, take a look here:
The mobility drills in the video include:
Hip figure-8s on the yoga/exercise ball
Cat Cows
Hip 90/90
Lunge mobility
I’ve also uploaded basic strengthening exercises for the hips/pelvis which can be found here:
These exercises include:
Lunges
Clamshells
Monster walks
Hip internal rotation exercises
Obviously, there are more exercises that can be done but I’ve just included some good basics as a starting point.
If you are performing an exercise and are experiencing pain then stop. If you are holding your breath during the exercise and/or experiencing doming/coning along your abdominal line, then stop the exercise because you are not managing your intra abdominal pressure (IAP) very well. Repetitive strain with doming/coning can lead to increased diastasis rectus postnatally. If you are having issues with controlling IAP then definitely see a pelvic floor physiotherapist.
Here are some tips to keep in mind while being active during your pregnancy:
Tip #1: Fuel your body
Do not be exercising on an empty stomach. You can eat a small snack an hour before your workout. Your body is already working overtime to grow your little baby so you need to fuel up to exercise as well.
Tip #2: Stay hydrated!
Ensure you are drinking enough water before, during and after your workout. You want to avoid dehydration.
Tip #3: Avoid overheating
Drink plenty of water/fluids throughout the day and avoid being physically active outdoors on really hot days.
Wear cool, comfortable and loose-fitting clothing.
Tip #4: Gradually introduce exercises
If you aren’t used to being physically active you want to work up to 150 minutes per week. Don’t be completing 150 minutes of exercise in week one of your journey. Begin by exercising 5-10 minutes a day, 3 days a week and then slowly add in a day or comfortably increase your workout time.
Tip #5: Find your why to help stay motivated
I don’t know about you but I was struggling with motivation. It helps to add physical activity into your routine when you know the “why” behind it. I knew that if I walked or got out of the house to move my body it was going to improve my mood, improve the health of me and my baby and possibly aid in labor. It also helped with mental health. Knowing your why is helpful.
Tip #6: See a Pelvic Floor Physiotherapist
I definitely recommend seeing a pelvic floor physiotherapist during your pregnancy. I saw mine at the end of my second trimester when I was finally starting to feel well. And yes you read that right, a pelvic floor physiotherapist (that’s me) went for a prenatal pelvic floor assessment. My body completely changed during pregnancy and I just needed some external feedback to know if I was connecting to my pelvic floor properly, to reassess its strength and see if I was pushing correctly when it comes to pushing a baby out.
It’s great to understand where your pelvic floor is at in regard to strength and if you are experiencing any pain. The pelvic floor during pregnancy experiences a lot of changes. Exercise and preparation for labour/delivery are important and can help prevent complications post-labor/delivery.
If you would like more information about the Pelvic Floor and pregnancy or have more questions about anything discussed above, please feel free to send me an email or DM on Instagram! You can also book an appointment with me.
I hope this blog post helps ease your nerves or answer any questions about prenatal exercise!
And remember… be kind to yourself and take baby steps.
Lots of love,
Leila Awada, PT
Disclaimer: Please check with your doctor or appropriate healthcare provider to ensure exercises are safe for you! I, Leila Awada/itsaphysiolife/LA Physio & Wellness Inc. will not be responsible for any injuries that may occur during the performance of any exercises provided.