EXERCISE IN PREGNANCY

 This is a question I am often asked in obstetrics consultations regarding exercise in pregnancy. Most of the women we see take part in some sort of recreational physical activity, but only 15% of them exercise at the recommended level, which is 30 minutes of moderate activity every day of the week. 

Most women believe that pregnancy is the time to eat everything and gain as much weight as possible. Too much pregnancy weight gain can lead to problems such as Gestational Diabetes, large for gestational age babies, and a higher rate of caesarean section. We know that the woman's body changes during pregnancy, for example, her blood volume is increased by 40% and the stroke volume by 10%. There is decreased vascular resistance to enhance the placental perfusion. The growing uterus can shift the center of gravity and cause lumbar lordosis and back pain in 50% of pregnant women. The ligaments of the bony pelvis also become lax and can lead to severe discomfort. 

Moderate exercise can have multiple benefits for the mom and the baby. It can decrease the gestational weight gain and decrease the rates of pre-eclampsia, insulin resistance, and gestational diabetes. The guidelines suggest that overweight women should not gain more than 10% of their body weight in pregnancy. The recent trials have not found an increased risk of preterm birth or low birth weight in women who exercised in pregnancy. 

In summary, moderate exercise is encouraged in uncomplicated pregnancies. There is no evidence that moderate exercise can harm the mother and baby. We do not recommend exercise for women with chronic diseases such as severe anemia, cardiac disease, intrauterine growth restriction, or extreme morbid obesity. Forms of exercise such as horse riding, scuba diving, or skiing are also not recommended. I personally found moderate walking in the third trimester very helpful, although I was in so much pain and felt that my symphysis pubis in ripping apart. I tried to bounce on the gym balls as well, although I did not go to spontaneous labour and required induction of labour, but my labour progressed well, and I feel the exercise played an important part.