Sport and exercise during pregnancy and after birth

During pregnancy

When a woman is pregnant, it is usually safe and beneficial to continue exercising and staying active during this time. However, it is important that she follows some basic guidelines and seeks advice from a professional to ensure that she is not taking any risks to herself or her unborn child.

Question: “Won’t I harm my unborn child with sport? They say you shouldn’t go jogging anymore? Besides, I don’t want to increase the risk of a premature birth.”

It’s understandable that you’re asking yourself these questions and it’s good that you’re looking into the issue to be on the safe side. However, we can answer all your questions with a NO. Sport and exercise per se are not harmful, even during pregnancy. Providedthat there are no medical reasons against it. It is therefore important that you talk to your gynecologist about your exercise plan and, ideally, review it with a pelvic floor physiotherapist (e.g. Anneke) and adjust it week by week.

Exercise during pregnancy is important for your health and that of your child, to prevent possible pregnancy risks, to prepare you optimally for the birth process and the time afterwards and to maintain your mental strength. To date, there is no evidence that moderate exercise provokes premature birth or causes side effects for the unborn child.

The World Health Organization (WHO, 2020) updated the exercise recommendations during pregnancy. It even advises against inactivity and recommends staying as active as possible during a normal pregnancy. We offer group pregnancy fitness classes, please register here..

2.5 hours of moderate* endurance training per week, strength training 2 days a week and daily pelvic floor training are recommended for every expectant mother with an uncomplicated pregnancy. Those who were already exercising before pregnancy may continue their vigorous** training.

*Moderateheart rates are 125 – 146 beats per minute (under 29 years) and 121 – 141 (over 30 years). **Vigorousheart rates are 147 – 169 (under 29) and 142 – 162 (over 30).

But which exercises are safe? What should you avoid? And where should you focus?

Sports such as swimming, cycling, pregnancy fitness (we also offer these at Physio Restart, read more at Services), Pilates, yoga, fast walking or hiking and jogging are also permitted. You should only be careful with contact and high-risk sports where there is a risk of falling (horse riding), being hit in the stomach (boxing) or colliding, or where too high intensities can be achieved (maximum strength training). However, the latter can be done during pregnancy if you control your training well and are used to it!

CMO guideline

The pelvic floor is certainly a very important area during pregnancy that you should pay extra attention to. In addition to strengthening it, it is important that you also train relaxation, especially towards the end of your pregnancy. The table below gives you two examples of different types of training (there are other important ones too!). Try it out now! If you would like to do a pelvic floor examination, you can find out more about this here.

Activate your pelvic floor by closing both orifices as if you wanted to hold back urine and stool or pull a turnip out of the ground. It is important that you do not pull in your stomach, hold your breath or contract your buttocks. Place your hands calmly on your stomach and buttocks to control these errors. When relaxing, it is important that you do it slowly and consciously and don’t just let everything fall away. However, this alone is not pelvic floor training. It is much more varied and involves so much more.

Table 1:

1. maximum strength with relaxation:

Tense as hard as possible without compensating and consciously release. Repeat this 10 times with a pause of approx. 5 seconds. 2. relaxation:

Divide the contraction and relaxation into two phases of equal strength. To do this, first apply 50% of your strength, then another 50%, first relax only half again, and then completely. Repeat this 5 times.

Pregnant women should watch out for warning signs, such as dizziness, nausea or pain, and stop the activity immediately if these occur. It is also important that you drink enough fluids. Plan rest periods and take regular breaks, especially if you are still working and have other children at home, to minimize fatigue and maintain your energy levels.

Further information

The following video gives you another very clear overview:

Active Pregnancy Foundation – Pregnancy CMO Guidelines – YouTube

After the birth

No, you don’t have to wait 6-8 weeks after the birth before you can resume light activities. However, a certain amount of recovery immediately after the birth (early postnatal period 2 weeks) is important, use the first few days after the birth to recover, gather strength for the time ahead, get to know your baby or babies, cuddle and enjoy it. Avoid any household activities, shopping and schedule your visits well.

If you have a pelvic floor physiotherapist accompanying you during the late postpartum period (from 3 weeks after birth), he/she will discuss with you which movements are suitable. This depends on your (health) condition, your birth, your current daily routine and sleep, your available time and mood, symptoms. The exercise recommendations are always reassessed based on the examinations during the therapy sessions. The most important thing now is that you do the correct exercises for the abdomen and pelvic floor, which can be different for every woman, so don’t try unsorted YouTube videos or start something too early. We also offer postnatal recovery classes for later. Book your place: here.

CMO guideline

Is there anything to consider after the birth?

Yes, pay attention to the following symptoms, among others: loss of urine or bowel movements, increased urination, pulling in the lower abdomen, back pain, pressure in the pelvic floor area, pain (e.g. during urination or sexual intercourse). Don’t worry and don’t be ashamed, because many women describe these symptoms, but they should definitely be treated as early as possible and ideally prevented.

CMO guideline

Click here for the video for after the birth (in English):

Active Pregnancy Foundation – Postnatal CMO Guidelines – YouTube

Overall, it is important that you continue to stay active during pregnancy and start again soon after giving birth, but also take care of your body and your limits. A customized training plan and regular consultations with Anneke can help ensure a safe and healthy workout. We can do a lot during pregnancy, so get good advice.

Author:

Anneke Penny

Book your appointment for physiotherapy, massage or group courses: here.

References:

1 CMO guidelines UK Chief Medical Officers’ report.

2 Bø, K. et al. (2019) “Comment and questions to Mottola et al. (2018): 2018 Canadian guideline for physical activity throughout pregnancy,” Journal of Obstetrics and Gynaecology Canada, 41(10), pp. 1404-1405.

3 Davenport MH, Kathol AJ, Mottola MF, et al. Prenatal exercise is not associated with fetal mortality: a systematic review and meta-analysis. Br J Sports Med 2018.

4 Evenson KR, Barakat R, Brown WJ, et al. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med 2014;8:102-21

5 Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4-Recommendations for future research. Br J Sports Med 2017;51:1724-6

6 Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med 2017;51:1516-25.

7 Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2-the effect of exercise on the fetus, labor and birth. Br J Sports Med 2016;50:1297-305.