BY DR. MARIA KEHOE, PHD, BSC. MISCP
A time of change
Pregnancy often triggers women to stop and consider their health behaviours and the health of their unborn child. Women, their partners and families often have questions and concerns about participating in exercise during pregnancy. Current research suggests that heathy women and their babies may benefit from participating in regular exercise, during pregnancy.
The purpose of this blog is to give you an overview of the benefits and safety of exercise during pregnancy. Modifications for CrossFit, in response to the normal physiological and anatomical changes that occur during pregnancy are considered. This blog is for information purposes only and should not be taken as medical advice. For a tailored assessment of your physical health and wellbeing during pregnancy, contact your General Practitioner or Obstetrician.
The benefits of exercise during pregnancy?
Benefits of exercise during pregnancy include
- Improved fitness which has general consequences for good health
- Increased energy
- Improved mood
- Relief from backache, swelling and constipation
- Improved sleep
- Reduced risk of gestational diabetes
- Improved management of gestational diabetes
- Improved brain activity in your new born
Despite beneficial effects of exercise, only 1 of 6 pregnant women in the United States and Northern Europe follows the recommendations and the majority of pregnant women reduce the duration, frequency, and intensity of exercise once they become pregnant (Fieril et al. 2014).
Is it safe to exercise?
It is best to check with your General Practitioner or Obstetrician prior to engaging in an exercise programme to ensure it is safe to participate on an individual basis. Tell your coach or fitness instructor in confidence as soon as you know you are pregnant. A healthy woman can continue with an exercise programme or start a new exercise programme during pregnancy. Generally walking, swimming and stationary cycling are safe even for beginners. Emerging evidence suggests that resistance exercise (with low level of added resistance and high levels of repetitions) is safe for both mother and baby. Exercise should be enjoyable and enhance a sense of wellbeing rather than inducing a state of distress. Many regular recreational athletes continue their usual exercise routine up until delivery, but every fitness programme should be assessed for the risks that may be present for the pregnant woman.
What about CrossFit?
There are several normal changes that occur during pregnancy that will influence participation in CrossFit or a strength and conditioning programme. In CrossFit or a strength and conditioning programme, many exercises can be scaled or modified. Listen to your body, discuss what feels comfortable and possible modifications with your coach. The following are the normal physiological and anatomical changes that occur during pregnancy and some suggestions on how to modify exercise programmes to minimise the potential adverse consequences of these.
a) Cardiovascular changes
Venous return is compromised during pregnancy leading to decreased cardiac output and orthostatic hypotension (dizziness / fainting).
b) Changing body weight and shape
Your posture, centre of gravity, balance, coordination and flexibility will be affected as you get heavier and your body weight and shape changes.
c) Joint laxity
During pregnancy, hormones are released to increase the laxity of your ligaments to allow for birth, this process affects not only your pelvic joints but all joints in your body.
d) Tummy Muscles
Divarication of rectus abdominus muscles (DRA) is the separation of the abdominal muscles down the middle of your abdominal muscles caused by the growing uterus. This can be seen as a bubble, ridge or dome shaped protrusion from the end of the breast bone to the belly button on any type of sit up manoeuvre.
e) The pelvic floor
Stress urinary incontinence (urinary leaking when coughing / sneezing or exercising) is common during or after pregnancy. As a woman’s weight naturally increases during pregnancy, there is increased load on the pelvic floor.
( note pelvic floor exercise booklet available on http://www.iscp.ie )
Take home messages
- Pregnancy is a great time to exercise and look after yourself but take care and progress slowly if taking up any new activity especially a form of exercise like CrossFit.
- Consult with your doctor and discuss your intention to exercise. Tell your coach or fitness instructor that you are pregnant.
- Consider the changes that occur in pregnancy and modify your programme regularly with your coach.
The American College of Obstetricians and Gynaecologists provide some useful information in relation to the benefits of exercising during pregnancy, absolute contraindications and precautions during exercise and, some warning signs that you should stop exercising. Every pregnant woman or coach working in a fitness or exercise facility should familiarise themselves with these expert guidelines:
The special interest group, Pelvic Obstetric and Gynaecological Physiotherapy (POGP), has published a nice information leaflet on Exercise in the Childbearing Year. All the contraindications and precautions for safe exercise in pregnancy are published here and are in an easy to read format.