Physical activity during pregnancy

Physical activity before pregnancy

If a woman is planning to conceive, she should take care of her physical fitness at least six months before getting pregnant. This is because it is easier to continue exercising during pregnancy than to get used to the strain of training while carrying a developing foetus. However, in the month in which a woman decides to start trying for a baby, she should not strain herself excessively. Extra exercise is not conducive to conception. 

Before becoming pregnant a woman should focus on exercises to strengthen her abdominal muscles, back and spinal muscles. By increasing their flexibility this will make it easier to cope with the difficulties associated with childbirth later on. 

What other benefits are there to exercising before you conceive? Well, as studies show, women who were active physically before pregnancy and continued training during it, had a smaller weight gain (on average 3 kg less) than women who did not exercise during pregnancy. Lower body weight was also obtained by those women who started to move only after pregnancy, but this only applies to those cases where women exercised at least 3 hours per week. At this point it is worth noting that, according to the Polish Gynaecological Society, those women who were not active before pregnancy can take up safe exercise only at the beginning of the second trimester of pregnancy. 

What are the benefits of playing sports while pregnant?

Exercise primarily reduces back pain and helps control body weight. In addition, they increase blood flow in the uterus and placenta, which translates into better fetal development and a healthy pregnancy. Other benefits of undertaking physical activity during pregnancy are:

- better condition of the mother's circulatory system and heart;
- improved posture;
- increased resistance to fatigue
- improved quality of sleep;
- better fitness preparation for childbirth;
- Reduced time for cervical dilation during labor;
- Reduced duration of labor;
- positive effect on the weight of the newborn.

Contraindications to exercise during pregnancy

Before a pregnant woman starts physical activity, she should consult her doctor. There are diseases and conditions that prevent you from exercising while you are pregnant. Exercise may also be contraindicated during pregnancy, for example if it is accompanied by dizziness. 

Absolute contraindications to physical activity during pregnancy include:

- high-risk pregnancy, 
- multiple pregnancies,
- hydrops,
- microcephaly,
- pyelonephritis,
- anemia,
- gestosis of pregnancy.
Great caution, on the other hand, should be exercised if the pregnant woman has:

- diabetes,
- heart disease,
- poor health,
- a history of premature birth,
- a separation of the pubic symphysis,
- mental illness.
Even if a woman is healthy, symptoms may occur during exercise that should make her stop training and consult a doctor. These symptoms include vaginal leakage or bleeding, shortness of breath, severe abdominal pain, and dizziness.

Types of physical activity allowed and prohibited during pregnancy

The most gentle and recommended forms of physical activity for pregnant women are walking, swimming, Pilates, yoga or Nordic walking. The gym remains a debatable form of activity. Training in a gym is allowed only if the woman is healthy and has already done weight training before. Forbidden sports are extreme sports of any kind, skiing, cycling, combat sports or team games. 

Exercise in the first trimester of pregnancy

Since there is a greater risk of miscarriage during the first three months of pregnancy, the safest activities during this period are walking, Nordic walking and swimming. However, before undertaking any physical activity, it is advisable to consult your doctor and establish an exercise plan with a physiotherapist, who will tell you which exercises are permissible in the first trimester of pregnancy (e.g. certain stretching exercises) and which are better to wait until the second trimester. 

Exercising during the second trimester

In the second trimester, when nausea and the discomfort associated with it pass, a woman is more willing to exercise. Moreover, the 1st trimester passes, during which the pregnant woman is at risk of hypermobility due to excessive production of relaxin (which leads to a greater risk of injuries and sprains). In the second trimester pregnant women are more likely to experience increased lumbar lordosis or pelvic anterior tilt. It is therefore advisable to base your training on exercises that will bring relief to the lumbar spine. When training, pregnant women should avoid exercises performed in a lying position. Such positions can lead to excessive compression of the inferior vena cava and the aorta, which will be manifested by increased bradycardia, excessive sweating, pale skin, increased blood pressure, and dizziness. 

Exercising during the third trimester

In the third trimester, a pregnant woman should not do exercises that require her to rotate her torso or increase the tension of the rectus abdominis muscle. A good solution in this period are exercises on a large ball, on which, assisted by a physiotherapist or trainer, a pregnant woman learns to relax those muscles that will be active during childbirth. In order to increase the safety of exercises, individual exercises are recommended (available in Dworska Hospital), in which an experienced instructor focuses only on one patient and is able to catch technical errors, and is responsible for safe selection of exercises individually for each future mother.

Source: 

• G. B. Curtis, J. Schuler, Ciąża. 40 kolejnych tygodni, Warszawa 2009, s.45-46, 82.
• S. Clarkson,  Ciąża po 35 roku życia. Poradnik fitness dla kobiet, Białystok 2016, s.16, 20.
• M. Gablanowska, S. Radziszewska, Aktywność fizyczna kobiet w ciąży, w trakcie porodu oraz połogu, „Sztuka Leczenia” 2019, nr 1, s. 59-64.
• K.J. Moczygemba, Aktywność fizyczna podczas ciąży, „Pielęgniarstwo Polskie” 2017, nr 4(66), s. 641. Dostęp online 27.07.2020: http://www.pielegniarstwo.ump.edu.pl/uploads/2017/4/640_4_66_2017.pdf.