22, what a magic number! More specifically 22 minutes a day! Yep, that is right, research suggests that 22 minutes a day of moderate intensity exercise can help to reduce your risk of pre-eclampsia, , gestational diabetes, gestational hypertension and prenatal depressive symptoms by 25%. For an uncomplicated pregnancy, this is one of the many reasons why exercise can be so beneficial.
Guidelines suggest that pregnant women should aim to be active most days of the week for at least 2.5-5 hours of moderate intensity exercise, or 1.23-2.5 hours of vigorous exercise! So what does that look like, moderate exercise can be gauged using the “talk test”, meaning you can comfortably hold a conversation during exercise, whereas vigorous intensity exercise means you are unable or it is difficult to hold a conversation.
Let's break down some ins and outs of exercising in each trimester.
First Trimester
Depending on how you are feeling and when you find out you are pregnant, will dictate what exercise looks like in the first trimester. From a pathophysiology lens cardiovascular and respiratory capacity changes already start to take place. This means the heart rate goes up and oxygen consumption increases. These changes combined with early pregnancy symptoms such as nausea, vomiting and fatigue, may mean that exercise capacity and energy levels are reduced. Additionally, being mindful of not overheating with exercise and drinking plenty of water, as the body’s ability to regulate temperature changes.
2nd trimester
As energy levels begin to return during the second trimester, exercise output can too.
Strength training is a great option, and can also help to manage skeletal and postural changes that occur during pregnancy. Things to keep in mind include; keeping the weight at a comfortable load, now is not the time for making PBs or testing 1RMs. There are so many ways to modify exercises, such as switching from barebells to dumbbells, using resistance bands, reducing repetitions and range of motion to suit where you are at! Other hot topics around exercise include those done lying on your back and ‘traditional’ core exercises, if leaning to the side of caution best to avoid exercises where you lie flat like bench press or sit ups, if you are unsure or want to seek alternatives physiotherapists are your best port of call!
Let’s talk about aerobic training, particularly running. If you have a previous history of running, often it is safe to continue doing so during the second trimester. You may need to consider modifications such as pulling back on your distance, or switching up to interval running. It is important to be mindful of the impact that running and other high impact exercise has on the pelvic floor muscles and connective tissues, symptoms of leaking urine and feeling heaviness in the pelvis is when you should stop and seek advice. Otherwise alternative aerobic exercises can include swimming, stationary cycling, dance class and walking.
The third trimester!
If you haven’t already, the third trimester is also a great time to start to consider your pelvic floor muscles and see a women's health physiotherapist to assess your pelvic floor function, review bladder and bowel habits, discuss your birth plan and considerations during your postpartum recovery. Physiotherapists can assess your pelvic floor muscle strength, length and coordination and help to provide quality education to help you achieve your birth and recovery goals.
In terms of exercise, it can be good to start shifting from strength training to mobility and down training especially as full gestation nears. This can look like guided meditation, breathing exercises, hip and trunk stretches too.
Overall exercise options can be so diverse and play an important role, especially in uncomplicated pregnancies, listening to your body, and watching out for warning signs is so important throughout your pregnancy journey!
This general advice only, always seek out professional advice for specific options.
Davenport MH, Ruchat S, Poitras VJ, et alPrenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysisBritish Journal of Sports Medicine 2018;52:1367-1375.
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