The complete guide to pregnancy fitness

When you’re pregnant you realise just what your body is capable of doing. But as well as growing another human being, your body is also primed to be strong and active, at this time more than ever.

Exercise can help to reduce pregnancy symptoms such as fatigue and swelling of extremities. And it can combat mental symptoms too, with research showing women who exercise during pregnancy experience less insomnia, stress, anxiety and depression. Releasing all those endorphins boosts your mood and may even lower your perception of pain.

As for labour, women who engaged in exercise were 66% less likely to go into premature labour, according to Swedish researchers. This seems to be true even if you’re an exercise novice. Comparing ordinary women who did some exercise in pregnancy with athletes who stopped working out in the first trimester, showed that those who exercised had quicker labours and needed fewer intervention during the birth.

Add that to getting back into those pre-pregnancy jeans a lot faster and having more energy and strength to look after your newborn – what else could you ask for? Whether you were a dedicated gym bunny or a committed couch potato before you got pregnant, you can exercise now as long as you follow the guidelines. Here’s all you need to know…

How much, how often and how hard?

If you didn’t work out before getting pregnant, start gently with about 15 minutes of exercise, three times a week. Build up to no more than 30 minutes, four to seven times a week.

If you already exercise regularly you can continue, but should be maintaining your fitness level, rather than trying to improve it. Limit sessions to 45 minutes and if you can’t hold a conversation while exercising, you’re working out too hard.
Make sure you stay well hydrated and exercise in a ventilated area, as you can get hotter than usual in pregnancy. Watch your blood sugar levels too, especially if you have gestational diabetes, by eating small, regular, healthy snacks.

Fit for pregnancy...

Running

What it helps with
Constipation, lethargy, depression/anxiety, varicose veins.

Why?
‘The increase in progesterone in pregnancy relaxes the smooth muscle action in your intestines, plus taking iron supplements can make constipation more likely,’ says Alison Merry, former midwife and founder of Blooming Fit (bloomingfit.com). ‘It also affects the function of the bicuspid valves, which prevent blood pooling in your legs and increasing the likelihood of varicose veins. Physical activity boosts your bodily functions and improves circulation.’

Pregnancy fitness expert Jane Wake (baby-a-wake.com) says, ‘The release of feel-good chemicals will improve mood and help ward off depression and anxiety.’

How to do it safely
‘If you weren’t a runner prior to pregnancy, I wouldn’t recommend taking it up now because it’s high-intensity,’ says Jane. ‘But if you’re used to running, there’s no reason to stop now you’re pregnant. The intensity should be moderate – a good gauge is still being able to say three sentences – and ensure you keep your core muscles engaged to prevent lower back pain. Mix it with other lower-impact activities, though – the hormone relaxin will loosen your joints in pregnancy, increasing the risk of injury. ‘Listen to your body – when running starts to feel awkward, painful or wrong, it’s time to stop. A good alternative for non-runners is running in water, but wear aqua shoes to prevent slipping.’


Walking

What it helps with
Constipation, lethargy, depression/anxiety, nausea, varicose veins, lower back pain.

Why?
‘Walking is great cardiovascular exercise, but only if you keep up a good pace,’ says Jane. ‘Aim to get your heart rate up and feel a little breathless. The brilliant thing about walking is it’s easy to fit in to your day. Being outside also has extra mood-boosting benefits.’ ‘Lower back pain is often a result of sitting still for too long,’ says Alison. ‘Moving the joints lubricates them and releases tight, short muscles.’

How to do it safely
‘It’s tempting to stride out to increase your speed,’ says Jane. ‘But this puts strain on your pelvis, so increase your cadence (step frequency) rather than increasing stride length. Keep your core muscles engaged. You can wear a pelvic support belt if you’re new to exercise, but try pulling your core muscles away from it instead of relying on it to hold them in.’

Cycling

What it helps with
Constipation, lethargy, depression/anxiety, varicose veins, lower back pain, pelvic pain, puffy ankles.

Why?
‘As well as all the cardio benefits, the stationary recliner bikes are good because they support your back, which can help if you have pelvic girdle pain,’ says Jane.

How to do it safely
‘If you’re cycling outside, bear in mind the risk of falling off,’ says Jane. ‘This becomes more important in the second trimester as your balance can be affected and the baby is no longer protected within your pelvis. Stationary cycling is a great alternative. Always stretch out your quads and hip flexors afterwards – they naturally tighten in pregnancy and cycling tightens them even further.’

Pilates

What it helps with
Urinary incontinence, lower back pain, depression/anxiety, lethargy.

Why?
Pilates puts more focus on strengthening the core stability muscles, but you’ll also reap the benefits of the controlled breathing techniques. ‘Your body is constantly shifting and changing, and Pilates helps to redress the balance,’ says Jane. ‘It can be practised from conception until birth.’

How to do it safely
‘You can attend a general Pilates class, as long as it’s with a teacher who’s qualified to teach pregnant women and you tell them you’re pregnant,’ says Jane. ‘Current guidelines state that you should avoid supine (on your back) positions from the second trimester.’

Weights

What it helps with
Lower back pain, loose joints.

Why?
‘As the ligaments surrounding your joints become looser due to the hormone relaxin, resistance work can strengthen the supporting muscles and tendons,’ says Jane. ‘Strength work also improves your general posture and helps to prepare you for when you’ll have to repeatedly lift and carry your baby after the birth.’

How to do it safely
‘Get advice from a professional who’s trained in antenatal fitness,’ says Jane. ‘There are lots of things you shouldn’t do while pregnant, such as lift heavy weights above your head or perform vigorous twisting motions. Ask for a specific, functional programme to prepare you for the arrival of your baby.’

Yoga

What it helps with
Lower back pain, urinary incontinence, lethargy, depression/anxiety, leg cramps.

Why?
Yoga works on the pelvic floor muscles to help prevent urinary incontinence after birth and the controlled, deep-breathing techniques and focus on meditation relieve stress and boosts energy. Stretching muscles can relieve cramps.

How to do it safely
‘The British Wheel of Yoga recommends starting pregnancy yoga from 14 weeks and it can be practised right up until you go into labour,’ says pregnancy yoga teacher Linda Beach (lindabeach.co.uk). ‘Find a teacher who’s qualified in pregnancy yoga (visit bwy.org.uk), as there are specific things they need to know. For example, the effects of the hormone relaxin make you more flexible during pregnancy, so you must stay within safe limits of stretching.’ 

Swimming

What it helps with
Constipation, lethargy, depression/anxiety, varicose veins, lower back pain, puffy ankles.

Why?
Swimming feels great in pregnancy because your bodyweight is supported. ‘It can help puffy ankles because the weight is off your feet,’ says Jane.

How to do it safely
Ensure the pool is no warmer than 32˚C. ‘Keep a drink by the pool,’ says Alison. ‘You still sweat in water and it’s easy to become dehydrated because you can’t feel your body temperature rise.
‘Swimming is great for easing lower back pain, but the exaggerated leg action in breaststroke can put pressure on the pelvic joint, so alternate between front crawl, sidestroke and backstroke instead.’
If you’re not very good at these strokes, use floats to help you.



Fit for birth...

All of the exercises shown here will help you when you finally bring your baby into the world. ‘Labour is called labour for a good reason!’ says Dr Virginia Beckett, spokesperson for the Royal College of Obstetricians and Gynaecologists. ‘It can be long and hard work and having good cardiovascular fitness means you’ll be able to labour for longer without getting tired. Good muscle tone may help with pushing and good flexibility means you’ll be able to open your pelvis more easily and get into good birthing positions, such as squatting.’

...and beyond

If you had a straightforward vaginal delivery you can start gentle exercise, such as walking, stretching and pelvic floor exercises, immediately. Pelvic floor exercises are particularly important as they can help prevent urinary incontinence. ‘As for other types of exercise, it takes about six weeks for the effects of relaxin to stop working, so you should wait until then to resume impact exercise,’ says Dr Beckett. ‘There are no concrete rules though, so judge it by how you feel. The same applies to abdominal work – your stomach muscles may have separated during pregnancy, so they need time to knit back together. Your exercise tolerance will come back quickly if you exercised throughout pregnancy.

‘Wear a good sports bra because your breasts will be bigger and more tender, but rest assured exercise has no effect on the quality or quantity of breastmilk.’

For more information on pregnancy and exercise, visit rcog.org.uk.

Gym excuses busted

Think being pregnant is top of your list of excuses to get out of exercising? Think again…

You’ve got lower back pain
‘You’re actually much better off moving about than staying still,’ says Alison Merry. ‘Try this move to combat lower back pain: Kneel on all fours, move your weight back towards your heels, then shift weight from your left heel to right heel to loosen and mobilise the lower back muscles.’

You’re embarrassed about how you look in your gym kit
‘People at the gym are only interested in themselves and won’t be concerned with what you look like,’ says Alison, ‘but investing in some nice gym wear, rather than wearing your husband’s old baggy T-shirt might help you feel better.’ Try www.activemums.co.uk.

Gyms are too expensive
Chances are, you’re saving a fair bit of cash by missing out on Chardonnays with the girls. Just one large glass can cost about £4, so just two a week adds up to £32 a month – the average price of a gym membership!

You get too hot and sweaty
‘Wear more layers that you strip off as you get hotter and wear breathable fabrics,’ says Alison. ‘Take cool-down breaks and stay well-hydrated.’

The Exercises you must not do

- The Royal Collage Obstetricians and Gynaecologists recommend taking extra care if you want to take part in sports such as horse riding or skiing, in which there is a risk of falling, as this can have serious consequences for your baby.

- Sports where there is a risk of being hit in the abdomen such as judo, kickboxing, or squash should be avoided altogether.

- Avoid exercises that involve lying flat on your back, particularly after
16 weeks as it can cause low blood pressure.

- If a woman exercises at high altitudes, the amount of blood flowing to the womb is decreased. Avoid exercise at altitudes over 2500 metres until you have acclimatised – this may take a few days.

- Avoid scuba diving because the baby has no protection against decompression sickness and gas embolism under water.