importance of exercise during pregnancy

THE IMPORTANCE OF EXERCISING DURING PREGNANGY
By Rachelle Oseran.

As professionals involved in the health of pregnant women, the advice we give these women is to eat nutritious food, get adequate rest and exercise. But what type of exercise is recommended? At what intensity? How frequently? Fortunately, many research studies on prenatal exercise have been published, so we now have the tools to guide the women under our care.

The current recommendations of the American College of Obstetricians and Gynecologists (ACOG) for exercising during pregnancy state that, in the absence of obstetric complications, all pregnant women should do at least 30 minutes of moderate intensity aerobic exercise on most days of the week. This includes women who were not exercising prior to becoming pregnant. Continue Article

The Canadian guidelines go one step further in encouraging pregnant women to exercise by stating that “Women and their care providers should consider the risks of not participating in exercise activities during pregnancy, including loss of muscular and cardiovascular fitness, excessive maternal weight gain, higher risk of gestational diabetes or pregnancy-induced hypertension, development of varicose veins and deep vein thrombosis, a higher incidence of physical complaints such as dyspnea or low back pain and poor psychological adjustment to the physical changes of pregnancy.”

What type of exercise are they recommending? Most of the research that has been done listing numerous benefits to the mother and baby is based on low impact aerobic exercise that is weight bearing, performed 3 – 5 times a week. Weight-bearing exercise is any exercise performed in which the lower body supports the weight of the upper body in movement. Examples of this type of exercise include walking, treadmill walking or a low-impact aerobics class. Swimming is a wonderful form of exercise during pregnancy as the buoyancy of the water gives the woman a feeling of weightlessness. While it will maintain a woman’s cardiovascular fitness, swimming doesn’t provide many of the benefits that weight-bearing exercise provides.

Why is it so important to exercise during pregnancy? The benefits to the pregnant woman are numerous and include increased energy and improved sleep, decreased incidence of urinary incontinence and a reduction in pregnancy discomforts such as hemorrhoids, leg cramps and constipation. Several studies have shown that at least 50% of women experience some kind of back pain during pregnancy. These same studies have found that exercising substantially decreases back pain, particularly lower back pain. Women who exercise during pregnancy return to their pre-pregnancy weight quicker than women who did not and lose less bone density while breastfeeding.

Several studies have shown that exercising during pregnancy reduces the chances of miscarriage by 40%, reduces pregnancy-induced hypertension and gestational diabetes and even reduces premature labor and the premature rupture of membranes.

Numerous benefits regarding labor have been cited. Regular aerobic exercise raises the level of endorphins. In normal labor, the body releases endorphins in increasing amounts to help women transcend the pain of the contractions. The endorphin levels of women who exercised during pregnancy double or even triple during labor, which is why research studies show that there is much less use of epidurals in women who exercised in pregnancy. Studies also show a greatly reduced incidence of cesarean sections in exercising women.

The benefits to the baby are also numerous. Research has shown that exercise increases the growth of the placenta which protects the fetus in stressful situations. There are 15% more blood vessels and surface area of the placenta at term. The stress hormones (adrenalin and noradrenalin) can reduce the amount of oxygen reaching the baby and could even cause fetal hypoxia in labor. However, because the rise of these stress hormones in fit women is blunted, many research studies have shown that babies born to exercising women suffer less stress in labor and are healthier at birth than babies of non-exercising mothers.

Dr. James Clapp, a researcher who has done extensive studies with exercising pregnant women, followed these babies through age 5 and found that they scored higher in intelligence tests than other babies. He postulates that the reason is the increased vestibular stimulation, the changes in temperature and the fetal heart rate fluctuations that result from exercising during pregnancy. A report from the Proceedings of the National Academy of Sciences noted that, in a study of mice, exercising while pregnant influences the growth of neurons in offspring both before and after birth, with an overall increase in the size of the brain.

Yoga during pregnancy has also become very popular recently. While yoga exercises do not provide the same benefits that have been listed above that weight-bearing aerobic exercise provide, the gentle stretching and improved body flexibility decrease muscular tension and stiffness. Yoga breathing enhances relaxation which leads to an increased sense of “well-being”. Studies show that women with high stress are at increased risk for spontaneous abortion, preterm labor, malformations and long-term functional disorders in children. Both yoga and aerobic exercise substantially reduce stress in pregnant women. Many prenatal exercise classes combine low-impact aerobics with body conditioning, Pilates or yoga and relaxation exercises for a full workout.

It is important to note that, while fit women can continue with their regular exercise routine as long as they feel comfortable, new exercisers should be supervised by a fitness professional who is certified in prenatal fitness. In all forms of exercise, women who are both new to exercise and long-time exercisers need their doctor’s clearance that their pregnancy is normal.

Great Shape/YMCA is nationally recognized as the leading expert in prenatal exercise and runs training workshops for instructors from around the country. For more information on prenatal exercise or attending a training workshop, contact 02-6258436.

Rachelle Oseran is a Lamaze Certified Childbirth Educator and a Fitness Professional certified by ACE (the American Council on Exercise). She co-directs
Great Shape/YMCA in Jerusalem and teaches prenatal and postnatal exercise classes as well as childbirth preparation classes.