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Exercise and pregnancy, the basics.

Which exercises are safe during pregnancy?

Can I exercise whilst trying to conceive?

What about during IVF?

I should probably stop exercising when I’m pregnant, shouldn’t I?

I saw someone weightlifting pregnant at the gym, isn’t that irresponsible?

Can my patient continue exercise now she’s in the third trimester?

I hear these questions daily from patients, partners, healthcare professionals, personal trainers and social media platforms. Pregnancy is sometimes treated as a fragile mystical thing when it comes to exercising and there is a great deal of uncertainty and fear expressed by the general population.

There has been some fantastic research and subsequent guidelines produced over the past few years which give clarity on the situation and apply to most women. The straightforward answer is yes, we all, absolutely, should be keeping active during pregnancy.

Activity incorporates anything which raises the heart rate and gets you moving, from swimming to brisk walking and salsa to weight lifting[1], but there are a few things to bear in mind.

Top tips:

1. Weight

All females should gain some weight during pregnancy. How much is healthy, is determined by your starting BMI. Are we eating for two? Certainly not, but not gaining a healthy amount of weight is as harmful as gaining too much[2].

What’s Healthy? Calculate your pre-pregnancy BMI …….

BMI Category // Healthy Weight Gain during Pregnancy

Underweight // 12.5-18.0kg

Normal // 11.5-16.0kg

Overweight // 7-11.5kg

Obese // 5.0-9.0kg

Gestational diabetes and excessive weight gain are becoming more common in the UK[3]year on year, if you’re planning to start a family, getting fit and healthy first is important for your health and that of your baby. Keeping moderately active is also closely correlated with better chance of conception[4].

2. Keep it up!

Females who have carried out certain activities prior to pregnancy are likely to be proficient and therefore able to continue those through pregnancy, with some reasonable adaptations as the body changes. For example, if you have always hiked, jogged, weight lifted or performed Pilates you can keep it up, usually at a lower intensity.

Adapting to your biomechanics, as the body changes shape, exercises that involve lying on your tummy or back have to be swapped to side lying after the 1sttrimester. As the bump grows some exercises become less feasible, such as cycling.

When to stop exercising?

Abnormal bleeding - some women continue to have monthly bleeding or occasional spotting during their pregnancy. But any change in your ‘normal’ or anything you’re unsure about you should seek your doctors opinon.

Pain: especially that which worsens with exercise.

Chest pains

Headaches, felt even with light activity.

3. Heat

Particularly in the first trimester, overheating can impact on development of the foetus. Therefore, hot yoga or hot sweaty studio classes are not a good idea.

4. Moderate Intensity is best

This is defined as exercise which raises your heart rate but allows you to still speak in full sentences throughout. National guidelines recommend 150 minutes of moderate intensity exercise per week.

5. Maintenance

The goal of exercise during pregnancy is to maintain activity, not to make progress in your abilities. There is no current evidence to support being able to hit new PB’s during pregnancy.

6. And of course, Pelvic Floor Exercises

Strengthening your pelvic floor during pregnancy will NOT make it more difficult to give birth vaginally. It is important to practice contraction and relaxation of the pelvic floor muscles throughout pregnancy and there is good evidence that women who do so have better recovery of those muscles post-delivery[5].

Useful Resources:

Professor Greg Whyte's, Bump It Up Book.

Reference list:

[1]Bo K et al., Br J Sports Medicine. (2015) Strength Training in Pregnancy.

[2]Barakat, R et al., Br J of Sports Medicine. (2014) Exercise during pregnancy and gestational diabetes-related adverse effects: an RCT.

[3]NICE, (2015) Gestational Diabetes. Guideline NG3.

[4]Tommy’s. Website (2018):

[5]Bo. K et al., Br J of Sports Medicine. (2011) Effect of PFMT during and after childbirth in the prevention and treatment of urinary incontinence: a systematic review.

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