• The Fit Midwife

How do you Have the Healthiest Pregnancy??? Exercise of Course!!!

If there are two things that perfectly demonstrate the strength of women, it is their ability to grow and birth children and their athletic prowess. Both spectacularly challenging in their own right.

As more and more women taken the athletic and sporting world by storm it stands to reason that they may at some point continue to participate in their chosen field during pregnancy. But there is still such a stigma about prenatal exercise. Medical professionals are scared of it. Scared of the supposed risks, of what they do not know. And as a result, women become scared.

This last week has seen the release on new guidelines from The Society of Obstetricians and Gynaecologists of Canada and The Canadian Society for Exercise Physiology (CSEP). Pregnancy often is a limiting factor when it comes to exercise studies. Which is crazy as it is a category that warrants an evidence base all on its own. Anyway, what did this study tell us?


Sorry for the shouty caps.... but it is nothing we did't know already is it?? What were we expecting, to hear exercise is suddenly detrimental?

It actually found that regular exercise (here defined as 150 mins of activity per week) can reduce the risk of newborn complications such as large for gestational age. And it has maternal health benefits such as decreased risk of pre-eclampsia, gestational hypertension (high blood pressure), gestational diabetes, caesarean section, instrumental delivery, urinary incontinence, excessive gestational weight gain and depression.

These major complications can be reduced by 40%. That is a huge number. There really is no contesting the benefits when you read it.

If you are keen to explore a bit more you can find it here: https://bjsm.bmj.com/content/52/21/1339

This is such a great new study because it will change the norm for exercising in pregnancy.

"You should just rest", "You don't need to exercise anymore now you are pregnant", "My best friend's sister's dog walker was told exercise was dangerous" blah blah blah..... We have heard it all. In the past, there has been much hearsay on the negative effects of exercising in pregnancy. Linking exercise to low birth weight, increased risk of miscarriage and inducing premature labour. However, the evidence in this field does not support any of these theories. Research as early as the 1980’s and 1990’s actually showed that exercise may decrease these complications.

There is so much research on the benefits of exercise in general life and they are just as applicable in the antenatal and postnatal period. Some of the physical benefits are; reducing the risk of heart disease, diabetes, cancer, obesity and musculoskeletal problems to name but a few. There are also numerous mental health benefits to regular exercise; it can reduce the risk of anxiety, depression, increase self esteem and confidence, elevate mood and improve cognitive function. It is therefore not surprising that exercise is now more important than ever to women who are of childbearing age.

However, it appears to be a common misconception that a pregnant woman cannot maintain her athlete status (regardless of whether that is your 3 times a week zumba, yoga, weightlifting…) with newspapers and social media article slandering these athletes for continuing their chosen sport throughout their pregnancy. This is becoming a common reoccurring theme in the media. A study led by the University of Washington’s Institute for Health Metrics and Evaluation (IHME) 2013, found that the number of people getting the recommended amount of exercise increased significantly between 2001 and 2009, and the increase was greater for females than for males. As it was identified that more women are taking up exercise over the last decade, it is reasonable to assume the athletic population will have a large number of potentially pregnant women. But let's be honest, there is still much unease at seeing a pregnant woman training?

Let’s put this in to context. Alysia Montano, an Olympic runner, competed in an 800m race at 34 weeks pregnant. Paula Radcliffe, again an Olympic runner, ran 14 miles per day throughout her pregnancy. Serena Williams won her 23rd Grand Slam title whilst in her first trimester.

Crossfit athlete Miranda Oldroyd continued her training, showcasing her athletic strength on her Instagram account during her pregnancy.

It is important to remember that whilst these women are professional athletes, there are a large number of non competitive athletes training hard in the same disciplines. For example, non-competitive athletes Sophie Guidolin and Lea-Ann Ellison were subjected to online bullying after posting pictures of themselves training with weights whilst pregnant. It is absurd to think that women keeping active and healthy in pregnancy attracts so much scrutiny and negative press. It is disgusting. And it is scaremongering behaviour.

So I don’t know about you, but I exercise to be stronger, fitter, healthier. To reduce my risk of diabetes, high blood pressure, blood clots, heart disease. But mainly, I do it to stay sane. It is my therapy. It may sound stupid. But when I am having a rubbish day, or feeling particularly emotional about something (thanks hormones, idiot people etc), instead of sitting in my car and crying or eating an entire cheesecake, I drive to my gym, I pick up heavy weights, I do workouts until I am sweating and can barely catch my breath. And in these moments, my mind is free and clear.

I have previously spoken about my struggles with anxiety. If I did not have my training as an outlet then I am not sure what I would do or what direction my life would be taking now. So now why would this be any different for mums and dads to be? Pregnancy and the postpartum period is fraught with anxiety, the unknown, sleep deprivation and flagging energy levels.... So if you can find an outlet such as training which benefits your mental health, you should seize that opportunity.

That is why I exercise. That is why I love working with MamaBFit. The lifestyle change we encourage is not just exclusive to pregnancy but continues in the postpartum period and in to everyday life as a family. It provides an amazing mentality to raise children with. The empowerment is palpable.

But let’s break this down and talk about why I as a Midwife and fitness enthusiast (soon to be personal trainer) think you should train in your pregnancy:

  • "Exercise releases endorphins. Endorphins make you happy. Happy people just don’t kill their husbands. They just don’t!!" Ok, so I went all Elle Woods in Legally Blonde on you there (admit it, you read it in her voice). But it is true. Exercise increases endorphin release. Endorphins are mood enhancing hormones naturally produced by the body. This increase in pregnancy can elevate your mood and as such evidence has shown has direct correlation to reducing the likelihood of anxiety and prenatal depression.

  • Exercise is directly linked to reducing stress levels. Exercise is a very commonly prescribed treatment for high stress levels.

  • Increased physical activity has been shown to improve sleep quality in pregnancy. Consider this as a remedy when you cannot sleep and have stolen your partners pillow to shove between your legs and under your bump.

  • It reduces constipation. High levels of progesterone can slow the intestines. Exercise (along with a high fibre diet) can reduce the likelihood of this happening.

  • Increased flexibility. Higher levels of relaxin and progesterone make the smooth muscle in your body more lax. This is so your tummy can stretch to accommodate your growing baby and allow your pelvis to widen slightly. This improved flexibility, when supervised by a trained antenatal instructor, can assist you in your prenatal exercise.

  • Exercise in pregnancy improves posture. As the weight of your growing baby bump puts strain on your lower back, shoulders and tilting pelvis, there are several specific exercises that can strengthen these areas. Reducing lower back pain.

  • Exercise improves circulation. Improved circulation is related to placental perfusion (good flow of blood to the placenta). And reduces the risk of deep vein thrombosis.

  • Women who exercise in their pregnancy are less likely to put on an excessive amount of weight. I want to stress here that PUTTING ON WEIGHT IN PREGNANCY IS NORMAL!!!! 10-12kg is around the average. You need to, for your body to grow the tiny human! However you are not eating for two. That my friends is an lie, an excuse that leads to excessive weight gain, which becomes very detrimental to your pregnancy.

  • Reduced risk of pre-eclampsia (High blood pressure requiring medication and possible induction, with several other complications)

  • Reduced risk of gestational diabetes.

  • Babies who adopt a “back to back” position with you (their back along your spine, so baby is facing up instead of looking down) are more common in sedentary women, women who sit at desks a lot etc. Exercising in pregnancy encourages your baby to adopt a more ideal position for labour.

  • Women who exercise before and during pregnancy are more likely to experience an easier labour and delivery. They are more likely to remain active in their labour, which is a method of pain relief. Some studies show up to 40% of women who trained in their pregnancy declined any pharmacological (medication) pain relief at all.

  • Delivery wise you are up to:

  • 75% less likely to require a forceps delivery

  • 55% less likely to require an episiotomy

  • 4 times less likely to require an unplanned caesarean section delivery

  • Women who train in their pregnancy have a faster recovery from whatever their chosen delivery method is, be it normal delivery or Caesarean Section and everything in between.

  • Training in pregnancy, especially in an antenatal specific class can help strengthen and tone your pelvic floor muscles. This is what you push your baby out with. These are what can be strengthen post birth to stop you peeing your pants when you sneeze.....

  • Also, you are around like minded women. You can create a social circle, make lifelong friends who are a support network. And this is something you absolutely need when you have your baby and your partner is back to work.

With all these benefits how can you not give it a go? Just get up and start moving in whatever way you want to. Then we go from there.

If exercise was a prescription more commonly used the world would be a much healthier (and much more sane) place. So if you are debating whether or not to continue, or to even start exercising in your pregnancy, just do it.

Prenatal physical activity should be considered a front-line therapy for reducing the risk of pregnancy complications and enhancing maternal physical and mental health.

I know I harp on about it. Relentlessly. I am that annoying Crossfit lady who drank the kool-aid and wants everyone to train too. But think about it this way... You wouldn’t run a marathon without preparing your body. Why would you attempt labour, which has the equivalent energy expenditure, without first making your body as strong and as ready as you can?

Just remember to train smart. With the right guidance to suit you on a personal level. Make sure your trainers are correctly qualified. And do check with your Doctor/Midwife too.

Healthy mums have healthy babies. So do what is within your power to optimise your pregnancy.

Nikki xx

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