Sport and exercise during pregnancy and after birth
Updated: Apr 14
During pregnancy
When a woman is pregnant, it is usually safe and healthy to continue exercising and staying active during this time. However, it is important that she adheres to some basic guidelines and is advised by a professional to ensure that she does not take risks to herself or the unborn child.
Question: "Won't I harm my unborn child with sports? They say you shouldn't go jogging anymore? In addition, I do not want to increase the risk of premature birth in any case."
It is understandable that you ask yourself these questions and it is good that you deal with the topic to be on the safe side. But we can answer all these questions with a NO. Sport and exercise per se are not harmful even during pregnancy. Provided that there are no medical reasons against it. Therefore, it is important that you talk to your gynecologist about your exercise plan and, at best, review it with a pelvic floor physiotherapist (for example Anneke) and adjust it week by week.
Exercise during pregnancy is important for your health and the health of your baby, to prevent possible pregnancy risks, to prepare you optimally for the birth process and the time after, and to maintain your mental strength. To date, there is no evidence that we provoke premature birth or produce side effects for the unborn child with moderate exercise.
The World Health Organization (WHO, 2020) updated the exercise recommendations during pregnancy. It even discourages inactivity and recommends staying as active as possible during normal pregnancy. We offer group clases during pregnancy, get your slot: here.
A 2.5h moderate* endurance training per week, strength training 2 days per week and daily pelvic floor training is recommended for every expectant mom with an uncomplicated pregnancy. Those who were already exercising before pregnancy may continue their vigorous** training.
*Moderate heart rates are 125 - 146 beats per minute (under 29 years) as well as 121 - 141 (over 30 years).
**Vigorous heart rates are 147 - 169 (under 29) as well as 142 - 162 (over 30).
But which exercises are safe? What should you rather avoid? And where should you put your focus?
For endurance and strength, sports such as swimming, cycling, pregnancy fitness (we also offer this at Physio Restart, read more about it under services), Pilates, yoga, fast walking or hiking and even jogging is allowed. You should only be careful with contact and high-risk sports where there is a risk of falling (horseback riding), hitting your abdomen (boxing) or colliding, or where the intensity can be too high (maximum strength training). The latter can be still done, if you have a good control and are used to this training.
CMO guideline
Certainly, the pelvic floor is already during pregnancy a very important area, to which you should still pay additional attention. It is important to train relaxation as well as strengthening, especially at the end of your pregnancy. Using the table below, you can see two examples of the different types of training (there are other important ones!). Try them out right away! If you would like to go an examination of your pelvic floor, get more information: here.
You activate your pelvic floor by closing both orifices as if you were trying to hold back urine and stool or pull a turnip out of the ground. It is important that you do not pull in your abdomen, hold your breath or contract your buttocks. Calmly place your hands on your abdomen and buttocks to control these errors. When relaxing, it is important that you do it slowly and consciously and don't just drop everything. But this alone is not the whole pelvic floor training, its much more adverse and fun.
Table 1:
1. maximum strength with relaxation:
Tighten as hard as you can without compensating and consciously release. Repeat this 10 times with a pause of about 5 seconds.
2. relaxation:
Divide the contraction and relaxation in two equal phases. Contract first 50% of your overall strength, afterwards again 50%, relax half of it, before you relax fully. Repeat 5x.
Pregnant women should pay attention to warning signs, such as dizziness, nausea or pain, and if these occur, stop the activity immediately. It is also important that you drink enough fluids to ensure that you stay hydrated during exercise. Plan adequate rest periods and take regular breaks, especially if you are still working and have more children at home, to minimize fatigue and maintain your energy levels.
More information
The following video gives you a good overview about this topic during pregnancy:
After birth
No, you don't have to wait 6-8 weeks after birth to resume light activities. However, some rest right after birth (early postpartum period 2 weeks) is important, use the first days after birth to recover, gather strength for the coming time, get to know your baby, cuddle, and enjoy it. Avoid any household activities, shopping and divide your visits well.
If you have a pelvic floor physiotherapist as a companion during late postpartum (from 3 weeks after birth), she will discuss with you which movements are appropriate. This depends on your (health) condition, your birth, your current routine and sleep, your available time and mood, symptoms. The exercise recommendations will always be re-evaluated based on the examinations during the therapy sessions. The most important thing now is to do the right exercises for the abdomen and pelvic floor, which can be different for every woman. Later, we also offer group classes post-natal. Get your slot: here.
CMO guideline
Gibt es etwas zu beachten auch nach der Geburt?
Yes. Look out for the following symptoms, among others: loss of urine or stool, increased urination, pulling in the lower abdomen, back pain, pressure in the pelvic floor area, pain (including during urination or sexual intercourse). Do not worry and do not be ashamed, because these symptoms describe very many women, but should definitely be treated as early as possible and preferably prevented.
CMO guideline
Here is the video clip for after birth:
Overall, it is important that you continue to be active during pregnancy and start again soon after giving birth, but also pay attention to your body and limits. A customized training plan and regular consultations with Anneke can help ensure a safe and healthy workout.We can do a lot of exercises still during pregnancy, get the right information from an expert.
Book appointment for Physiotherapy, Massage oder Group classes: here.
Author:
Anneke Penny
References:
1. CMO guidelines UK Chief Medical Officers' report.
2. Bø, K. et al. (2019) “Comment and questions to Mottola et al. (2018): 2018 Canadian guideline for physical activity throughout pregnancy,” Journal of Obstetrics and Gynaecology Canada, 41(10), pp. 1404–1405.
3. Davenport MH, Kathol AJ, Mottola MF, et al. Prenatal exercise is not associated with fetal mortality: a systematic review and meta-analysis. Br J Sports Med 2018.
4. Evenson KR, Barakat R, Brown WJ, et al. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med 2014;8:102–21
5. Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4-Recommendations for future research. Br J Sports Med 2017;51:1724–6
6. Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med 2017;51:1516–25.
7. Bo K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2-the effect of exercise on the fetus, labour and birth. Br J Sports Med 2016;50:1297–305.