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Do Pregnant Women Need to Exercise?

Staying active and flexible during and after pregnancy deter the occurrence of preeclampsia (1), severe musculoskeletal complication (2) and gestational diabetes. It also aids in the recovery from childbirth and postpartum weight maintenance.

The ACOG or American College of Obstetricians and Gynecologists endorses moderate-intensity exercise for at least 30 min on most, if not all days of the week for pregnant women. Examples of moderate-intensity exercise are brisk walking, low impact dance aerobics, and biking.

According to study author in Petersen et al, reported in the Medicine & Science in Sports & Exercise, Terry Leet, Ph.D., women should avoid only activities that may cause abdominal distress. Examples of these are contact sports and scuba diving. However, women should continue to exercise if they exercised prior to pregnancy and women who did not exercise prior to pregnancy should start with moderate, non-weight-bearing activities, such as cycling, brisk walking or swimming.

A study reported by Borodulin et al. (2008) included 1,482 women, of which 71.6% were white, 17.3% African American and 11.1% other. Most of the women self-reported some physical activity during the second (96.5%) and third (93.9%) trimester. Physical activity consisted of household indoor-related activities, recreational activities and care-related responsibilities. Volume and level of exercise intensity decreased between the second and third trimester.

Unfortunately, the recommendations set by ACOG fell on many deaf ears. Women who were pregnant and met the recommended physical activity levels were more likely to be non-smokers, non-Hispanic white, more educated, not married, younger, and have higher incomes. Women smokers and those coming from a lower socioeconomic status were markers for a more passive lifestyle during pregnancy.

What is surprising is that despite its benefits, exercise seems to be losing its appeal. Pregnant women who worked out at least three times a week declined from 9% in 1994 to 6% in 2000. The same goes for non-pregnant women. Activity levels decreased from 17% in 1996 to 14% in 2000. Worse, pregnant women who needed to exercise were the same ones who were not getting enough exercise when they were not pregnant. Therefore, they would be less likely to start exercising in the first place.

What would account for patients remaining inactive during pregnancy and physicians hesitating to urge pregnant patients to exercise? Possibly from a holdover of the paternalistic, archaic way of treating pregnant patients, people still feel that pregnancy is a time for staying off your feet to prevent miscarriages or to alleviate the pains of carrying around added weight.

Physicians, fitness professionals and personal trainers should encourage physical activity during pregnancy with proper education of the health benefits of exercise during and after pregnancy. They should point out that the American College of Obstetricians and Gynecologists has adopted the Center for Disease Control exercise guidelines: everyone should get at least 30 minutes of moderate exercise every day. Moderate regular exercise is beneficial to both the mother and the fetus. It can also improve overall cardiovascular health, well being and decreased risk for gestational diabetes.

References:

Borodulin, K.M., Evenson, K.R., Wen, F., Herring, A.H., and Benson, A.M. (2008). Physical activity patterns during pregnancy. Medicine & Science in Sports & Exercise, 40(11), 1901-1908.

Petersen et al, Correlate of Physical Activity among Pregnant Women in the United States, Medicine & Science in Sports & Exercise; Nov. 2005; p.1748-1753.

Definition of Preeclampsia and Musculoskeltal complications:

1) Preeclampsia – an aberrant state of pregnancy identified by fluid retention and hypertension.

2) Musculoskeletal complications – discomfort in the back, pelvis and tenderness of the lower extremities.

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