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Exercise and pregnancy

Pregnancy lasts for approx. 40 weeks, (9 months) and is divided into 3 trimesters.

  • 1st Trimester = Fitness decreases, Nausea & vomiting, Fatigue. 
  • 2nd Trimester = Fitter but not to pre- pregnancy levels, Feeling of well being. 
  • 3rd Trimester = Fitness decreases, weight increases, restrictions of movement. Tiredness.

Research of ex. & pregnancy is ongoing. New information is constantly being made available. For ethical reasons most research is performed on animals, usually quadrupeds, therefore results are not conclusive where humans are concerned.


Physical Benefits; all the usual benefits apply to the pregnant participant, as they do to a non pregnant exerciser. such as;

  • Increased circulation.
  • Increased or maintained stamina & endurance.
  • Increased feeling of well being.
  • Improved posture and more able to adapt to changes.
  • Increased lung capacity.

Other more specific benefits would include:

  • Maintaining aerobic fitness.
  • Maintaining muscular fitness.
  • Can help avoid excessive weight gain.
  • Can help decrease backache.
  • Can help post partum recovery.
  • Decreases minor discomforts of pregnancy.
  • Help with relaxation & improves sleep.

Psychological Benefits; .

  • Helps positive self image.
  • Support of group, especially in pre- natal setting
  • Improved self image.
  • May help relieve emotional stress of pregnancy.

Although exercise can help labour and delivery, ensure that the expectant Mum does not get an unrealistic expectations. Exercise will not guarantee a pain free, non- caesarean , no episiotomy birth.


As with all participants there is a need to screen your expectant Mums, both pre and post partum, for any contraindications to exercise.

Firstly advise your pregnant student to get a health check and clearance by her Doctor. Let her Doctor know exactly the type of exercise that the expectant Mum is undertaking (do this via the client). She might give either written or verbal feedback to say whether it is OK for the expectant mum to commence or continue an exercise programme.

Absolute Contraindications;

  • History of 3 or more miscarriages
  • Ruptured membranes surrounding the baby.
  • Multiple pregnancy, twins triplets etc.
  • Incompetent cervix.
  • Bleeding or diagnosed Placenta Previa (placenta has implanted over or close to cervix.)
  • Cardiac disease.

Relative Contraindications;

  • Hypertension.
  • Thyroid disease.
  • Palpitations.
  • History of bleeding in previous pregnancies
  • Extreme underweight, excessive obesity.
  • Fever / High temperature.
  • Anaemia.
  • Diabetes.
  • Previous premature labour.
  • Breech presentation (3 rd trimester.)
  • Extremely sedentary lifestyle.

With all the above categories there is a need for constant monitoring both by the G.P and you to ensure that it is safe to continue exercising. Most of these complaints can arise at any time and may contraindicate the participant from vigorous activity even if she was previously able to exercise.

Some symptoms may occur during the class. It is advisable to make your participant aware of these so that they can recognise the need to stop.

  • Pain - especially in the back or pelvic region.
  • Dizziness.
  • Palpitations.
  • Feeling faint.
  • Numbness.
  • Persistent nausea.
  • Bleeding.
  • Shortness of breath
  • Contracting of uterus.
  • Difficulty in movement.
  • Visual disturbances.

As the instructor you need to have a constant supply of alternatives to be able to modify your class to suit the individuals needs. Encourage her to listen to her body, this will be the best guide as to whether the activity is inappropriate.


The F I T T principle applies with the following recommendations.

Frequency- 3 times a week or pre pregnancy workload if higher.

Intensity - For the conditioned exerciser 65-85%, still apply. Newer participants can work 50 - 60% of VO2 max.

Time - Duration depends on pre- pregnancy fitness.

Type - High and Low impact aerobics. (depending on pre pregnancy activities.) Walking, running jogging, cycling etc.

The aerobic workout can follow a similar format to a usual class structure with a few modifications. The environment has to be suitable, e.g. suitable heating/ ventilation, sprung flooring, well lit etc. Try to provide a safe, non- competitive environment.

Warm up.

  • Longer with more gradual mobility & pulse raising.
  • Controlled movements with no quick changes of direction.
  • Extra control of any full R.O.M. movements
  • Prep stretches- watch positions & don’t take stretch to maximum.

Aerobic Curve.

  • Non ballistic or jerking movements.
  • Controlled R.O.M with legs and arms.
  • Early cueing especially when using travelling moves.
  • Avoid twisty or quick changes of direction. i.e. pivot turns.
  • Gradual curve.
  • Monitor intensity.
  • Post stretches (see prep stretches)
  • Slower music for new exerciser.

M.S.& E.

  • Avoid supine position, after 4 th month or when the uterus gets noticeably larger. This position compresses vena cava and thus can hinder the venous return to the heart.
  • Try to find alternative positions i.e. standing, sitting, semi-reclined, lying on side, all fours.
  • Once bump shows lying prone will be uncomfortable.
  • Avoid standing in one place for too long. i.e. if doing prolonged arm work uterus will press on pelvic blood vessels and may cause blood pooling.
  • Watch for postural changes, work/ stretch muscles giving consideration for opposite muscle group.
  • Avoid deep flexion or extension of any joint.
  • Sit down and stand up slowly this will avoid orthostatic hypotension (dizziness.) once up move the legs around for a little while in order to get blood circulating.
  • Avoid back strain when getting up, roll onto side and use arms and legs.
  • Make new moves slow and controlled. Stress the importance of breathing correctly.
  • Kegel- pelvic floor- exercises. As weight increases the uterus bears down on these muscles, they weaken and stretch. Their function is to keep the bladder and reproductive organs in position, therefore it is important to work these muscles.

Kegal exercises.

  • Sit or lie comfortably.
  • Tighten the vaginal area as if stopping urination midstream.
  • Hold tightly for about 6-8 secs , breath normally.
  • Relax. & repeat.
  • You can use the ‘Elevator method’ or maybe use
    imagery such as ‘Bite the bullet’ do try not to offend.


Abdominal muscles need to be kept strong to adapt to the changing shape and to help avoid backache and to keep good posture.

They may also come in handy for the pushing process later on! Abdominals are stabilising muscles how we exercise them is the question, not if. Adaptation of positioning is important. Core stability and muscle balancing are all important. The client can exercise on their side, or on all fours they can stand or be seated. As an instructor you will need to keep up to date on the current recommendations for your clients.

Muscle walls become stretched with progressing trimesters separation of the Rectus Abdominus (Diastasis Recti), can occur to any woman fit or not. Reasons that this occurs can be due to the increase in relaxin, or as the result of poor biomechanics of everyday posture/ activity, or poor exercise technique. The separation is usually between 2-6 inches. Once the separation has reached 2 inches it is advisable to stop rotational work as the obliques inserts into the Linea Alba. It may be useful to splint the abs with your hands or a towel this will also need to be done post partum until the tissues knit together.

Avoid poor technique by working slowly and by reinforcing correct breathing technique.


  • No developmental stretches (relaxin content). Never take the stretch beyond it’s normal length.
  • Hold 6-8 secs.
  • Never take stretches to their maximum.
  • Try to include some relaxation and visualisation.
  • Watch out for music and lyrics - some Mums are very sensitive.
  • Remember improving flexibility is not the main aim for this participant.



This can be potentially harmful to the foetus. Because of the compression of the bladder many women avoid drinking too much water. Encourage them to drink and watch for signs of dehydration. i.e. fatigue, lethargy, use simple urine testing techniques to check hydration..

  • Dehydration is linked to premature labour.
  • Water is needed for the body to function. System will slow down Mum could become dizzy or faint.
  • Watch overheating excessive sweating this can cause dehydration.
  • Mothers temperature should not exceed 38 degrees cent. Foetus is always 1 deg. hotter. Mums should not use saunas, steam rooms and hot Jacuzzi’s for this reason.
  • Sweating diverts blood to the surface and away from the foetus.


Relaxin is released to loosen the pelvic joints early on in pregnancy. Unfortunately it also affects all the other joints and connective tissue. This has implications on joint stability and can make the joints weaker. It is thought to be the main cause of Diastasis Recti.


  • Heart rate increases to support metabolic demands () this makes pulse rate monitoring ineffective
  • Blood vol. Increases by up to 40% to increase o2 capacity. Plasma increases more than the red blood cells and can cause anaemia.
  • The blood favours the placenta. The foetus can however give up ½ of its supply for a short time with no ill effects.
  • Varicose veins may worsen due to the dilation of the vessels and the increased blood flow.


  • Glucose is major fuel during pregnancy / exercise. Low blood sugar may occur . eat small carb. meal 1 hour prior to class.
  • Protein also needed to provide building material for foetus.

Post partum

Check the mother has undergone her 6 wk check before returning to exercise. Caesarean approx 12 - 13 weeks.

  • Watch for movements thst cause stress incontinence.
  • Continue Kegal exercises.
  • Return at beginner level.
  • Relaxin will continue to be present after the birth, if breastfeeding it will be present for the duration.
  • Include remedial posture & pay attention to ab separation.
  • Keep intensity low, Lactic acid build up makes milk unpalatable to babies.
  • Rehyd. Very important especially for those who breastfeed their baby
  • Wear a supporting bra..
  • Mothers may experience mood swings. (for many years!)

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