Not long ago, pregnancy was considered to be a time of weakness and fragility that imposed near inactivity on the mother-to-be. But things have changed. Nowadays, with baby bumps being paraded by celebrities on the covers of magazines and a growing interest in wellness and fitness, pregnancy is increasingly being seen as the perfect opportunity to get healthy and reap the benefits of exercise, regardless of current fitness levels.

In fact, the American College of Obstetricians and Gynecologist's (ACOG) new book Your Pregnancy & Birth (4th edition) advises the continuation of exercise routines at pre-pregnancy levels, and if you have not been active before, starting now is a good idea.

Pregnancy is a trying time for any woman, and delivery puts a huge amount of strain on the body. As such, it is important that a woman be mentally and physically prepared for the big day. Like any event that requires great physical effort, whether it is running a marathon, hiking up a steep hill or delivering a baby, being fit increases your ability to cope with the demands.

Does exercise affect labour & delivery?

According to a recent study, women who engage in regular and demanding exercise during pregnancy, such as running, seem to have easier deliveries than women who do not exercise. In fact, among women who had natural deliveries, those who exercised aerobically at or above 50 per cent of their pre-conception level throughout pregnancy had almost 30 per cent shorter active labours.

Also, the need for labour-inducing medications, an episiotomy, an epidural anaesthetic or an operative delivery like a Caesarean, is less likely. Another study found that women who exercised three or more times per week experienced slightly shorter second stage labour in comparison to women who did not exercise during pregnancy. Being in shape does not decrease the pain, but it definitely gives you the endurance you need to get
through labour.

For first time mothers, the thought of childbirth may bring feelings of anxiety – with good reason. Hearing horror stories of agonising labours lasting longer than 36 hours is certainly a reason for concern. However, the strong association between the length of labour and fitness levels should be enough motivation to remain physically active during pregnancy.

But what exercise is considered safe during pregnancy and how long and intense should the workout sessions be? The current ACOG guidelines recommend exercising at least
30 minutes on most, if not all, days of the week. However, this does not mean that vigorous exercise cannot be performed for longer durations. According to a clinical study, pregnant women who exercised at low to moderate intensities (with their heart rate going up between 129 beats per minute to 149 beats per minute) had lower incidences of a Caesarean delivery, and those who exercised for more than 40 minutes had even lower incidences.

On the other hand, it has been suggested that vigorous physical activity may increase the risk of pre-term birth, but the evidence is inconclusive. In response to physical activity, two neurotransmitters are released in the body. Both of these chemicals — adrenaline and noradrenaline — affect the uterus, which could theoretically induce pre-term birth via uterine contractions. It has also been suggested that increased contractions are a result of the mechanical stimulation of the uterus during exercise. However, a recent study within the Danish National Birth Cohort showed a reduced risk of pre-term birth among the almost 40 per cent of women who engaged in some kind of exercise during pregnancy in comparison with non-exercisers.

In addition, it was concluded that vigorous exercise during pregnancy does not raise the risk of pre-term delivery, and is evidence of the safety and potential benefits of exercise during pregnancy. So, if you choose to exercise more than 30 minutes a day, you can be comforted by the knowledge that it does not adversely affect your or your baby's health. It is still advisable, however, to check with your doctor before beginning any new activity to ensure a safe, healthy pregnancy.

Exercise benefits

Kegel exercises are often encouraged during pregnancy to strengthen the pelvic floor muscles before and after delivery to prevent urinary incontinence. However there have been conflicting views regarding its effects on labour and delivery. While some suggest a strong pelvic floor might obstruct labour, others believe it actually facilitates it and reduces the need for instrumental delivery. One recent study found that Kegel exercises in fact had no impact on ease of delivery.

Another popular form of exercise that is encouraged throughout pregnancy is yoga. Daily stressors combined with the heightened sense of anxiety regarding pregnancy and childbirth can take a toll on the body. Yoga's holistic approach to stress reduction through the practice of deep relaxation using different postures, breathing, and mind calming techniques has been shown to improve birth weight and decrease the risk of pre-term labour. Regardless of the exercise selection, regular leisure-based physical activity performed at least three times per week can protect against adverse birth outcomes.

Not only does exercise and physical activity benefit the outcome of labour and delivery, but the foetus benefits as well. Babies born to women who exercise aerobically during pregnancy are less likely to have problems associated with stress during childbirth. Complications with foetal heart rates, Apgar scores, and meconium were all decreased in fit and healthy mothers.

What's more, beginning a moderate-intensity, weight-bearing exercise programme early on in a normal pregnancy not only increases foetoplacental growth, but the babies are born heavier and longer as well. Several studies support these findings. Research about the effects of pre-natal fitness on a baby's birth weight are abundant, for the simple fact that birth weight is the single most important determinant of neonatal mortality. For instance, one Indian study showed that physical activity in the first trimester is associated with low birth weight in babies. Additionally, another study found that women who exercised for durations lasting longer than 40 minutes in their third trimester gave birth to newborns of slightly higher birth weights than women who exercised for less time. Those mothers also gained less maternal weight — an added bonus for any new mother!

Although a lot of the information seems conflicting, when a compilation of several studies is examined, it appears that physical exercise during a normal pregnancy definitely does not have any adverse affects on the mother or the foetus, and, if anything, women report feeling fewer discomforts as their pregnancy advances. Childbirth is the culmination of nine months of anticipation after what seems to be the longest mental and physical roller coaster ride ever. Being a fit and healthy mother is without doubt a good foundation to support the birthing process and the sleepless nights to come.

Get in touch

Certified fitness professional Bernadette Abraham can be contacted on 050-2832020 or bernacise@gmail.com.

By Bernadette Abraham

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