Exercise During and After Pregnancy: How to Work out Safely
If you work out regularly and you’ve just discovered you’re having a baby, you may be wondering how it will affect your fitness routine, not just while you’re pregnant but also during the first few months after your baby is born.
Being pregnant doesn’t usually mean you should stop exercising or taking part in any physical activities. Indeed, the more active and fit you are, the less likely you may be to experience problems during your pregnancy.
Many women find that exercise helps them to adjust to the physical changes that take place during pregnancy. Staying active can help prepare you for the physical challenge of labour, and make it easier for you to carry the weight you gain while you’re pregnant.
Other benefits include better sleep and energy levels, as well as a lower chance of developing varicose veins and swollen feet, hands or ankles. Staying active may help prevent back pain, anxiety and depression too, plus it may help reduce your risk of developing gestational diabetes (diabetes during pregnancy) and high blood pressure.
Keeping fit while you’re pregnant is also a must if you don’t want to spend a long time getting your body back to its pre-pregnancy weight once your baby arrives (according to a survey by babycenter.com, almost 60 per cent of new mums were still carrying a few extra pounds one or two years after giving birth (i)).
Aside from keeping fit whilst pregnant, managing your nutritional needs can also be confusing, with a wealth of advise from many different sources. To learn more about how to manage your nutritional needs in pregnancy why not read our article.
How much is the right amount?
The amount of exercise you should aim for is the same as that for other adults – that is, 150 minutes of moderate activity each week. Moderate-intensity activity can be described as an activity that makes you breathe faster, but not so fast that you can’t hold a conversation – so if you’re too breathless to talk, take a break.
If you’re already active the UK Chief Medical Officers recommend that you simply keep going and maintain your physical activity levels (ii). If you’re not active, on the other hand, start gradually: for instance, try doing just 15 minutes of continuous exercise three times a week to start with and slowly build up to doing five 30-minute weekly sessions.
The Chief Medical Officers recommend a variety of activities, including walking, running, swimming, cycling and dancing, or you could try signing up for an aerobics class (make sure you tell the instructor that you’re pregnant before you start any new class).
You may also want to do some muscle-strengthening exercises, including walking uphill, carrying shopping, climbing stairs, doing yoga or other similar resistance exercises. According to the Chief Medical Officers, light to moderate muscle strengthening exercises haven’t been shown to have any adverse effects on health during pregnancy, and they may help improve your muscle strength. For pregnant women this means 8 - 12 repetitions of muscle strengthening activities involving all major muscle groups twice a week.
What not to do
If you’re used to working out frequently or at a high intensity you may need to change the type of activity you do or adapt it while you’re pregnant. That’s because some types of activities should be avoided during pregnancy, including those that carry a high risk of falling or impact injuries (contact sports such as kickboxing, judo or squash, for example).
You should also avoid activities that involve lying down face upwards on your back – in the supine position – for prolonged periods, especially after week 16 of your pregnancy. This is because your bump can put pressure on the main blood vessel that brings blood back to your heart, causing low blood pressure and making you feel faint.
Other activities you should avoid include scuba diving, as your baby has no protection against decompression sickness and gas bubbles in your bloodstream (gas embolism). Also don’t work out at an altitude of 2,500m above sea level or higher until you have acclimatised, as you and your baby could develop altitude sickness.
Meanwhile, some other dos and don’ts include:
DO always warm up before exercising and cool down when you finish.
DON’T let yourself overheat while you’re exercising or exercise when the weather’s hot.
DO drink plenty of water and other fluids when you exercise.
DON’T exercise for more than 45 minutes at a time.
DO stop if you have any unusual symptoms such as feeling faint, headache, pain, breathlessness or muscle weakness.
DON’T forget to speak to your doctor of midwife before starting to exercise if you smoke, if you’re very overweight, if you have a medical condition (pregnancy related or otherwise), or if you’re not normally very active.
Finally as your pregnancy progresses – or if your maternity team advises – you may want to slow down a little and make sure you don’t exhaust yourself. Remember, you’re aiming to maintain a good fitness level rather than train for peak fitness.
Working your pelvic floor
Exercises that strengthen the pelvic floor are recommended during pregnancy, as they come under a lot of strain during pregnancy and childbirth.
Your pelvic floor is made up of a layer of thick, firm muscle that supports the pelvic organs – the bladder, bowel and uterus in women – and stretch from the tailbone at the back to the pubic bone at the front. Pregnancy and childbirth can make the pelvic floor muscles weak and loose, but if you keep your pelvic floor strong it can reduce your risk of developing pregnancy-related stress incontinence (that is, when you leak a little bit of urine whenever you cough, sneeze, laugh or strain).
Pelvic floor exercises (or Kegels) are easy to do, and the NHS recommends that all pregnant women should do them, even if you’re young and you don’t have a problem with stress incontinence now.
First, learn which muscles you should be working. Imagine you’re trying to stop passing wind, then relax (try not to squeeze your buttock muscles at the same time). Then imagine you’re trying to stop the stream of urine when you go to the toilet, and again relax. Once you’ve identified these muscles, you can start exercising them.
Here’s a pelvic floor exercise described by the NHS:
Squeeze and draw in the muscles around your anus and your vagina at the same time – it should feel as if the muscles are lifting when you squeeze them. At first, do this quickly, tightening and releasing the muscles immediately.
Then engage the muscles slowly and hold the squeeze for a count of 10 (if you can) before you relax.
Do three sets of eight squeezes each day.
After giving birth
NHS experts advise waiting until after your six-week postnatal check before getting back into a proper exercise routine – though if you had a caesarean your recovery will take longer, so check with your GP, midwife or health visitor before launching into any type of activities.
However, there are a few gentle exercises you can do almost straight after the birth if you had a straightforward delivery, such as pelvic floor exercises, gentle stretches and walking. For further information on getting back into shape after pregnancy why not read our article.
You could also try what the NHS calls deep stomach exercises to help tone up your stomach muscles. These involve lying on your side with your knees bent slightly, gently drawing in your lower abdominal muscles and your pelvic floor muscles as you breathe out, holding for a count of 10, releasing and breathing normally again, then repeating.
Most importantly, however, avoid other stomach exercises such as sit-ups, as your abdominal muscles may have separated during pregnancy and will need time to heal.
Then after six weeks (or when your GP or midwife gives you the go-ahead) you can start getting back to the activities you did before you had your baby, though it’s advisable to start slowly and build up to your pre-pregnancy exercise level gradually. Safe types of exercise to start with include swimming, aqua fitness, yoga, Pilates, cycling, light weight training and low-impact aerobics.
If you’re breastfeeding, doing half an hour of moderate exercise every day shouldn’t affect your production of breast milk. You should, however, wear a supportive bra when you work out and you may also want to use nursing pads to disguise any leaks.
Exercising with your baby
There are also exercises you can do with your baby, including outdoor classes that include your baby and their buggy as part of the workout (Buggyfit for example). Alternatively, try taking your baby for a walk in their buggy with another new mum or a group of mums. Some aqua fitness classes are also designed for new mums and their babies – if you’re not sure what’s on offer in your area, ask your health visitor.
You can try doing toning exercises with your baby at home too, such as the following:
With your baby in a front sling, stand with your feet slightly wider than hip-width apart then bend your knees and squat, bringing your weight into your heels and pushing your bottom out (make sure your knees are in line with your toes). Rise and repeat 10 times.
Try walking forward while you’re in the squatting position with your baby still in the sling. Lower into the squat, then, keeping your abdominal muscles tight, push off one heel and take a step forward, then repeat with the other leg. Walk across the room, then – while still squatting – try walking backwards in the same way to the start position.
Keeping your baby in the sling, stand up tall and look straight ahead. Take a big step forward with one leg and bend both knees 90º (your front knee should stay over your ankle, and your back heel should lift off the ground). Push back with your front leg and bring both feet together again. Repeat on the other leg, do 10 reps on each side)
Sit with your legs crossed and hold your baby securely in front of your chest. Straighten your arms upwards, lifting your baby and keeping your elbows slightly bent. Hold for a second or two then lower your arms and your baby back to the starting position. Repeat 10 times. You can also do this exercise while lying face up on the floor with your knees bent. As your baby grows you’ll be lifting a heavier weight.
Lying on your back with your knees bent, feet flat on the floor, sit your baby on your stomach and hold them securely on either side with both hands. Squeeze your core and bottom muscles and lift your mid-section and baby off the floor, keeping your feet, shoulders and head in contact with the floor (your body should form a diagonal line from your shoulders to your knees). Hold for a few seconds, then slowly bring your bottom back down to the floor. Repeat 10 - 20 times.
Getting back into exercise may be the last thing on your mind after having a baby, but the benefits are worth the effort. For more tips on staying active, why not visit our other sports articles?
GOV.UK. (2017). Physical activity in pregnancy infographic: guidance.
Christine Morgan has been a freelance health and wellbeing journalist for almost 20 years, having written for numerous publications including the Daily Mirror, S Magazine, Top Sante, Healthy, Woman & Home, Zest, Allergy, Healthy Times and Pregnancy & Birth; she has also edited several titles such as Women’ Health, Shine’s Real Health & Beauty and All About Health.