Pregnancy - Management - Exercise

Exercise

The Clinical Practice Obstetrics Committee of Canada recommends that "All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy". Although an upper level of safe exercise intensity has not been established, women who were regular exercisers before pregnancy and who have uncomplicated, healthy pregnancies should be able to engage in high intensity exercise programs, such as jogging and aerobics for less than 45 minutes, with no adverse effects if they are mindful of the possibility that they may need to increase their energy intake and are careful to not become overheated. In the absence of either medical or obstetric complications,they advise an accumulation of 30 minutes a day of exercise on most if not all days of the week. In general, participation in a wide range of recreational activities appears to be safe, with the avoidance of those with a high risk of falling such as horseback riding or sking or those that carry a risk of abdominal trauma, such as soccer or hockey.

The American College of Obstetricians and Gynecologists reports that in the past, the main concerns of exercise in pregnancy were focused on the fetus and any potential maternal benefit was thought to be offset by potential risks to the fetus. However, they write that more recent information suggests that in the uncomplicated pregnancy, fetal injuries are highly unlikely. They do, however, list several circumstances when a woman should contact her health care provider before continuing with an exercise program. Contraindications include: Vaginal bleeding, dyspnea before exertion, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal movement, amniotic fluid leakage, and calf pain or swelling (to rule out thrombophlebitis).

The Journal for Nurse Practitioners (2007) reports that many pregnant women do not exercise and they recommend that moderate exercise should be advised for pregnant women as part of prenatal care. They advise that exercise has benefits for both mother and fetus as well.

A 2006 Cochrane review of prenatal exercise-related studies assessed the effects of regular aerobic exercise (at least two to three times per week) on physical fitness, the course of labor and delivery, and the outcome of pregnancy in healthy women. They concluded that regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness, however the authors noted that the trials were small and not of high methodologic quality and the data was insufficient to infer important risks or benefits for the mother or infant. The authors suggested that larger and better trials are needed before confident recommendations can be made about the benefits and risk of aerobic exercise in pregnancy.

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