It is important to exercise and to exercise safely when you are pregnant.

IS EXERCISE SAFE DURING PREGNANCY?
Historically, pregnant women were advised not to continue or start regular exercise because the activity raises concerns about foetal stress and preterm delivery. However, recent studies have showed that exercise is not only safe, but is also beneficial for pregnant women in many ways.

Recent meta-analysis by Di Mascio et. al. showed that exercise in pregnancy is not associated with an increased risk of preterm labour and low birth weight. Pregnancy is also an ideal time to start exercise for those who are sedentary previously, because of high motivation (doing it for your baby) and frequent contact with healthcareprofessionals.

It does not compromise foetal and maternal well-being as showed by Barakat et al, in his study. Another study by Wiebe et. al. showed that exercise is safe for pregnant mothers who have chronic hypertension, gestational diabetes and obesity.

Benefits of exercise in pregnancy include decreased risk of preeclampsia, caesarean section, diabetes, low back pain, big baby and urinary incontinence.

In the recommendation by the American College of Obstetrician and Gynaecologist, 2015, exercise in pregnancy has minimal risk, and is encouraged for all uncomplicated pregnancies as early as the first trimester.

Before you start exercising, ensure that you are healthy and have no pregnancy complications. Consult your doctor for evaluation, before starting your exercise.

You may also read a checklist from Physical Activity Readiness for Pregnancy Medical Examination (PARmed-X for pregnancy) at www.csep.ca to look for any contraindication for exercise and discuss with your doctor the findings in the checklist.


The view of Mount Kinabalu from Pekan Nabalu.

WHAT IS THE EXERCISE FREQUENCY RECOMMENDED FOR A PREGNANT WOMAN?
The recommendation of exercise for pregnant women is similar to that of adult but with modifications. The American College of Obstetrician and Gynaecologist recommends a gradual progression of exercise which leads to a goal of moderate intensity exercise, for at least 20-30 minutes per day.

The frequency is most or all days per week. The minimum duration is 10-15 minutes per session. You may have two to three sessions per day. Since the heart rate response in pregnancy is blunted, assessment of intensity is done using the "talk test" or rating of perceived exertion. A heart rate monitor is seldom used.

The intensity recommended is moderate, rating of perceived exertion is between 13-14 (somewhat hard) on 6-20 Borg scale of perceived exertion. If using the "talk test", as long as the person is able to carry on a conversation while exercising, the intensity is up to moderate. As a general rule, women should practise "listening to their body". If it feels pleasant, keep going; if it is uncomfortable, stop and seek advice. You may continue exercise during the post-partum period.

Start exercise gradually, as soon as it is medically safe.


Ensure you are well-hydrated during exercise. Photo from babycenter.com.

WHAT TYPES OF AEROBIC EXERCISES ARE GOOD DURING PREGNANCY?
Aerobic exercise is recommended during pregnancy. Choose exercises that are safe for you. Choose exercises with a reduced risk of abdominal trauma and risk of falls.

Contact exercise, such as football, basketball, hockey or boxing should be avoided. Exercise with risk of a fall, such as horse riding, cycling, surfing, skiing, skating and racquet sport should be avoided too.

Scuba diving may increase risk of foetal decompression syndrome. Exercise is also not recommended at an altitude of more than 1,800m. Other exercises that involve laying supine or in a motionless position is not recommended, because it reduces venous return to heart and lung. This includes yoga and pilates.

Exercises that are considered safe are walking, swimming, stationary cycling, low-impact aerobics, modified yoga and pilates, running and jogging. However, running and jogging are only for those who were regular with their exercises before pregnancy, after consultation with their doctors.


Exercise is not recommended for pregnant women with severe anaemia. Photo from baby-pedia.com.

An avid sportsman who believes in the healing power of exercise, Assoc Prof Dr Ahmad Taufik Jamil is Universiti Teknologi Mara’s public health consultant and exercise physician. Reach him at atjamil@gmail.com

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