"What exercise can I actually do, before and after pregnancy?” All your questions, answered by an expert.

There are two types of pregnant people: those who follow *All The Rules* and those who... well, "don’t". And never the two shall meet.            

Well not quite, but it’s probably best to avoid brunching together. If you can get past the menu minefields of mimosas (nope!), smoked salmon (ooh, soon) and poached eggs (see you next year), you’re sure to trip when the conversation turns to, “So, are you sleeping on your front or back?”

When it comes to pregnancy, everyone has an opinion on what a pregnant person should and shouldn’t be doing. 

Of course, there’s medically recognised advice for what to do during pregnancy but many of The Rules we hear are actually rooted in superstition or myth.

Full disclosure: I’m a card-carrying rule follower. So when I finally got pregnant after years of trying having dropped my hard-earned savings on IVF, I wasn’t taking any chances. 

But that presented a problem when it came to exercise. 

According to Exercise & Sports Science Australia (ESSA), the organisation behind Exercise Right, exercise is, of course, important for everyone; regular physical exercise can provide many social, mental, health and fitness benefits. 

Exercise has been shown to reduce stress, anxiety and depression as well as make people happier in general. This is all thanks to endorphins, the “happy hormones” associated with peace, calm and stress relief.

For all those reasons and more I’ve been working out regularly for most of my adult life.

Until I got pregnant and waded into the quagmire of pregnancy Facebook Groups. All of a sudden, I thought my options were limited to aqua-aerobics and pregnancy yoga (but not until after 12 weeks and something about keeping a “gentle uterus” ¯\_(ツ)_/¯). 

I found it hard to separate the fact from the fear-mongering.

So, I jumped at the chance to ask Esme Soan, an Accredited Exercise Physiologist, the recommended dos and don’ts on exercise during pregnancy.

If “Accredited Exercise Physiologists” sounds like a big deal, it is. They are university-qualified allied health professionals. They specialise in designing and delivering safe and effective exercise interventions. Services are also usually claimable under compensable schemes such as Medicare and covered by most private health insurers. So yeah, Esme knows her stuff.

Let's get this straight: can I actually exercise while I'm pregnant? 

YES! We know exercising during pregnancy is safe and supported by the research – and that exercise is medicine. Even, previously inactive people are encouraged to start new activity once they are pregnant; just start slowly and gradually progress until you are doing 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous physical activity each week. 

Plus, it's great to also perform daily pelvic floor exercises, and muscle strengthening activities on at least two days each week.

If you are already active, keep going but you may need to modify or adapt activities as pregnancy progresses. 

Image: Exercise Right.

Does my type of exercise need to change from trimester to trimester? 

First up, exercise is *not* a one size fits all situation – so consider getting an individualised prescription from an Exercise Physiologist. 

If you were completing triathlons before falling pregnant, your level of activity across the week will look different to someone who didn’t have a regular exercise routine. 

Take the triathlete example: In your first trimester we might support continuing running and higher intensity work. In trimester two we would change to resistance training and walking. After 28 weeks of pregnancy, we’d be modifying to avoid supine exercises (lying flat on the back) and some yoga poses.

In the last trimester we would be focusing on pelvic stability with pilates, swimming, walking and/or weights.

So I’m allowed to run when pregnant?

Yes, you can! But there may come a point in your pregnancy when it’s not a good idea, even if you physically can do it. Your pelvic floor is a network of ligaments, fascia and muscle, and already is doing a lot of additional work to support the ever increasing weight of your uterus. 

What exercises should I actually completely avoid during pregnancy? 

Avoid activities that involve:

• Significant changes in pressure like skydiving or scuba diving
• Risk of contact/collision/falling (swap road cycling for stationary cycling)
• Heavy lifting that requires valsalva, a breath holding strategy that requires lots of extra work for that poor pelvic floor!

What are the warning signs I should stop exercising?

If you are feeling unwell with dizziness, shortness of breath (really huffed and puffed with usual activity), headache or chest pain before or during exercise, it’s advised you stop, and seek advice from your care provider (OB, GP, midwife or exercise physiologist). Also, any gush of fluid from your vagina: cease and seek medical attention.

Can exercise actually reduce things like hypertension and gestational diabetes when I’m pregnant? 

Yes, "exercise is medicine" is the mantra of exercise physiologists like myself! Research has shown that regular exercise before and during pregnancy (and especially in the first trimester) may have a protective effect and reduce development of gestational diabetes. Exercise can also assist with regulation of blood glucose in women diagnosed with gestational diabetes.

Image: ESSA.

What are the rules about body temp when exercising? 

Avoid heat stress and high body temperature, especially in the first trimester. Although it is unlikely that normal physical activity/exercise would cause core body temperature to reach levels that may be harmful to foetal development - exercise levels should be adjusted in excessively hot weather, especially when there is high humidity. Stick to air con, try not to exercise in the middle of the day (high temperatures), and keep well hydrated!

Should I be tracking my heart rate? Is this an excuse to get an Apple watch?

Heart rate is not used as an indicator of intensity in pregnancy anymore.

Instead, we recommend using the (free!) RPE (Rating of Perceived Exertion) scale, where 1 is sedentary (not moving), and 10 is maximal effort! Activities in the range 3-7 are considered safe and recommended for health benefits in pregnancy – intensity can also be judged using the ‘talk test’; in moderate intensity activities you should be able to talk, but not able to sing!

How long after giving birth can I start exercising? Is the six week rule hard and fast for everyone?

You can return to some gentle rehabilitative exercises earlier than 6 weeks, like walking, but you certainly don’t get the green light automatically at 6 weeks to return to high impact work like running or impact work!

Regardless of what kind of delivery you have (C-section or vaginal birth), your tissues need at least 6-8 weeks to heal, and even up to 6-12 months to regain their tensegrity (fancy word for ‘bounce’)! The best way to restart exercising is with an individualised plan from an Exercise Physiologist. We can help to safely build back up to the activity you love to do, with consideration of your pelvic floor, abdominal wall, pelvis and body – whilst recovering on minimal sleep!

My toddler mimicking my postpartum exercises! Image: Supplied.

How can I start incorporating regular exercise into my postpartum routine? 

Walking with the pram, joining parents and bubs fitness class like Pilates, and getting a home program designed by an Exercise Physiologist. If you have barriers to getting back into exercise like leaking of urine, heaviness in your pelvis, prolapse, pain, or abdominal separation, don’t be put off. These are all things that we know exercise rehabilitation can help manage. 

What type of exercise can help a postpartum body?

In general, slow and steady wins the race with returning to exercise postpartum, and there are brilliant professionals like Exercise Physiologists out there who are here to help with program design and guidance! 

Some of my favourites are:

• Pilates based exercises can be great to help with rehabilitation of your pelvic floor and abdominal wall

• Swimming for a low impact aerobic workout

• Walking, especially in nature for mental health

My own exercising view these days! Image: Supplied.

So, what have we learned? If you are pregnant and are not experiencing any complications, there is no reason why you can’t enjoy exercise whilst pregnant. 

In fact, staying active has a heap of benefits for parents-to-be. Unfortunately for rule-lovers like me (and let’s be honest… you) there is no one-size-fits-all approach so you’re best to get in contact with an appropriately qualified exercise professional. 

Accredited Exercise Physiologists are uniquely qualified and have the skills and knowledge to help you exercise safely and effectively during pregnancy and postnatally. Exercise & Sports Science Australia (ESSA) offers an easy-to-use search tool which allows you to browse accredited exercise professionals in your area. 

Search for an ESSA accredited exercise professional in your area here.

Feature Image: Getty.