Benefits of Exercise during Pregnancy
Exercise throughout pregnancy is beneficial for both mother and baby, and can enhance prenatal comfort and function, improve birth outcomes, and support postpartum recovery. The maternal physiological adaptations are enhanced with exercise, to include 10-15% higher blood volume and cardiac output, improved metabolic functioning, improved respiratory function, and increased volume and functional capacity of the placenta (Clapp et al, 2012).
The fetus tolerates anticipated and unanticipated stress better during pregnancy and labor. At the conclusion of labor, the hormone erythropoietin levels, red blood cell percentage, and acid accumulation in the blood were lower in these babies, demonstrating that they were better able to tolerate the stresses of late pregnancy and labor (Clapp et al, 2012). Birth outcome benefits of maternal exercise includes: leaner babies at birth that regulated their body temperature efficiently; regained birth weight quickly; and maintained appropriate blood glucose levels after birth (Clapp et al, 2012).
Resistance training throughout pregnancy alleviates common prenatal discomforts such as pelvic girdle and low back pain through the incorporation of myofascial sling connection and strengthening to support the region (Elden et al, 2005).Resistance training, particularly of the posterior chain reduces postural compensations and movement habits that may increase prenatal discomfort, and should be incorporated in a prenatal fitness routine (Schoenfeld, 2011). Aerobic training throughout pregnancy decreases the risk of developing gestational diabetes and hypertension related complications, and should be incorporated in prenatal fitness routines (Davenport et al, 2018).
Maternal Benefits of Exercise
Exercising throughout pregnancy has numerous benefits for the mother during pregnancy, birth, and the postpartum periods. During pregnancy, the mother is less likely to suffer from a prenatal complication such as hypertension (39% decreased risk), pre-eclampsia (41% decreased risk), or gestational diabetes (38% decreased risk) (Davenport et al, 2008); suffer from low back or pelvic girdle pain (Eggen et al, 2005); and gain an appropriate amount of weight during pregnancy (Clapp et al, 2012). During birth, the mother is less likely to have a cesarean birth (ACOG, 2020); lower incidence of labor augmentation; instrument assisted delivery; higher likelihood of going into spontaneous labor; and shorter active labors (Clapp et al, 2012). In the postpartum, the mother is more likely to have a quicker recovery, decreased occurrence of pelvic floor dysfunction, and enhanced mental health benefits from exercising throughout pregnancy into the postpartum period (Clapp et al, 2012).
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Fetal Benefits of Maternal Exercise
The initial concern with maternal exercise during pregnancy is the affects on the fetus and if those effects are detrimental. The risk of miscarriage, congenital malformations, prematurity, and heat stress are not increased by maternal exercise (Clapp et al, 2012). However, understanding that there are no increased risks does not define what the benefits and improved fetal outcomes are due to exercise that could be motivating for a pregnant woman.
Fetal heart rate, bowel function, and physical activity during maternal exercise demonstrates an improved capability to deal with temporary reductions in uterine blood flow and oxygen delivery (Clapp et al, 2012). These reductions may occur in everyday life, and during unanticipated maternal stress. The improved capability to respond to stress helps the fetus be more resilient during pregnancy and labor, particularly if there are any complications.
Three factors influence the fetal heart rate changes: duration, type, and intensity of the exercise. Exercise at a high intensity did not increase the occurrence of meconium; the fetal heart rate increases rather than decreases and fetal breathing motions and physical activity remain the same demonstrating that there is sufficient oxygen delivery (Clapp et al, 2012).
At the beginning of labor, babies of women who exercise throughout pregnancy had lower incidence of obstetrical complications (1-2% compared to 5% in non-exercising, but physical active group, and 10% in the non-exercise group), and had decreased erythropoietin hormone levels, demonstrating that these babies were better prepared at the onset of labor (Clapp et al, 2012). These babies had increased tolerance for the stress of labor and contractions; umbilical cord entanglement had a decreased occurrence; and lower incidence of meconium at birth (Clapp et al, 2012). At the conclusion of labor, the hormone erythropoietin levels, red blood cell percentage, and acid accumulation in the blood were lower in these babies, demonstrating that they were better able to tolerate the stresses of late pregnancy and labor (Clapp et al, 2012). Birth outcome benefits of maternal exercise includes: leaner babies at birth that regulated their body temperature efficiently; regained birth weight quickly; and maintained appropriate blood glucose levels after birth (Clapp et al, 2012).
prenatal Fitness Programs
References:
ACOG. (2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period. Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-periodClapp, J., & Cramm, C. (2012). Exercising Throughout Your Pregnancy. Omaha, NE: Addicus Books.
Clapp, J., Kim, H., Burciu, B., Schmidt, S., Petry, K., & Lopez, B. (2002). Continuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth. American Journal of Obstetrics and Gynecology, 186(1), 142–147. https://doi.org/10.1067/mob.2002.119109
Elden H, Ladfors L, Fagevik Olsen M, Ostgaard HC, Hagberg H. Effects of acupuncture and stabilizing exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: Randomised single blind controlled trial. BMJ. (2005): 330(7494):761
Davenport, M., Poitras, V., Gray, C., Barrowman, N., Skow, R., Meah, V., … Mottola, M. (2018). Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1367–1375. https://doi.org/10.1136/bjsports-2018-099355
Schoenfeld, B. (2011). Resistance Training During Pregnancy: Safe and Effective Program Design. Strength and Conditioning Journal, 33(5), 67–75. doi: 10.1519/ssc.0b013e31822ec2d8