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When is it not safe to exercise during pregnancy?

Would you like to know whether it is safe to exercise during pregnancy? Here I have outlined the official contraindications and guidelines as currently recommended by various governing bodies.

These days it is officially recommended by the ASCM, RCOG & ACOG that a woman with no contraindications or conditions, that would be exacerbated by exercise, should be encouraged to take part in a pregnancy-safe exercise programme. However to ensure that both mother and baby are as safe as possible it is also extremely important that each woman be aware of the following:

  • Her own unique medical history and circumstances

  • Activities/sports to avoid

  • Prenatal physiological changes that affect ability to exercise

  • The potential risks that could occur when exercising during pregnancy

  • The warning symptoms that may manifest and warrant immediate cessation of exercise

  • The relative contraindications that require medical consent before participation

  • The absolute contraindications that prevent a pregnant woman taking part in exercise

  • Whether to start exercise if previously inactive or active

Activities/sports to avoid

Certain activities or types of exercise could put the baby or mother at risk of abdominal or musculoskeletal injury due to impact or falls. These activities/sports should be avoided and include:

  • Horse riding

  • Gymnastics

  • Hot Yoga

  • Aerial yoga

  • Rock climbing

  • Skiing

  • Water skiiing

  • Scuba diving

  • Ball sports: tennis, netball, football, hockey, basketball etc.

  • Full contact martial arts or boxing

Prenatal physiological changes that affect ability to exercise

A woman's body has undergone many physiological and anatomical changes which will affect her ability to exercise safely. This warrants a regressive rather than progressive approach to exercise. Some of the general changes include:

  • Increased laxity and instability of the joints due to increased levels of the hormone relaxin.

  • Compromised balance as the centre of gravity shifts forward due to the growing baby and uterus.

  • Breathlessness due to reduced space in the thoracic cavity.

  • Muskuloskeletal imbalances and discomforts due to postural changes e.g. lower back pain, pelvic girdle pain

  • Increased size and sensitivity of the breasts

  • Nausea and vomiting (morning sickness)

  • Dizziness due to low blood sugar, pressure on blood vessels or low blood pressure (hypotension)

Potential risks of exercising during pregnancy

A womans body has undergone many physiological and anatomical changes which increase the risk of certain exercise-induced conditions developing. In general, when there are no other contributing factors or contraindications then the potential risks are outweighed by the potential benefits and women are encouraged to participate in a pregnancy-appropriate exercise programme. However women should be aware of the risks in order to make an informed personal decision to participate or not.

These risks include:

  • Hyperthermia due to high body temperatures

  • Hypoglycaemia due to low glucose/carbohydrate levels

  • Physical injury due to joint laxity and instability

  • Hypoxia due to reduced blood flow and insufficient oxygen reaching the foetus

  • Supine hypotensive syndrome

  • Premature rupture of membranes

  • Miscarriage

These risks can be reduced by adhering to the recommendations of your medical practitioner (GP, Midwife or consultant) and taking part in exercise classes or programmes that have been designed by a Fitness professional who is qualified in prenatal fitness. Being aware of the exercise guidelines issued by The ASCM, RCOG & ACOG will also empower you to make intelligent choices by being aware of official recommendations.

Warning symptoms

Once participating in exercise you should be in tune with what is the norm for your pregnancy and alert to any signs and symptoms that indicate that something is wrong. If and exercise or activity is uncomfortable, painful or you are uncertain whether to continue then err on the side of caution. If any of the following symptoms manifest then you must immediately discontinue the exercise and seek medical advice/treatment. Remember that your body is changing continuously so something that feels fine one day may not feel acceptable the next. Remember to seek out and talk to your qualified fitness professional, be tuned into your body, alert to any symptoms and always seek out advice and support at the earliest opportunity.

  • Dizziness

  • Headaches

  • Muscle weakness affecting balance

  • Calf pain or swelling

  • Chest pain

  • Dyspnea before exertion

  • Amniotic fluid leakage

  • Regular painful contractions

  • Vaginal bleeding

Relative Contraindications

Relative contraindications require medical clearance wherein a woman exhibiting the following contraindications should seek medical consent before partaking in exercise as she may be advised to not take part in a structured exercise programme and instead limit her activities to those of daily living e.g. walking, non-arduous work etc.

  • Severe anaemia

  • History of miscarriage

  • Morbid obesity

  • Intrauterine growth restriction

  • Poorly controlled type 1 diabetes

  • Poorly controlled hypertension

  • Poorly controlled seizure disorder

  • Poorly controlled hyperthyroidism

Absolute Contraindications

These are conditions where exercise is not recommended and require a pregnant woman to avoiding exercise all together, they include:

  • Multiple gestation

  • Incompetent cervix

  • Placenta previa (after 26 weeks)

  • Pre-eclampsia

  • Ruptured membranes

  • Pregnancy induced hypertension

  • Premature labour (current pregnancy)

  • Restrictive lung disease

  • Heameodynamic heart disease

Starting prenatal exercise if previously inactive or sedentary

It is also generally recommended that you can commence a moderate exercise programme even if you have previously been inactive or sedentary. The key is to start with a low intensity exercise programme with a focus on performing safe exercises at a level that allows you to improve your health without over-taxing your body and your baby.

It is important to remember that whilst exercise is beneficial to both experienced and inexperienced pregnant women, who have no contraindications, it is also best to seek out the safest exercise experience by training with a knowledgeable Fitness professional who is trained in prenatal and postnatal exercise and who fully understands the importance of in-depth health screening, bespoke, individualised programming, regressive training and the journey of pregnancy and postnatal recovery.

If you have no contraindications or have been medically cleared for exercise then count yourself as fortunate and enjoy the opportunity to be active during your pregnancy.


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