Exercise during pregnancy is safe for women and their unborn babies It is essential that midwives advise women of the UK chief medical officer's ([CMO], 2019) physical activity guidance and support them during pregnancy to be physically active and to exercise safely.
It has been a long-standing myth that pregnant women should take it easy when pregnant and refrain from exercise altogether. This is bound in fear of harming themselves or their baby. There is some evidence that moderate intensity physical activity will not harm the woman or her unborn baby (National Institute for Health and Care Excellence, 2010).
Midwives, as the lead professionals for low-risk women, should encourage women to be physically active during pregnancy and incorporate activity discussions as part of the antenatal care pathway. The CMO's advice is that women should aim for at least 150 minutes of moderate intensity activity per week and this should continue in the postpartum period as soon as they are able.
Physical activity advice in healthcare settings is being discussed at a global level. There is a view that it is a ‘best buy’ for getting populations active and healthy (Global Advocacy Council for Physical Activity, 2012). Therefore, midwives are in a key position to inform women of the benefits of staying active during pregnancy.
Benefits
There are many benefits of keeping active during pregnancy according to the UK CMO's (2019) guidance and it's crucial that all midwives and future midwives are aware of the benefits of physical activity. They will then be in a position to give women this information to reassure them that keeping active and exercising is safe and will put them in optimum health for labour and birth. Being physically active during pregnancy helps to:
Non-active women
If the woman is not active already, then it is essential that she is advised to not take up strenuous exercise suddenly but to start gradually and build up the activity; simply walking is a good start. It is free and is easy to build into daily life. As we are still in the midst of the COVID-19 pandemic, it is best to continuously check government updates pertaining to outdoor activity. Other activities can be done at home however, including walking up and down stairs, and dancing.
Active women
Women that are active should be encouraged to continue their activities until such time as they feel they can no longer manage. Swimming, cycling, running and yoga are safe. Pilates are amongst the recommended activities within the CMO (2019) guidance and this has proven popular with many women. Nonetheless, during the pandemic in the UK many of these exercises will be limited due to the current situation. Midwives can suggest access to online classes specifically designed for prenatal women, such as the NHS classes prenatal and postnatal classes: https://www.nhs.uk/conditions/nhs-fitness-studio/prenatal-and-postnatal-exercise/
Being active at home is beneficial to women and use of homemade weights such as filled water bottles as dumbbell's, household chairs to sit/stand up are all useful when exercising indoors. It's crucial that midwives remind women not to lie flat on their back when exercising to avoid supine hypotension. It is essential that women are advised to regularly do pelvic floor muscle exercise antenatally and incorporate this into their daily routines to help prevent incontinence following birth.
Exercises to avoid
There are some exercises that women should avoid as they risk her bump being hit. These include football, rugby, martial arts etc. If there are any doubts about exercise, such as a risk of losing balance or ‘bumping the bump’, then a discussion with the woman is suggested.
Tips for midwives
It is necessary that midwives try to have a physical activity conversation at each antenatal appointment. Brief advice can be effective even if it is only a one minute or five-minute conversation about activity using the CMO's infographics. Its recognised that midwives have a lot to discuss during a clinical antenatal session so these visuals are helpful.
It's crucial to describe physical activity as being achievable for women and not let them think it is about joining a gym or buying expensive equipment. Get across the message to women that by being physically active during pregnancy, this will help both mum and baby achieve optimum health outcomes following labour and birth.