Exercise in Pregnancy

We all have busy lives, but whether this is your first pregnancy or you have children at home, exercise is extremely beneficial to you and your baby. One of our CNMs Emily wrote this blog on the importance of exercise in pregnancy:

Dear WillowAZ Current and Future Clients,

With my kids back in school, I finally had a chance to go back to the gym. I am a busy, hard working mother and most days I do not make any time for myself. This week I had the chance to go to two of my favorite workout classes, and as I was surrounded by other adults and pregnant women, I decided to write about the current research on exercise. I will include not only current research, but some other tips to help you get motivated to take some much needed time for yourself!

Exercise Across a Lifespan

Whether you are pregnant, thinking about getting pregnant, or never going to be pregnant, exercise is imperative for our mind, body, and soul. Most resources suggest that moderate intensity exercise can decrease the chance of heart disease, Type 2 Diabetes, obesity, depression, anxiety osteoporosis, and osteoarthritis. Exercise can also improve mood and self-body image. There is even research that suggests that maintaining a proper Body Mass Index and exercising regularly can decrease the hot flashes and other negative symptoms of Menopause.

 

The recommendation for adults to exercise by the US Department of Health and Services is 150 minutes of moderate exercise split between 3-5 sessions. The CDC also recommends adding weight lifting to two of the exercise days, and this is an imperative part about decreasing osteoporosis.

Benefits of Exercise in Pregnancy

In addition to the above benefits of exercise in adults, there are other benefits for the pregnancy. The benefits of exercise during pregnancy are increased energy, strength and endurance, improved sleep, and an improved self-image (Journal of Midwifery & Women’s Health, 2016). Exercise has also been shown to help women maintain an appropriate weight, and decrease back pain, depression, blood sugars in gestational diabetic women, and the risk of a Cesarean Section. Other research shows neuromuscular benefits to the newborn and a decrease in childhood obesity.

The midwives at Willow Midwife Center for Birth & Wellness AZ have seen all of these benefits, and have also seen the social aspect that yoga classes provide to our clients. Women get a chance to share their previous birth stories or say something positive that can help others.

Another huge benefit – that still needs further research – is that the mothers who regularly participate in yoga at Willow AZ Midwife Center and/or other exercise classes, seem to have quicker active labor and second stage of labor. While this is currently anecdotal research, it is something we plan to continue to research before we share our findings.

Current Research (For research lovers!):

• Exercise and Appropriate Weight Gain: A meta-analysis of moderate, 3 days/week, showed that women were able to maintain an appropriate BMI during pregnancy, and if they were overweight, they did not gain excessive weight (Syngelaki et al., 2019).
• Lower BMI Long Term: One randomized control study looked at women’s BMI six years after they engaged in regular exercise during their pregnancy and these women still had a lower BMI than the women that did not exercise (Bo et al., 2019).
• Improved Brain Function in the Newborn: One research study showed that one month old infants had increased neuromuscular function if their mother engaged in regular aerobic exercise during pregnancy (McMillan et al., 2019).
• Decrease Childhood Obesity: Exercise in pregnancy increases neuromotor development in the newborn and has been shown to help children be more active and decrease their risk of childhood obesity.
• Decrease Risk of Cesarean Section: While there are many factors involved in needing a CS, some research shows that women who exercise has a decreased chance of a CS (Wang et al., 2019). Continued research will strengthen this research.
• Improved Self-Esteem and Pregnancy Satisfaction: A randomized control trial showed women who exercised 2-3 times a week reported a more positive self-image and overall seemed more positive about their pregnancy (Haakstad et al., 2016).
• Decreased Lower Back Pain: A research study showed that muscle relaxation, like that found in yoga, leads to decreased back pain during pregnancy (Zehra and Nazan, 2014).
• Decreased Stress: These researchers said that women reported decreased stress and better coping when they engaged in exercise during their pregnancy (Cioffi, 2011).
• Decreased Postpartum Depression: There have been various research studies that show an increased in mood and a decrease in depression with regular exercise (Faucher, 2013).

Ways to Incorporate Exercise During Pregnancy:

Now that you know more of the benefits of exercising, we would encourage you to think about what obstacles are standing in your way. I know that you may have certain pregnancy complaints like nausea, tiredness, lower back pain, but these should not keep you from exercising.

Yoga three days a week, and walking on the other days helped me immensely during each of my pregnancies. My lower back pain was worse on days I did not exercise. Also, while chasing a toddler around is tiring, unless you play a chase game that has you jogging for 10-20 minutes, I would not count this as exercise!

• Yoga: Yoga is offered three days a week at WillowAZ and is free to our clients. This is a great way to meet other mothers, and to engage in exercise, breathing, and relaxation that can help you during your pregnancy and birth. We provide yoga mats and blocks. Check our calendar for dates and times.  If you can’t make our classes, check out local studios.

• Walking on a Treadmill or Outside: You can walk at a brisk pace for 20-30 minutes/day or work up to that level. In the cooler months in Arizona, put on those supportive shoes and walk on some of the mild to moderate trails. Make sure you bring plenty of water and remember that your center of gravity can be off, so walk carefully.
• Join a Gym: Gyms offer many workout classes. You can modify your workout based on how you are feeling that day and if you have exercised in the past. You can even bring a friend or your partner, and make fun little challenges like a squat challenge!
• Dancing: Put on some good music and dance for 20-30 minutes!
• YouTube: YouTube has many workout videos that are geared towards pregnant women; things that you can do from the comfort of your own home. I love Yoga with Adriene.
• Exercise Apps: There are various pregnancy apps that allow you to work out at your convenience.
• Swimming: Swimming laps is an excellent form of moderate exercise that can also help you stay cool.
• Weight lifting: Pick up those light free weights and either find a video on YouTube or take a gym class that involves light weights.
• Bicycle: You may enjoy riding a stationary bike, or riding outdoors in cooler months.

Ways to Encourage Success:

• Make sure you are drinking plenty of water, especially in the summer months. We encourage you to aim for a gallon of water.
• Have a protein meal or snack 30 minutes before your workout, and within an hour after the workout. The protein is beneficial to the pregnancy and muscle growth.
• If you are new to exercising, or if it has been a while, start out with ten-minute workout sessions and increase daily.
• Always listen to your body and take rest breaks as needed. Also use your breath to guide you during your practice. Some of this breathing may help you during your labor.
• If you a taking a work out class at the gym, the instructor may give you modifications or make your own. It is recommended that women greater than 20 weeks pregnant do not lie on their back for more than a few minutes. While there is not a lot of research on crunches in pregnancy, it is probably best to engage in other abdominal exercises like an assisted side plank or forearm plank.
• Add work out days and times to your calendar, and hold yourself accountable.
• Set up day care for other children so you can have some much needed alone time.
• Buy new clothes that fit your growing pregnancy belly and make you feel more comfortable during the workout.
• Bring your favorite music to encourage you during your workout. You may even like this motivational or relaxing music during labor.

We know you all have busy lives, but whether this is your first pregnancy or you have children at home, exercise is extremely beneficial to you and your baby.  The Midwives at WillowAZ encourage you to exercise 150 minutes/week and let us know if you have any questions or concerns.

We strive to find time to work out too because there are benefits for adults throughout their lifespan!

Love,

Emily CNM (and all WillowAZ Midwives)

 

Note: If you are not one of our clients or are considered high risk, talk to your provider before starting a new exercise routine.

 

References

Adesegun, D., Cai, C., Sivak, A., Chari, R., & Davenport, M. H. (2019). Prenatal exercise and pre-gestational diseases: A systematic review and meta-analysis. Journal of Obstetrics  and Gynaecology Canada: JOGC = Journal D’Obstetrique Et Gynecologie Du Canada:  JOGC, 41(8), 1134-1143.e17. doi:10.1016/j.jogc.2018.10.007

Akmeşe, Z. B. and Oran, N. T. (2014), Effects of Progressive Muscle Relaxation Exercises Accompanied by Music on Low Back Pain and Quality of Life During Pregnancy.  Journal of Midwifery & Women’s Health, 59: 503-509. doi:10.1111/jmwh.12176

Cioffi, J. , Schmied, V. , Dahlen, H. , Mills, A. , Thornton, C. , Duff, M. , Cummings, J. and Kolt, G. S. (2010), Physical Activity in Pregnancy: Women’s Perceptions, Practices, and Influencing Factors. The Journal of Midwifery & Women s Health, 55: 455-461.  doi: 10.1016/j.jmwh.2009.12.003

Dougherty, M. C., Bishop, K. R., Abrams, R. M., Batich, C. D. and Gimotty, P. A. (1989), THE EFFECT OF EXERCISE ON THE CIRCUMVAGINAL MUSCLES IN POSTPARTUM WOMEN. Journal of Nurse‐Midwifery, 34: 8-14. doi:10.1016/0091-2182(89)90123-7

Faucher, M. A. (2013), MINDFULNESS YOGA IMPROVES SCORES ON DEPRESSION SCALES AND FOSTERS MATERNAL–FETAL ATTACHMENT. Journal of Midwifery & Women s Health, 58: 111-112. doi:10.1111/j.1542-2011.2012.00264_2.x

McMillan, A. G., May, L. E., Gaines, G. G., Isler, C., & Kuehn, D. (2019). Effects of aerobic exercise during pregnancy on 1-month infant neuromotor skills. Medicine and Science in Sports and Exercise, 51(8), 1671-1676. doi:10.1249/MSS.0000000000001958

Regular group exercise in pregnant women. (2016). Journal of Midwifery & Women’s Health, 61(4), 518-519. doi:10.1111/jmwh.12496_4

Haakstad, L. A. H., Kissel, I., & Bø, K. (2019). Long-term effects of participation in a prenatal exercise intervention on body weight, body mass index, and physical activity level: A 6-year follow-up study of a randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, , 1-9. doi:10.1080/14767058.2019.1636028

Syngelaki, A., Sequeira Campos, M., Roberge, S., Andrade, W., & Nicolaides, K. H. (2019). Diet and exercise for preeclampsia prevention in overweight and obese pregnant women: Systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 32(20), 3495-3501. doi:10.1080/14767058.2018.1481037

Wang, J., Wen, D., Liu, X., & Liu, Y. (2019). Impact of exercise on maternal gestational weight gain: An updated meta-analysis of randomized controlled trials. Medicine, 98(27), e16199-e16199. doi:10.1097/MD.0000000000016199