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Exercise whilst pregnant – what athletes need to know
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Exercise whilst pregnant – what athletes need to know

by Rebekka Atz

You have been training for years. Your sport is part of your life, and staying strong, fit and healthy is not just a “get ready for summer” trend for you—it is a mantra, a religion, a passion. It is what defines you. It is a top priority in your life.

But you are not just an athlete. You are a female athlete. That changes everything. Maybe you’ve thought about having a baby sometime in the future, or are even considering trying to conceive soon. Maybe you just discovered that you are pregnant. This is exciting and overwhelming news for every woman. But for female athletes, pregnancy brings about an even more profound change.

As an athlete, you own your body. You know your body very well, and you have years of experience in training it, making it stronger, faster, better, leaner, more endurable and more skillful. Being pregnant means sharing this space. You lose control, accept changes that compromise your athletic performance to an uncertain degree, and changing your beloved routines.

Until now, preparing for competitions and achieving new personal bests have determined your daily, weekly and even yearly schedule. But from now, on there will be a different routine counting gestational weeks and preparing for the birth and arrival of your baby. Even if you planned your pregnancy and are looking into retiring from your chosen sport, this is a bit different, isn’t it?

You still want to find satisfaction in lifting, running, playing and sweating regularly. But is this safe for you and the baby?

There are some risks involved with exercising during pregnancy:

Risk of hypo-glycaemia (low blood sugar) after exercise: Glucose is the metabolic fuel for your muscles during exercise. Strenuous exercise can lead to a lower blood sugar level after training. Whilst this is true for all athletes, studies show that in pregnant athletes, the blood glucose level decreases faster and to a significantly lower level than in non-pregnant women1. Blood glucose is also the main energy source for your baby’s growth and development. Regular exposure to low blood glucose levels can lead to foetal malnutrition, intrauterine growth restriction and reduced birth weight1,2.

Risk of reduced blood flow/ oxygen to the uterus: When you are lifting or running, your working muscles need more oxygen to function. Your body responds by redistributing blood from the uterus and gut to the working muscles. This can lead to decreased oxygen delivery to the uterus, placenta and fetus1.

Risk of increased maternal core body temperature: Theoretically, a woman’s core body temperature rises in proportion to the intensity and duration of the exercise. The foetus could receive heat from the mother, which can alter foetal development. This is a concern especially in the first trimester of pregnancy2.

Risk of injuries: A blow or fall onto your stomach can damage the placenta at any stage during pregnancy. And once the foetus moves higher in the womb and is not protected by the pelvis, there is also the risk of damage to the baby through direct impact2. The physical changes in your body (loosening of joints, change in posture, increase in body weight) also make pregnant women more prone to other sports injuries. To treat and cure an injury is more complicated during pregnancy because you want to avoid any unnecessary exposure to things like medication, pain killers, x-rays and surgery that might be necessary if you happen to injure yourself during a workout.

This might all sound a bit scary. But as an athlete, you already know that your body is an amazing, complex and clever building, complete with back ups and systems in place to deal with challenges. Your body knows that you are pregnant, and it prioritizes the developing baby. If you are a trained and healthy athlete, your body won’t just starve your baby during one workout session, or deprive her of oxygen or allow her to overheat.

The foetus is protected, to a certain extent, from low maternal blood glucose levels. The placenta can utilise alternative fuels, such as maternal blood lactate. And if you are a conditioned and trained athlete, the amount of blood that is redistributed from the placenta and uterus during exercise might be less significant than it would in an untrained pregnant woman. There are also certain protective mechanisms in place that ensure oxygen transfer to the placenta and baby3. During pregnancy, the blood volume and skin blood flow of the mother are increased, which promotes heat dissipation so the core temperature of the mother is more stable1.

Whilst this is good to know, this is still not the time for experimenting or adopting a “go hard or go home” attitude. Instead, it is the time for treating your body well, nourishing it and loving it. As an athlete, you are trained to be in tune with your body. You understand the signals it sends, and you know when it is too much, too hot or too hard. Don’t push it, LISTEN!

There is no recommended, exact upper level of exercise intensity, frequency and duration for pregnant athletes. Every woman and every pregnancy is different. You should discuss your exercise plans with your medical practitioner or fitness professional.

Sports Medicine Australia provides the following guidelines for pregnant athletes3 :

  • Don’t exercise in the hottest or most humid times of the day
  • Wear light clothing and stay hydrated to avoid overheating
  • Avoid maximum intensity exercise (moderate intensities of <75% HRmax )
  • Extensive stretching and jerky, ballistic movements should be avoided
  • High intensity exercise should not exceed 15 minutes
  • Stay under your 70%VO2

Every woman’s circumstances are different, and every athlete’s career might be at a different stage when she falls pregnant. There is no single piece of advice about exercising during pregnancy that is suitable for all pregnant athletes.

But you should try to avoid thinking about the pregnancy as an interruption to your sports career, or as a performance inhibitor. Being pregnant will open up a whole new world to you. Because you are an athlete, and therefore are very much in tune with your body, you might be able to enjoy a more full appreciation of the physical changes that you undergo whilst growing this new person inside your womb. Being a sports person doesn’t just mean you perform well and train hard. It also implies that you are healthy, fit and strong, which are all great prerequisites for growing a healthy and strong baby. Your conditioned body will be able to cope with the physical changes of this pregnancy really well, and the extra weight that you will be carrying will be less likely to cause any pain or other problems in your body.

Enjoy your workouts during pregnancy. Instead of grieving that you are not quite achieving your usual performance measures, be playful and use the time to try new routines and training methods that you haven’t explorede. Here are some ideas:

 

  • Swimming: This is a life (and sanity) saver for many pregnant athletes. During pregnancy, you can work on improving your technical swimming skills. If you are up for it, you can still get your heart rate up with some interval training, eg sprinting laps, or low intensity endurance training. Especially during late pregnancy, you will appreciate the light as a feather feeling the water provides. Swimming is also safefor your joints and ligaments even after hormones start to loosen them.
  • Yoga: Ideally you have already practised yoga prior to falling pregnant, but even if not, a good teacher will be able to familiarize you with the best and most suitable practices for you. Yoga is great for flexibility, but it is also amazing for developing structural strength and body control, which are desirable skills for any sport. Yoga might also help to improve your mental strength, focus and relaxation techniques, which are also crucial for any successful athlete.
  • Rehab: Think about an injury you have suffered in the past. You probably rehabbed your shoulder or knee well enough to return to training, but it might not be totally back to normal. Rehab exercises are time consuming and usually not very exciting, so you only did the bare minimum. Well, now you have time to focus on the old injury and make some improvements.  Work with your rehab expert and get those 5000 repetitions and 200 sets of slow, single-leg squats done now.

 

 

Make sure you enjoy your pregnancy, and find quiet time as well. Be open to this experience. There are bigger things in the world than your latest PB. Pregnancy and having a new baby are happy, joyful times to celebrate and cherish. Don’t let your athlete-ego get in the way of this.

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No matter how fit you are, you should stop your workout immediately, if you experience any of the following4:

  • Pain (especially abdominal or pelvic pain and headache)
  • Any gush of fluid from the vagina
  • Calf pain or swelling
  • Chest pain
  • Unusual decreased foetal movement
  • Dizziness
  • Excessive fatigue
  • Excessive shortness of breath
  • Painful uterine contractions and vaginal bleeding

 

There are also a number of contraindications for exercising during pregnancy, these include3,4:

  • Preeclampsia/ eclampsia
  • Preterm premature rupture of the membranes
  • Antepartum hemorrhage
  • Placenta previa
  • Persistent 2nd and 3rd trimester bleeding
  • Preterm labor
  • Incompetent cervix
  • Significant maternal cardiac disease
  • Restrictive lung disease
  • Growth-restricted fetus
  • Chronic placental abruption
  • Multiple gestation (ie. twins or triplets)

References

(1) Mottola, M. F., & Wolfe, L. A. (2008). The pregnant athlete. Encyclopaedia of Sports Medicine: Women in Sport, 194-207.

(2) Webb, K.A., Wolfe, L.A. & McGrath, M.J (1994) Effects of acute and chronic maternal exercise on fetal heart rate. Journal of Applied Physiology 97, 2207-2213.

(3) Sports Medicine Australia (SMA). 2001. Participation of the Pregnant Athlete in Contact and Collision Sports. Fact sheet obtainable through Sports Medicine Australia Web site (www.sma.org.au).

(4)Sports Medicine Australia (SMA). Pregnancy and Exercise.

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