Exercise During and After Pregnancy

Our Women’s and Men’s Health Physiotherapist, Zoe Eggleton was recently featured West Essex Life Magazine talking about exercise during and after pregnancy. You can read the full article here.
Pregnancy is a fantastic opportunity to improve your health before your little one comes along. Being active in pregnancy will help to improve your sleep, lift your mood and keep you fit, as well as having medical health benefits such as lowering your risk of high blood pressure, pregnancy diabetes and controlling weight gain.

If you are already exercising regularly, well done and keep going! Have a think about what you do and if you need to modify it as your pregnancy progresses.

What exercise can I do during pregnancy?
Safe forms of exercise include cycling, swimming, doing exercise classes such as Pilates, dancing, low-impact circuits, lifting light weights and walking. Strenuous exercise such as heavy weight-lifting, running and challenging core exercises such as planks aren’t recommended for pregnant non-exercisers but in some cases can be continued by very fit women under close supervision of a physiotherapist.

After your first three months of pregnancy, try to avoid lying flat on your back to exercise because the weight of the baby can cause your blood pressure to drop. You should aim to exercise at a moderate level (where you breathe harder but can still hold a conversation) and should take care not to ‘bump the bump’.

This means that contact and racquet sports probably aren’t ideal once you move into second trimester. Sports such as skiing and diving are also not recommended for obvious reasons. You should be aiming to exercise for at least 150 minutes (2.5 hours) cumulatively over the course of the week for optimal health during pregnancy. Every activity counts!

I don’t normally exercise but I’d like to be fitter during my pregnancy
If you aren’t exercising currently, wait until you are 13 weeks before starting. Do ten minutes of moderate exercise 2-3 times per week and gradually build up. Listen to your body. If your pregnancy or medical history is complicated in any way you should check with your healthcare professional (e.g. obstetrician or midwife) first. If you experience any warning signs, such as difficulty in breathing or vaginal bleeding, stop exercising and seek advice.

How can I avoid urinary incontinence during pregancy and what exercises can I do to avoid it?
Urinary incontinence is common in the late stages of pregnancy and postpartum. Pelvic floor exercises help to stop leakage so are important for all pregnant women to do daily. The pelvic floor muscles are like a hammock that stretches from the tailbone to the pubic bone. Your baby and your pelvic organs (bladder, womb and bowel) rest on top of the muscle, so it works hard during pregnancy!

Tip for pelvic floor exercises 

• To do the exercises, lie or sit down to start with.
• Make sure your buttocks and thigh muscles stay relaxed during the exercise and that you keep breathing!
• Squeeze and lift your back passage like you are trying to stop yourself passing wind.
• At the same time, squeeze and lift your front passage as if you are trying to stop yourself passing urine.
• Hold the squeeze for a count of 10 seconds.
• Relax for 10 seconds, then repeat 10 times.
• Next, do 10 quick squeezes.
• These should last just one second each but should be as strong as you can do.

Try to do 3 sets of pelvic floor exercises daily (both the holding and the quick exercises). Progress to doing your exercises standing up for a harder challenge. Smartphone apps such as ‘Squeezy’ are helpful if you need a reminder!

How soon can I start exercising after giving birth?
Once your baby has arrived, allow your body to recover for the first 6 weeks. Re-start your pelvic floor exercises as soon as possible (ideally within the first 24 hours, once you are passing urine normally). They are important even if you have had a Caesarean section, because the muscles have still been weakened and stretched by pregnancy.

During the first 6 weeks, your attention is likely to be more on feeding, sleeping and surviving so if you manage to do your pelvic floor exercises 3 times daily and get yourself out for a short walk you have done fantastically well! Feeding the baby is a good opportunity to do your pelvic floor exercises.

Build up your walking distance day by day being mindful of your posture. Are you standing like you are still pregnant, with a big inward arch in your lower back and your tummy sticking out? Try to gently pull in your lower abdominal muscles and stand up straight!

If you do find yourself wanting to do some gentle strengthening exercises in this time period, the Pelvic Obstetric and Gynaecological Physiotherapy website has a useful booklet called Fit for the Future which explains some gentle floor-based exercises that you can do safely in the first 6 weeks.

Your postnatal check up
When your baby is 6 weeks old, you will have a check-up with your GP and if all is well, you can start to work a little harder.

Separated stomach muscles (diastasis recti)
Most mums will be keen to tone their tummy. First, check your six-pack muscles (rectus abdominis). These muscles part during pregnancy and gradually come back together after the baby is born, usually by the 8 week mark. Doing strenuous tummy muscle exercises before the muscle has closed can lead to a persistent tummy muscle gap known as a rectus abdominis diastasis, which can cause a persistent ‘mum tum’.

• To test if you have a diastasis, lie on your back with your knees bent and feet on the floor.
• Feel with your fingers just above your tummy button.
• Lift your head and shoulders up whilst gently feeling side-to-side with your fingers.
• You should be able to feel the two edges of the six-pack muscles.
• The gap between them should be less than 2 fingers’ width (approx. 2.7cm).
• If this is the case, you can return to Pilates- and yoga-style exercises, and gradually build up to more strenuous exercises such as those with both legs raised, planks, over the next month.

Once your baby is 3 months old you should be able to return to gym-based exercises, running etc, if you choose. Remember to continue your pelvic floor exercises! If you are a high-level exerciser you need a high-level pelvic floor!

When to get help!
If you are not sure if you are doing your pelvic floor exercises correctly, you have pain in your back or pelvis during pregnancy or postnatally, you have bladder or bowel leakage or a bulging sensation in the vagina, or if you think you may have a rectus abdominis diastasis, please book an assessment with a Women’s Health Physiotherapist.

Want to book an appointment with Zoe?
Zoe has clinics at The Holly Private Hospital on Mondays, Wednesdays and Thursdays.

To book an appointment call our friendly appointments team on 020 8936 1201.

MummyMOT appointments are available for a postnatal review of your posture, pelvic floor and abdominal muscles and to obtain a personalised return to exercise plan.