Full Circle Midwifery

By Kim Smith, Reporter  Global News

Expectant mothers are finally getting some up to date advice when it comes to staying active during pregnancy. For the first time in 15 years, new guidelines are out. As Kim Smith reports, it’s dispelling old myths and providing a big incentive to keep moving.

A new Canadian guideline for exercise during pregnancyfound that physical activity is not associated with fetal complications and can reduce the chance of developing a major pregnancy complication.

Following three years of researching 675 unique studies, the 2019 Canadian Guideline for Physical Activity Throughout Pregnancy was released on Thursday morning. The previous guideline was 15 years old.

“It was high time that we developed these guidelines,” said Margie Davenport, an associate professor in the Faculty of Kinesiology, Sport and Recreation at the University of Alberta.   “There’s been an incredible amount of new information that’s come out looking at the safety and benefits of being active during pregnancy.”

The overarching recommendation is that all pregnant women — with the exception of those who shouldn’t exercise for medical reasons — should be physically active, which differs from the 2003 guideline.

“There’s no bad time to start physical activity when you’re pregnant,” Davenport said.   She said even for women who were not physically active before becoming pregnant, the same recommendations apply.

The guideline includes six recommendations, including pregnant women should get at least 150 minutes of moderate-intensity exercise each week.

“So that would be equivalent of a brisk walk, gardening, going for a swim,” Davenport said.

Six recommendations

• All women without contraindication should be physically active throughout pregnancy
• Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week
• Physical activity should be accumulated over a minimum of three days per week
• Pregnant women should incorporate a variety of aerobic exercise and resistance training activities to achieve greater benefits
• Pelvic floor muscle training (e.g. Kegel exercises) may be performed on a daily basis to reduce the risk of urinary incontinence
• Pregnant women who experience light-headedness, experience nausea, or feel unwell when they exercise flat on their back should modify their exercise position toavoid the supine position

Prenatal exercise can reduce odds of major complication

The research found prenatal exercise is not associated with fetal complication such as miscarriage, stillbirth and preterm birth.

“The three biggest fears that pregnant women have told us is: they’re going to have a higher risk for miscarriage, they might be more likely to have a preterm delivery, and they might have a smaller baby,” Davenport said.

“The evidence that we’ve found in our systematic reviews suggests that this is not actually a concern.

“Pregnant women [who exercise] are not at a higher risk for miscarriage, preterm birth or having a small baby.”

In fact, women who exercise during pregnancy can expect a 40 per cent reduction in the chance of developing a major pregnancy complication such as pre-eclampsia, gestational hypertension or gestational diabetes, Davenport said.

“If we can prevent these complications from developing in the mom, we might actually be able to impact the life-long health of both the mother and the baby.”

However, despite the recommendations, Davenport said pregnant women should not feel guilty for being inactive.

“If there are days when you can’t be physically active, you do need to listen to your body and take the time to rest and recover.”

What kind of exercise is not recommended?

Pregnant women should avoid exercise that involves physical contact or danger of falling.

“Great examples are downhill skiing or horseback riding.”

The guideline also strongly recommends that pregnant women avoid scuba diving, exercising at a high altitude and in excessive heat.

Are there pregnant women who should not exercise?

The guideline suggests that pregnant women with certain conditions should not exercise:

• Ruptured membranes
• Premature labour
• Unexplained persistent vaginal bleeding
• Placenta previa after 28 weeks’ gestation
• Preeclampsia
• Incompetent cervix
• Intrauterine growth restriction
• High-order multiple pregnancy (e.g.,triplets)
• Uncontrolled type 1 diabetes
• Uncontrolled hypertension
• Uncontrolled thyroid disease
• Other serious cardiovascular, respiratory, or systemic disorder

The guideline was reviewed and approved by the Society of Obstetricians and Gynaecologists of Canada and has been endorsed by groups including Alberta Health Services, Canadian Academy of Sports Medicine, Canadian Association of Midwives, Ontario Public Health Association, ParticipACTION and Perinatal Services BC.