Active Voice: Exercise in Pregnancy
By Bradley B. Price, M.D.
Viewpoints
presented in SMB commentaries reflect the opinions of the authors and
do not necessarily reflect positions or policies of ACSM.
Bradley B. Price, M.D., practices obstetrics and gynecology in Austin, TX. He maintains affiliations with the University of Texas Southwestern Medical Center at Dallas and holds a clinical faculty appointment with the University of Texas Medical Center in Austin. A longtime triathlete, he is currently world age group champion in Ironman 70.3. Dr. Price is an ACSM member.
The following commentary reflects Dr. Price’s views relating to the research article which he and his colleagues presented in the December 2012 issue of Medicine and Science in Sports and Exercise® (MSSE).
Based on abundant epidemiologic and experimental evidence that aerobic exercise improves cardiovascular fitness and reduces the incidence of disease, the American College of Sports Medicine as well as the Centers for Disease Control and Prevention, recommend that the general population exercise at moderate intensity for at least 30 minutes most days of the week. In 2002, the American College of Obstetricians and Gynecologists (ACOG) suggested that healthy pregnant women follow the same recommendations (see “Exercise During Pregnancy and the Postpartum Period” at the ACOG website.)
But why are only 16% of pregnant women reportedly following these exercise guidelines?
Bradley B. Price, M.D., practices obstetrics and gynecology in Austin, TX. He maintains affiliations with the University of Texas Southwestern Medical Center at Dallas and holds a clinical faculty appointment with the University of Texas Medical Center in Austin. A longtime triathlete, he is currently world age group champion in Ironman 70.3. Dr. Price is an ACSM member.
The following commentary reflects Dr. Price’s views relating to the research article which he and his colleagues presented in the December 2012 issue of Medicine and Science in Sports and Exercise® (MSSE).
Based on abundant epidemiologic and experimental evidence that aerobic exercise improves cardiovascular fitness and reduces the incidence of disease, the American College of Sports Medicine as well as the Centers for Disease Control and Prevention, recommend that the general population exercise at moderate intensity for at least 30 minutes most days of the week. In 2002, the American College of Obstetricians and Gynecologists (ACOG) suggested that healthy pregnant women follow the same recommendations (see “Exercise During Pregnancy and the Postpartum Period” at the ACOG website.)
But why are only 16% of pregnant women reportedly following these exercise guidelines?
Perhaps it is because there are abundant questions
in the minds of doctors, patients, and exercise professionals about
exercise in pregnancy.
The examples are numerous: “Does exercise cause
premature labor and delivery?” Will exercise cause excessive aches and
pains in pregnancy?” “Should sedentary women begin regular exercise in
pregnancy?” “Who should not exercise in pregnancy?” “What specific
aerobic and strength exercises are safe and useful in pregnancy?” “Is
exercise safe for the unborn baby?” “Will exercise benefit labor,
delivery, or postpartum recovery?”
In our recent research, reported in MSSE, we studied 31 women who had done no regular exercise for at least six months. The subjects were randomized at 12 weeks of pregnancy to a group exercise program for one hour, four days per week involving step aerobics, circuit training and brisk walking, all at a moderate level of perceived exertion. All continued to at least 36 weeks of pregnancy (40 weeks is full-term). Compliance was excellent because exercisers soon began to feel better overall, and they enjoyed exercising in a group setting with other pregnant women. The 31 sedentary women who had been randomized to the control group did no recreational exercise. All subjects completed a timed two-mile walk every six weeks through pregnancy, as well as tests of strength, flexibility and discomforts in pregnancy.
Eligibility for exercise was based on the 2002 ACOG guidelines: viable pregnancy with one fetus (no twins); body mass index under 40; and no history of premature delivery, infant delivered for small for gestational age, or unexplained fetal death. One participant had a history of premature delivery with twins but was allowed to participate because the current pregnancy was singleton.
Exercisers significantly improved strength and aerobic power without increasing musculoskeletal discomforts or reducing flexibility. There was one premature labor and delivery in the active group—the woman who had a previous history of premature birth with twins. Overall there was no difference in length of pregnancy between groups, fetal birth weights, or measures of alertness at birth (we used Apgar scores to appraise health status at birth.)
Most surprising, in our study exercising women were much more efficient at avoiding operative delivery: only 6% required unscheduled Caesarean section during labor, compared to 32% in the sedentary control group. In the control group, there were more C-sections performed for non-reassuring fetal heart rate patterns and for failure to progress in labor. Postpartum recovery was significantly faster in the exercise group.
For the previously sedentary women in this study who exercised per ACOG guidelines, benefits clearly outweighed risks, and widely applied, exercise could reduce the current epidemic of Caesarean deliveries.
In our recent research, reported in MSSE, we studied 31 women who had done no regular exercise for at least six months. The subjects were randomized at 12 weeks of pregnancy to a group exercise program for one hour, four days per week involving step aerobics, circuit training and brisk walking, all at a moderate level of perceived exertion. All continued to at least 36 weeks of pregnancy (40 weeks is full-term). Compliance was excellent because exercisers soon began to feel better overall, and they enjoyed exercising in a group setting with other pregnant women. The 31 sedentary women who had been randomized to the control group did no recreational exercise. All subjects completed a timed two-mile walk every six weeks through pregnancy, as well as tests of strength, flexibility and discomforts in pregnancy.
Eligibility for exercise was based on the 2002 ACOG guidelines: viable pregnancy with one fetus (no twins); body mass index under 40; and no history of premature delivery, infant delivered for small for gestational age, or unexplained fetal death. One participant had a history of premature delivery with twins but was allowed to participate because the current pregnancy was singleton.
Exercisers significantly improved strength and aerobic power without increasing musculoskeletal discomforts or reducing flexibility. There was one premature labor and delivery in the active group—the woman who had a previous history of premature birth with twins. Overall there was no difference in length of pregnancy between groups, fetal birth weights, or measures of alertness at birth (we used Apgar scores to appraise health status at birth.)
Most surprising, in our study exercising women were much more efficient at avoiding operative delivery: only 6% required unscheduled Caesarean section during labor, compared to 32% in the sedentary control group. In the control group, there were more C-sections performed for non-reassuring fetal heart rate patterns and for failure to progress in labor. Postpartum recovery was significantly faster in the exercise group.
For the previously sedentary women in this study who exercised per ACOG guidelines, benefits clearly outweighed risks, and widely applied, exercise could reduce the current epidemic of Caesarean deliveries.
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Given all the hormonal and physical changes that occurs in your body during pregnancy. From a practical sense it seems obvious that exercise can help you're body find some sort of "balance" in dealing with everything.
Ofcourse, too much of ANYTHING can become a bad thing.
Make sure to consult with your physician and do not overexert your self.
A healthy lifestyle is not a sprint, its a life long marathon.
xoxo
LO
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