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Exercise in Pregnancy: What are the Benefits? 

December 9, 2020

Dr. Madeleine Becker of the Marcus Institute recently co-authored an article in Psychiatric Times entitled, “Conventional and Integrative Approaches to Treating Anxiety in Pregnancy.” 1 In the feature, the experts report that while perinatal anxiety is a common concern,  there has been little focus on treatment. The article explores evidence-based treatments for anxiety during pregnancy and in the postpartum period. Exercise is one approach that has been shown to be effective and carries multiple health benefits. In this blog post, we will share the ways in which women can incorporate exercise into their pregnancy in a healthy way for both mother and baby. 

  1. Exercise is one of the most beneficial modalities that exists for medical and mental health conditions
  2. In most pregnancies, exercise has benefits in the perinatal period, both for mother and baby. Exercise can help with both mood and stress: regular exercise during pregnancy has been shown to have a positive effect on mood, reducing stress and anxiety levels and symptoms of depression. 23
  3. Exercise increases body and brain temperature leading to a sensation of relaxation and tranquility.  
  4. Exercise can improve mood and has been shown to have an effect on depression similar to antidepressant medications. 
  5. Exercise improves autonomic nervous system functioning by increasing heart rate variability and reducing symptoms of anxiety. 4
  6. In addition to mood benefits, regular physical activity can also lower the risk of excessive pregnancy weight gain, low back pain, gestational diabetes, and cesarean delivery. 5, 

Recommendations provided by the American College of Obstetricians and Gynecologists (ACOG)7 and the Centers for Disease Control and Prevention (CDC) 8 :

Healthy women should aim for at least 150 minutes of moderate-intensity aerobic activity divided over one week. 

  1. For those who are beginners or for those who do not normally exercise, a gradual increase in activity level spread throughout the week is recommended. Brisk walking is a good option for getting started. If previously inactive, any increase in activity can be helpful to your mood, even if you don’t reach 150 minutes! 
  2. For those who regularly engage in vigorous-intensity aerobic activity, they may continue at their current level provided that their condition and health remains unchanged and/or as recommended by their obstetric care provider. 

Precautions:

  1. Stay hydrated and drink plenty of fluids before, during, and after exercise.
  2. Wear a sports bra or belly belt to be most comfortable. 
  3. Avoid becoming overheated, lying on your back, and standing still for too long in one position

Some Activities to Avoid During Pregnancy:

  1. Contact sports and sports that put you at risk of getting hit in the abdomen, including ice hockey, boxing, soccer, and basketball
  2. Activities performed above 6,000 feet (if you do not already live at a high altitude)
  3. Skydiving, Scuba diving
  4. "Hot yoga” or “hot pilates,” which may cause you to become overheated
  5. Activities that may result in a fall, such as downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, and horseback riding
    1. Be sure to talk to your obstetrician about the level of activity, as there are some health conditions in pregnancy when exercise is not recommended. This includes certain types of heart and lung diseases, cerclage, pregnancy with twins or triplets (or multiples) with risk factors for preterm labor, Placenta previa after 26 weeks of pregnancy, Preterm labor, or ruptured membranes (your water has broken) during this pregnancy, Preeclampsia or pregnancy-induced high blood pressure or severe anemia. Be sure to discuss your exercise routine with your health care provider as you go through your pregnancy and through the postpartum period.

References:

1 Ballone, NT, Moffitt, C. Becker MA, Conventional and Integrative Approaches to Treating Anxiety in Pregnancy.  Psychiatric Times Vol 37, Issue 8 2019

2 Kołomańska-Bogucka D, Mazur-Bialy AI. Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review. Medicina (Kaunas) 2019; 55. DOI:10.3390/medicina55090560.

3 Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Cavero-Redondo I, Martínez-Vizcaíno V. Effects of exercise-based interventions on postpartum depression: A meta-analysis of randomized controlled trials. Birth 2017; 44: 200–8.

4 Stubbs B, Vancampfort D, Rosenbaum S, et al. An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Res 2017; 249: 102–8.

5 Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014; 211: 401.e1-11.

6 Nascimento SL, Surita FG, Cecatti JG. Physical exercise during pregnancy:  a systematic review. Curr Opin Obstet Gynecol 2012; 24: 387–94.

7 Physical activity and exercise during pregnancy and the postpartum period: ACOG committee opinion, number 804. Obstet Gynecol 2020; 135: e178–88.

8 CDC; Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Physical Activity: Healthy Pregnant or Postpartum Women. https://www.cdc.gov/physicalactivity/basics/pregnancy/index.htm (accessed Nov 9, 2020).