Pregnancy doesn’ t have to mean putting exercise on hold. Dr Mokgohloe Phasha, an obstetrician and gynaecologist at Netcare Parklane’ s Women’ s Wellness Centre in Johannesburg, explains how women can stay active, adapt their routines as their bodies change, and return to exercise after giving birth.
Pregnancy can raise questions about what’ s safe and when it’ s time to ease off. For women who enjoy running, swimming, cycling or spending time in the gym, the prospect of changing their routine can be daunting. Others may be wondering whether pregnancy is the right time to start exercising.
“ Pregnancy is a phase in a woman’ s life. It’ s not an ailment or disease,” says Dr Phasha.
“ Women are encouraged to continue to exercise and even start if they have not done so in times past.
“ Continuing to exercise during pregnancy will benefit the mom-to-be’ s mental state. Women who enter the labour ward having had exercise as part of their routine are confident in themselves and their bodies.”
Putting fears to rest
One of the biggest concerns around exercising during pregnancy is the fear of harming the unborn baby. Dr Phasha says that concern should not become a source of unnecessary anxiety.
“ Whilst concern is warranted, it should not be anxiety-driven,” she says.
“ Over 80 per cent of pregnancies are classified as low risk ie. no underlying medical condition that could complicate. Women with low-risk pregnancies are encouraged to exercise and move their bodies. Of course, one would need to modify some exercises to accommodate the bump.”
Those with high-risk pregnancies, including women with certain heart conditions or a history of recurrent preterm birth, should first seek clearance from their healthcare provider.
Even when there are medical complications, some form of gentle movement may still be appropriate, depending on individual circumstances. Dr Phasha warns against assuming that doing nothing is always the safest option, pointing to excessive weight gain and gestational diabetes as potential concerns.
Adjusting as your body changes
There is no single exercise programme that suits every pregnant woman. How much activity is appropriate depends on her fitness, how she is feeling and the changes taking place in her body.
The first trimester can bring severe nausea and vomiting, making it difficult to eat enough to support both everyday activity and the developing baby. Exercise may need to be scaled back on particularly difficult days, with nutrition and rest taking priority.
As the pregnancy progresses, a growing bump can make certain movements and positions uncomfortable or unsuitable. Dr Phasha advises women to be mindful of these changes rather than trying to maintain their pre-pregnancy routine at all costs.
Her guiding principle is simple:“ Everything in moderation is something to emphasise.”
Finding an activity that works
The important consideration is choosing exercise that is appropriate for their circumstances and adapting it when necessary.
Dr Phasha is wary of drawing up an overly restrictive list of permitted activities that might cause unnecessary anxiety or discourage women from doing exercise they enjoy. Instead, she encourages a measured approach, with individual needs and safety taking precedence.
“ The important thing is everything in moderation. Sports or exercise to avoid would include contact sports. Women can run, walk, swim, do Pilates, do yoga, cycle, hike, and do gentle weight lifting. The list is endless. Moderation, moderation, moderation. Listen to your body. Rest days are crucial. Nutrition should not be neglected.”
Knowing when to stop
Pregnancy is not the time to ignore pain or push through exhaustion in the name of fitness. Fatigue is a reason to rest, says Dr Phasha, and women should give themselves permission to take a day or two off when needed.
“ Your body knows its limits and it will tell you. Don’ t ignore pain. Don’ t ignore fatigue. Heed your health care worker’ s advice. Stop when advised to.”
A poor night ' s sleep, for example, may be reason enough to cancel a training session. Trying to compensate with caffeine or energy-dense food is not the answer to a body that needs rest.
Pelvic pain should not be ignored either. Dr Phasha recommends seeking advice from a physiotherapist and allowing time for recovery. A belly binder may also help support the abdomen and ease the load on the pelvis, where appropriate.
For nausea and vomiting, simple measures such as ginger and eating smaller, more frequent meals may help. If symptoms persist, women should speak to their healthcare provider, who can advise on treatment and prescribe medication when necessary.
Pain, unusual fatigue or other concerning symptoms should never simply be brushed aside.
For those with uncomplicated pregnancies who have been cleared to exercise, activity may be possible right up until delivery.
The key is to keep listening to the body and adjusting accordingly.
Returning after birth
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Giving birth does not mean a woman can immediately pick up where she left off with her training. The body needs time to recover, and the return to exercise should be gradual.
Dr Phasha generally advises women to wait six weeks before returning to exercise. The appropriate timing can vary, depending on the type of delivery, recovery and any complications, so women should follow their healthcare provider’ s advice.
“ Six weeks is what we advise women. Remember to start slowly, light weights, and gentle, two to three times a week, not daily. Build it all up. Don’ t pick up from your prepregnancy performance. Your body is still remodelling,” she says.
Muscles and ligaments need time to recover, while the demands of caring for and feeding a newborn can add to the physical load. Returning too quickly to hard, fast, heavy and frequent training can lead to injury and delay recovery.
“ Keep in mind your body is in repair mode and is providing nutritional sustenance for the newborn. Be gentle with it.”
Dr Phasha’ s golden rule?“ Everything in moderation. Listen to the cues your body is telling you.”
And, as she puts it:“ If your approach is hard, fast, heavy, and frequent, you are doing it wrong. Slow and steady, the tortoise beats the hare in a race.”
Dr Mokgohloe Phasha
Obstetrician and gynaecologist
13 Junction, Netcare Parklane – Women’ s Wellness Centre, Parktown, Johannesburg
Tel: 011 480 4324
reception @ myobgyn. co. za
www. myobgyn. co. za
www. modernathlete. co. za 39