How do we guide our pregnant patients?
Exercise can be an inconsistently managed area of antenatal care. GPs are well placed to appropriately advise patients regarding safe exercise practices throughout pregnancy.
As per NICE guidance 2016– Antenatal Care for uncomplicated pregnancies- ‘women should be advised that beginning or continuing a moderate course of exercise in pregnancy is not associated with adverse outcomes.’ Women should be advised about exercise including pelvic floor exercises at their booking visit and on an opportunistic basis. (1)
Women with uncomplicated pregnancies should be encouraged to engage in aerobic (cardiovascular) and strength training (yoga/pilates) exercises in the pre-conceptual, antenatal and post-partum period. There are no proven risks to the foetus if it is practised safely. Moderate intensity exercise for at least 20-30 minutes on 5 days of the weeks should be the eventual goal and adjusted where medically indicated. Pelvic floor exercises are of particular importance helping in the prevention of faecal and urinary incontinence. (1) In women who have obstetric or medical issues, exercise regimes should be individualised. Medical opinion should be sought to carefully evaluate these women before making recommendations on physical activity participation during pregnancy. (2-6)
Physical inactivity is the fourth-leading risk factor for early mortality worldwide. (7) In pregnancy, physical inactivity and excessive weight gain have been recognized as independent risk factors for maternal obesity and related pregnancy complications, including gestational diabetes mellitus (GDM). (8-10)
There is concern that regular physical activity during pregnancy may cause miscarriage, poor foetal growth, musculoskeletal injury, or premature delivery. For uncomplicated pregnancies, these concerns have not been substantiated. (2-6)
The full article first published in GP Magazine can be read here