Exercise Precautions and Contraindications
CONSULT your doctor before starting or continuing an exercise program. STOP exercising and consult your doctor immediately if any ill effects appear.
It is very important that pregnant women read Guidelines & Recommendations for Exercise During Pregnancy before starting or continuing an exercise program during pregnancy.
Before undertaking or continuing an exercise program, a pregnant woman must understand that certain precautions need to be taken and that they must first check to see if they suffer from any condition that is contraindicative to exercise during pregnancy. If an exercise program is undertaken, when in fact it shouldn't have been, there can be detrimental effects to the fetus and the mother. Thus, consultation with a physician is extremely important. Pregnant women who are cleared to exercise should listen to their bodies and heed any warnings issued by the body to cease exercising. Fitness is important, but so is the health of the life inside of the expecting mother.
Reasons to Discontinue Exercise and Seek Medical Advice (1,2,3)
1. any signs of bloody discharge from the vagina (can occur both during pregnancy and in the postpartum
period
2. any "gush" of fluid from the vagina (premature rupture of membranes)
3. sudden swelling of the ankles, hands, and face
4. persistent, severe headaches and/or visual disturbance; unexplained spells of faintness or dizziness
5. swelling, pain, and redness in the calf of one leg (phlebitis)
6. elevation of pulse rate or blood pressure that persists after exercise
7. excessive fatigue, palpitations, chest pain
8. persistent contractions (>6 to 8/hour) that may suggest onset of premature labor
9. unexplained abdominal pain
10. insufficient weight gain (<1.0 kg/month during last two trimesters)
11. suffering from physical pain (particularly in the back and pubic area)
12. if decreased fetal movement is observed
13. severe nausea, vomiting or dizziness
14. infection: including colds or other viral infections, or bacterial infections
15. anemia (i.e. low blood iron) - the expecting mother's doctor should check for this throughout the pregnancy and again before you are released from the hospital
Contraindications
Some women should not be exercise during pregnancy. Careful evaluation by a physician should be done to determine if exercise is safe for the expectant mother. The following outline some conditions/circumstances that contraindicate exercise during pregnancy:
Absolute Contraindications for Exercise in Pregnancy (3)
1. Severe structural heart disease, ventricular dysfunction or cardiac arrythmias
2. Peripheral vascular disease, uncontrolled hypertension or thyroid disease, other serious systemic disorder
3. Diagnosis of incompetent cervix
4. Two or more consecutive spontaneous abortions in previous pregnancies
5. Bleeding or diagnosis of placenta previa
6. Ruptured membranes or premature labor in current pregnancy
7. Development of pre-eclampsia/eclampsia in current pregnancy
8. Smoking or excessive alcohol intake (>2 drinks a day)
9. Very low blood fatness, poor nutrition, history of eating disorders
10. Multiple pregnancy (i.e. triplets, etc.)
Relative Contraindications for Exercise in Pregnancy (3)
1. Mild structural heart disease, ventricular dysfunction or cardiac arrythmia
2. Significant pulmonary disease (e.g. asthma)
3. Anemia or iron deficiency (Hb < 10.5 g/dl)
4. Medications that can alter cardiac output or blood flow distribution
5. Type I or Type II diabetes mellitus
6. History of premature labor or intrauterine growth retardation in previous pregnancies
7. Bleeding during current pregnancy; breech presentation in third trimester
8. Presence of twins (after 24 weeks gestation)
9. Very low physical fitness, poor nutrition
Summary
Although risks are minimal with moderation, even healthy, active women should be examined periodically to assess the effect of their exercise programs on the developing fetus, and their regimen should be adjusted or discontinued if necessary. Nonetheless, the consensus seems clear: In the absence of pregnancy complications, exercise has minimal risks and demonstrates benefits. (1)
Points of Interest
Women who have gestational diabetes are often helped by exercise, and such programs have been endorsed by the American Diabetes Association and the Second and Third International Workshop-Conference on gestational diabetes. (1) For more information on Gestational Diabetes, check out the POINT OF INTEREST at the bottom of the nutrition page: click here
CONSULT your doctor before starting or continuing an exercise program. STOP exercising and consult your doctor immediately if any ill effects appear.
References
1. Artal, R. & Sherman, C. (1999). Exercise During Pregnancy. The Physician and Sportsmedicine, 27 (8).
2. Wolfe, Larry A. (1993). Pregnancy. In J. Skinner, Exercise Testing and Exercise Prescription for Special
Cases (pp. 363- 385). Philadelphia: Lea & Febiger.
3. Fitness Canada and Amateur Sport Branch. (1983). Fitness and Pregnancy. Ottawa: Government Printing
Office.
(Nutrition) (Exercise on your Body) (Effects of Pregnancy) (Exercise Guidelines)
(Precautions & Contraindication) (Benefits of Exercise) (Exercise Programs) (Perinatal Dangers)
(Hints for Around the House) (Tips for Fitness Instructors)