The benefits of exercise can not be underestimated; hence it is still recommended even to pregnant patients. Exercise during pregnancy may not necessarily be as tough and as rigid as in non-pregnant individuals, yet it really does a lot of favorable health advantages. Exercise enhances maternal blood circulation, maximizes maternal respiratory capacity, helps alleviate swelling in dependent areas of the body, tones the maternal muscles, and gives a sense of well-being.
However, because exercise itself puts a considerable amount of stress to the body before the above advantages are felt by the individual, exercise is not an absolute recommendation. In the case of pregnant patients, the American College of Obstetricians and Gynecologists caution women with the following conditions not to exercise when pregnant:
1. Second or Third Trimester Bleeding
Conditions associated with vaginal bleeding during the second and third trimesters are placenta previa and abruption placenta. Placenta previa is when the placenta is implanted very low in the uterus covering the cervical os. Bleeding is usually painless. In abruption placenta, the placenta becomes detached from the uterine wall, causing painful vaginal bleeding. Exercise should be avoided in both conditions in order to prevent adding further pressure to the placenta.
2. Hypertension & Cardiac Conditions (Rheumatic Heart Disease, Cardiovascular Diseases, Congestive Heart Failure, etc,)
Women with elevated blood pressures, whether it is pregnancy-induced or a pre-existing medical condition, as well as those with known heart diseases, are forbidden to exercise. This is because when the woman engages in exercise; her exercising muscles will demand an increase in blood circulating to the area. This demand will be met by a compensatory increase in the rate and contracting power of the heart, which will be deleterious to those whose heart are not functioning normally to start with. Also, the accompanying increase in circulating blood volume and blood pressure further heightens any pre-existing hypertensive conditions. High blood pressure in pregnant women should be avoided, since it will bring about obstetrical complications such as abruption placenta, pre-eclampsia, seizure, and intrauterine growth retardation.
3. Premature Labor and Premature Rupture of Membranes (PROM)
Pregnant women at risk of delivering their baby prematurely (less than 37 weeks of gestation) should avoid exercise. These include those carrying multiple fetuses or those who have experienced preterm labor. They should limit physical activity and some are even prescribed with medications to stop uterine contractions.
4. Incompetent Cervix
Incompetent cervix or weak cervix is a condition wherein the lowermost part of the uterus called the cervix, painlessly and spontaneously dilates long before it should, resulting in preterm delivery. Usually, the pregnant woman with an incompetent cervix undergoes a cerclage procedure wherein suturing is done to reinforce the weak cervix. Bed rest is recommended. Any physical activity, especially exercise of any form, will only put added strain to the cervix, causing it to give in, initiating premature labor.
5. Intrauterine Growth Retardation (IUGR)
IUGR is a condition wherein the fetus is not growing adequately. It is usually diagnosed by serial ultrasound or through measurement of abdominal growth during pregnancy. This happens due to the inability of the placenta to provide adequate nourishment and oxygen supply to the growing fetus. When the pregnant woman is exercising, blood supply to the placenta is further decreased, compromising fetal health.
6. Rare conditions (e.g. thyroid diseases, isoimmunization)
Isoimmunization is when the mother makes antibodies that cross the placenta and destroy the fetal red blood cells. Hence, the fetus is in an anemic state and would need all the oxygen it can get. Unfortunately, exercise decreases oxygen delivery to the fetus.
7. Pregnant women who have active bacterial or viral infections should also temporarily stop exercising until they have recovered from the illness.
It is very important for a pregnant woman to understand that not all that she heard of or read as beneficial to pregnancy apply to all cases. Just like exercise, it might be the right thing to do for some uncomplicated pregnancies, but not a good thing to those with problematic pregnancy conditions.