Exercising during pregnancy - weighing up the options

A PREGNANT mother of two has caused controversy by posting photos of herself lifting weights on Facebook.

Taken while she was eight and a half months pregnant, 35-year-old American body builder Lea-Ann Ellison is shown squatting as she lifts a huge weight above her head.

The photos and Ellison’s subsequent defence of them have sparked a debate. Traditionally, women were prescribed bed rest while pregnant. It was thought that increasing core body temperature and shifting blood flow and energy from the foetus to the mother could lead to disturbances in growth and congenital problems. There were also concerns about the risk of injury during exercise.

The more modern approach is to stay fit and active. Which viewpoint is the correct one? Should the mothers who give birth to more than 70,000 babies in Ireland every year exercise while pregnant? Where should they draw the line and has Ellison crossed it?

“Pregnancy is not an illness,” Ellison told the parenting website, Parentdish. “Mums need to quit being suppressed and take their health back. Move their bodies. Labour is a huge task on a mother’s body and there is no better time to be strong than when preparing for childbirth.”

Women in developing countries might well empathise. Many carry litres of water on their heads and a toddler on their backs on a daily basis while pregnant. But women who have a choice in the matter, such as ex-Olympic athlete, personal trainer and mother of one Gillian O’Sullivan, take a more nuanced view.

“Lea-Ann’s case is a bit extreme,” says O’Sullivan. “Women have to accept that their bodies are doing something special and that time will pass. After the baby is born, they can get back into it again.”

O’Sullivan advises women to exercise, but carefully. “It makes getting back into shape much easier if you do,” she says. “It’s not good for your body to be without exercise for the best part of a year.”

The exercise you should choose depends on how fit you were prior to pregnancy. For those with a low level of fitness, Gillian recommends walking, swimming and using an exercise bike.

Those with a higher level can continue their routine, adapting it as the months go by. “You may find it fine for the first three to five months and then the weight of the bump may make some forms of exercise awkward,” she says.

“If you are a runner, you may find it’s uncomfortable from six to seven months. Do some walking or use gym equipment instead.”

She recommends weights as part of a pregnant woman’s exercise regime. “They help to maintain muscle tone. But towards the final stages of pregnancy there is pressure on the pelvic area from the baby and lifting overhead weights causes more pressure. I don’t see the point.”

O’Sullivan ran until she was six months pregnant and switched to a cross trainer until the end of the eighth month. “For the last few weeks, I just tried to get around,” she laughs.

Clare Rooney, a professional athlete, body builder and personal trainer in Galway, has her own take on the matter.

“Just as every woman and every pregnancy is unique, every training regimen should be unique too.” “It’s perfectly safe for a woman who is used to lifting weights to continue right up to delivery if her body is responding well.”

However, this doesn’t mean she fully endorses Ellison. “The intensity, frequency and duration have to change as the pregnancy progresses,” says Rooney. “There should be no supine exercises from week 16 onwards, no overhead pressing and no high elevation of heart rate or body temperature. Such exercises can cause a restriction in blood flow to the baby.”

She recommends Pilates for her pregnant clients. “Maintaining a strong core is critical,” she says. “The important issue is keeping the lower back supported and strengthening the hip, pelvic floor and abdominal wall muscles. This assists hugely in the birthing process and speeds up recovery.”

Dr Giles Warrington, a sports and exercise physiologist and lecturer in the School of Health and Human Performance at DCU, has specialised in this field and cites a 2010 report in Sports Medicine Journal and the latest recommendations from the American College of Obstetrics and Gynaecology to support his views.

“It’s been suggested that up to 60% of women are inactive during pregnancy and in the past, the idea of women engaging in regular exercise during pregnancy was discouraged for fear of damage being done to the mother and unborn child,” he says. “More recently, regular exercise has been understood to have positive benefits for both mother and child.”

These include building muscle tone, stamina and strength; improving posture; reducing back pain; decreasing constipation, bloating and swelling; and reducing blood pressure and circulation problems.

“There is also some evidence to suggest that moderate weight bearing exercise during pregnancy can reduce the length of labour and decrease delivery complications,” adds Dr Warrington. “However, in the specific case of Lea-Ann Ellison, lifting weights would be contra-indicated as it may affect blood flow as well as elevating blood pressure.”

Dr Warrington says women who are regular exercisers can continue exercising during pregnancy while those with a new to fitness should start gradually. He recommends 10 to 15 minutes of low-intensity aerobic exercise three times a week, increasing to 30 minutes five times a week as fitness and energy levels start to improve. The exercise can be done continuously or in ten minute bursts throughout the day.

When it comes to exercise, he recommends walking, using an exercise bike, swimming, jogging, low-impact aerobics, light resistance exercises, yoga and Pilates.

Experts advise checking with your doctor before embarking on any new exercise regime while pregnant. “Pregnancy is not a time to try and radically improve fitness levels or over-exert yourself,” says Dr Warrington. “All exercise programmes must be adapted to cater for your individual needs, with the prior approval of your doctor.”

“Every woman is different and every day is different,” adds Clare Rooney. “Listen to your body and it will tell you what it needs.”