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ACOG guidelines for exercise during pregnancy

The American College of Obstetricians & Gynaecologists (ACOG) published Guidelines for Exercise During Pregnancy, which have become the accepted stanard for fitness training when pregnant....

exercise during pregnancyThese guidelines describe the safe limits for frequency, intensity, duration, and type of exercise during pregnancy, and aim to ensure a healthy birth outcome, as well as avoiding injury and complications during the course of the pregnancy.

Following more research ACOG released a Technical Bulletin in 1994 as an update to the original 1985 guidelines. This bulletin did not replace the original guidelines, so both are still applicable and used by health professionals. However, it is widely accepted that the 1985 ACOG guidelines err on the conservative side, and it is evident from research after this time that more latitude can be taken with exercise intensity than stated in the original guidelines.

Contraindications – who should NOT exercise during pregnancy

Exercise during pregnancy is ideal for women who are considered low risk, but if you have specific conditions that affect your and your baby’s health then exercising while pregnant may not be safe. Note that pregnancy is not the time to be pushing your fitness limits and going for personal bests! If you are currently unfit or inactive then a cautious approach will be the healthiest and safest path, if you are currently fit and active then a maintenance program will be appropriate for you.

The following conditions are absolute contraindications to exercise during pregnancy published by ACOG, where exercise is not recommended:

• History of three or more spontaneous miscarriages
• Ruptured membranes
• Premature labour
• Diagnosed multiple pregnancies eg twins, triplets etc
• Intrauterine growth retardation (baby is smaller than expected)
• Incompetent cervix (cervix becomes softer and more open than normal)
• Placenta praevia ( portion of the placenta sits over the cervix making it more vulnerable to detachment)
• Pregnancy-induced hypertension
• Venous thrombosis or pulmonary embolism (clots to legs or lungs))
• Known cardiac valve disease
• Primary pulmonary hypertension
• Maternal heart disease

Relative contraindications – doctors clearance required to exercise

• Hypertension
• Anaemia
• Thyroid disease
• Diabetes
• Extremely over or under weight
• Extremely sedentary
• Breech presentation in third trimester
• History of bleeding during pregnancy

Activities to avoid when pregnant

Even if you are healthy or cleared by your GP to exercise during pregnancy, you should avoid the following activities due the risk of abdominal trauma and possible musculoskeletal injury:

• Contact sports or activities which involve a high risk of falling eg horse riding, rock climbing, gymnastics, water skiing, surfing, basketball, football, netball, hockey, skiing, etc.

Additional tips for pregnant women

• Be aware that your balance, strength, and agility will all be affected by your pregnancy, especially in the later stages. What was possible before pregnancy will be now more challenging and you need to be aware and careful of taking unnecessary risks.

• Listen to your body as much as possible – if you feel tired, unwell, or not in the mood for exercising it is a good idea to rest and not to be training!

To find out more about ACOG guidelines, exercise during pregnancy, pre natal fitness or post natal fitness, please contact us!


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