Pre-Pregnancy Physical Activity
Pregnancy comes with natural changes all over our body - some of the changes, but not limited to, are changes in women’s body weight, body composition, hormonal profile, fluid retention, and elasticity of passive structures. These changes, even though they are part of the natural process that prepares both the mother and the fetus for nurturing and growth, can also cause some challenges that a mother may face. We will explore a few of the challenges and the reasoning why it is beneficial to be proactive with physical activity prior to pregnancy.
BMI/Weight Gain - Weight gain during pregnancy is well expected, initially due to the mother’s physiological changes and later on primarily due to the growth of the fetus. Pre-pregnancy obesity, which is characterized by a high BMI, may be associated with conditions that are not limited to: gestational diabetes, pregnancy-induced hypertension, and other complications related to both mother and fetus health. Because high BMI can be a risk factor for pregnancy-related complications, becoming physically active for the purpose of losing weight can be essential.
Abdominal Pressure and Urinary Incontinence - Abdominal pressure increases primarily in the second and third trimesters due to fetal growth, which also increases the demands on pelvic floor muscles. In addition, our abdominal pressure rises when performing daily movements, such as lifting weight from the floor or even getting up from a chair. Practicing resistance training with a focus on pelvic floor muscle exercises may be beneficial for improving the strength and neuromuscular coordination needed to manage high abdominal pressure during pregnancy. Women who were physically active prior to pregnancy, with an additional focus on pelvic floor muscle training, showed a 62% reduced risk of experiencing pelvic floor dysfunction during late pregnancy.
Pain - As pregnancy progresses, there is an increase in physical demands on the body, a change in body mechanics, and changes in tissue flexibility. All of these can lead to higher loads on certain areas of the body, often leading to the experience of pain in pregnancy - primarily in the lumbopelvic area. Participating in a resistance training program to improve tissue conditioning prior to pregnancy may help reduce the risk of experiencing musculoskeletal-related pain during pregnancy.
Bone Health - This is usually not a significant limitation that we associate with pregnancy, but for some women, particularly underweight women, this can be a limitation as bone density tends to decrease during pregnancy and may be a risk factor for osteoporosis for certain women. Participation in physical activity is known to be highly beneficial - primarily heavier resistance training - to improve bone health and start from a higher reserve.
References:
Bø K, Nygaard IE. Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review. Sports Med. 2020;50(3):471-484. doi:10.1007/s40279-019-01243-1
Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12(12):CD007471. Published 2017 Dec 22. doi:10.1002/14651858.CD007471.pub3
Owe KM, Bjelland EK, Stuge B, Orsini N, Eberhard-Gran M, Vangen S. Exercise level before pregnancy and engaging in high-impact sports reduce the risk of pelvic girdle pain: a population-based cohort study of 39 184 women. Br J Sports Med. 2016;50(13):817-822. doi:10.1136/bjsports-2015-094921
To WW, Wong MW. Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound. Arch Gynecol Obstet. 2012;286(2):357-363. doi:10.1007/s00404-012-2315-5
