Serena Williams defeated her sister in yet another tennis final two weeks age ( the expected) then did the unexpected announcing she was currently five months pregnant with her first child. Of course this announcement gleaned international headlines for its impact value but should it? Just a month earlier a published study on exercise in pregnancy in the prestigious Journal of the American Medical Association JAMA received very little fanfare. Certainly the subject of sport and exercise in pregnancy deserves attention for several reasons. Obesity is rampant in Canada and half the population is female. Obesity is historically recognized as a risk factor for both mother and foetus as is excess weight gain during the pregnancy.
I’m not convinced Serena Williams is the best poster model for fitness in pregnancy. The idea of taking a 120 mile an hour tennis ball served to the midsection concerns me as is the risk of hockey pucks to the midriff but I do concede her skill level makes this contact highly improbable. But there are substantial reasons to initiate an exercise program before pregnancy and continuing during. Beginning with a statistical history, there is a large body of evidence women who limit their weight gain to proscribed Body Mass Index increases during every pregnancy are far less likely to require Caesarean section delivery and experience post delivery bladder dysfunction and possible surgical repair. There is also absolutely NO place in 21st century medicine for the homily pregnant women need to eat more and be less active.
I strongly believe All types of sports within reason are acceptable during pregnancy with the operant word being reasonable. I exclude all impact sports and yes, skydiving too! Canada Fitness guidelines are available on line. Another group of fitness activities to avoid include those with a potential for falling such as horseback riding, cycling and rock climbing. For those with pregnancy as an incentive to finally get off the couch, start with walking. Begin by parking your car a few blocks distant from your workplace. Monitor your heart rate and respirations. Avoid any competitive exercise. The goal is a 9 month marathon not a sprint. For those inclined to group activity, fitness classes and yoga and Pilates with qualified instructors are definite options
There are exceptions to these guidelines involving the “higher risk pregnancy”. Any activity for this group MUST involve medical supervision in advance of initiating any program. One of the reasons for early ultrasound is to determine low lying placenta position associated with early bleeding and premature cessation of the pregnancy. And finally, for that unfortunate small group of women with a history of multiple miscarriages, I would caution about avoiding what are known as Valsalva manoevres that occur when the pressure inside the abdomen increases excessively such as occurs in heavy weight lifting in squat position. The sensation is equivalent to forced exhalations blowing up an air mattress. And finally, in an era when everything seems to be a risk factor, remember pregnancy is a physiologic event not a disease. So exercise with common sense and common sense in your fitness program.
Dr. David Carll