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Exercising in water during pregnancy

The American College of Obstetricians and Gynecologists (ACOG) recommends moderate exercise at least three times a week during pregnancy to enhance maternal fitness and well-being. The ACOG also defends the practice of regular, moderate physical activity even for sedentary expectant mothers or for those with slight complications such as gestational diabetes. Absolute and relative contraindications to the practice of exercise must, nevertheless, be respected, including for instance multiple gestation, higher risk of premature labour, incompetent cervix, bleeding during pregnancy, severe heart diseases and fetal growth restriction.

Exercise in water offers several health benefits to pregnant women.
The top 10 benefits of exercising in water include:

1. Water exercise is fun!
Water allows women to enjoy a good workout as the buoyancy of water supports the woman. When in neck-deep water the body weight feels about one-tenths of what it does on land, meaning that you will be able to exercise more freely, doing more repetitions easily than you would on land. Most importantly water exercise will help pregnant mothers to sleep better and improve their mood. Exercise is linked to decreased incidence of depression and anxiety and increased self-esteem, enhanced body image and a greater sense of control

2. Water exercise is safe
Water exercise is suitable throughout the whole pregnancy as it allows the women to exercise safely and freely as her body changes and grows. There is no risk of falls and risks of injury are low as there is less weight bearing on the joints. Also if a woman already has pelvic girdle pain, it is a safe exercise to help in strength and pain reduction.

3. Water exercise promotes strength, flexibility and core stability
A water based exercise programme includes a warm up, workout with stretching and relaxation exercises at the end of each session. The exercise programme in water makes use of the resistance provided by the water to train and strengthen upper limbs, lower limbs and abdominal muscles. Water provides resistance to the abdominal and lower back muscles. Therefore the abdominal muscles can be challenged with specific exercises that allow the pregnant women to strengthen the core and maintain a neutral posture. Water allows for a large variety of abdominal muscle training because the pregnant body can move in ways not possible on land. In addition floats and weights can be used for added strength training.

4. Water exercise enhances cardiovascular fitness
Cardio-vascular fitness is maintained or improved in women who exercise while pregnant. All studies that have examined the effect of regular exercise in pregnancy conclude that it is important for maternal fitness.

5. Water exercise helps in reducing swelling
Research has shown that even standing in water for 20 minutes has a positive effect at reducing leg swelling. Water exercises have a better effect at reducing such swelling than simply elevating the legs or just standing in water.

6. Water exercise reduces low back pain
Water based exercises have been shown to be of great benefit to pregnant women with low back pain and in fact research has shown that women who attend supervised water exercise classes tend to need less sick leave days because of low back pain. Exercising the core allows women to have improved posture and body mechanics throughout pregnancy helping to decrease back pain.

7. Water exercise eases minor discomforts
Movement aids the digestive system to function better and can have an effect in easing constipation that is very common during pregnancy. Exercise also allows for improved bladder control in pregnancy, decreased incidence of varicose veins, improved sleep, less heartburn and fewer leg cramps

8. Water exercise helps in keeping a healthy weight throughout pregnancy
Exercise in pregnancy together with a healthy diet will allow the new mother to control the weight gained, which in turn will help to get back to pre pregnancy weight more quickly. Exercise is also recommended for mother with gestational diabetes mellitus, a high blood-sugar condition that can complicate 4–12% of pregnancies. The developed world is seeing an increased incidence of gestational diabetes in line with the rise in obesity. In addition, recent evidence shows that expectant mothers who gain weight early in pregnancy may be at increased risk of gestational diabetes. Physical activity is one way to help break the pattern of gestational diabetes, childhood obesity and adult diabetes. A physical activity programme of moderate intensity during pregnancy improves levels of maternal glucose tolerance.

9. Water exercise has cooling benefits
Pregnant women have an elevated core temperature and must be cautious about overheating themselves during exercise. Water that is of an appropriate temperature cools the body effectively during sustained exercise. Proper hydration throughout exercise is very important.

10. Exercise during pregnancy is linked to faster recovery post natal
Women who exercise throughout their pregnancy are found to have shorter births with less medical interventions. Postnatal recovery is also quicker allowing women to get to their pre-pregnancy shape faster. When you are strong and healthy during pregnancy you are better equipped to deal with the physical demands of childbirth.

Carolyn Sultana
Women’s Health Physiotherapist

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