The podcast discusses exercise recommendations before, during, and after pregnancy, including resistance training and restrictions on exercising. It explores the consequences of excessive weight gain and low physical activity during pregnancy, as well as the importance of preconception care. The speakers also talk about the discrepancy between self-reported activity and device-monitored activity and the lack of counseling on exercise for pregnant individuals. Additionally, they address the potential risks and benefits of physical activity during pregnancy.
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Quick takeaways
Exercise recommendations during pregnancy should be individualized based on pre-pregnancy activity levels, strength, and cardiovascular fitness.
Aerobic exercise is generally safe during pregnancy, with a focus on engaging in exercises that the individual feels comfortable with while minimizing risks.
Using the Rate of Perceived Exertion (RPE) and Talk Test can help individuals gauge and adjust exercise intensity during pregnancy.
Deep dives
Guidelines for Resistance Training during Pregnancy
The American College of Obstetrics and Gynecology recommends resistance training at least twice a week, hitting all major muscle groups through a full range of motion. Some previous restrictions, such as avoiding heavy weights, avoiding numerous reps, and avoiding isometric exercises, have been questioned and are not well supported by evidence. Recent studies did not find any negative effects on fetal blood flow during resistance exercises, including heavy lifting. Individualizing exercise recommendations based on a woman's pre-pregnancy activity levels, strength, and cardiovascular fitness is important.
Recommendations for Aerobic Exercise during Pregnancy
Aerobic exercise is generally safe during pregnancy, and women should avoid activities with a high risk of falls or blows to the abdomen. There are no specific heart rate recommendations, and the need for temperature restrictions during exercise is unclear. While altitude and diving restrictions exist, they are unlikely to affect most pregnant women. The focus should be on engaging in aerobic conditioning exercises that the individual feels comfortable with, while taking sensible precautions to minimize risks.
Contradictions and Precautions
The use of absolute and relative contradictions for exercise during pregnancy has decreased in recent guidelines. Most contraindications are rare and would be identified during routine prenatal care. The decision to exercise should be individualized based on the woman's specific circumstances and risk factors, with regular prenatal care providing a framework for addressing any concerns. Some recommendations, such as avoiding supine positions and sleep positions, are based on theoretical risks but are not well-supported by evidence.
Importance of Using RPE and Talk Test
The podcast episode discusses the importance of using the Rate of Perceived Exertion (RPE) and Talk Test in determining exercise intensity. RPE originated in the 1950s with the Borg Warner scale, which correlated RPE ratings with actual heart rates. National guidelines recommend using RPE and the Talk Test, which assesses the ability to talk in complete sentences during exercise. These tools help individuals gauge and adjust their exercise intensity based on their own subjective perceptions.
Benefits of Exercise during Pregnancy
The podcast highlights the numerous benefits of exercise during pregnancy. These include preserving or improving physical conditioning, reducing weight gain, lowering the risk of developing diabetes or high blood pressure, improving mood, reducing the need for cesarean delivery, and decreasing the incidence of urinary incontinence. Exercise also promotes better oxygen transfer to the fetus, improves fetal brain development, and may lead to higher IQ in children. Contrary to popular belief, exercise does not significantly increase the risk of miscarriage, poor fetal growth, musculoskeletal injury, or premature delivery for women with uncomplicated pregnancies.
In this week's podcast, Drs. Loraine Baraki and Jordan Feigenbaum discuss exercise recommendations before, during, and after pregnancy. Nuance included!
Research:
https://link.springer.com/article/10.1007/s42000-018-0085-6
https://pubmed.ncbi.nlm.nih.gov/16534041/
https://bjsm.bmj.com/content/52/17/1080.abstract
https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period
https://pubmed.ncbi.nlm.nih.gov/33709855/
https://pubmed.ncbi.nlm.nih.gov/33394898/
https://csep.ca/2021/05/27/get-active-questionnaire-for-pregnancy/
https://bjsm.bmj.com/content/52/21/1339
https://ywcavan.org/sites/default/files/assets/media/file/2021-01%20/parmed-xpreg.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843064/
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