We know that exercise plays a key role in helping to stay healthy during pregnancy, and in regaining your pre-pregnancy shape following the birth.  However, how much is too much? Are there any forms of exercise that could harm the baby? What exercises will help tone specific areas?

We asked Dr Joanna Helcké, a multi award winning pregnancy and postnatal fitness expert some of your questions about exercise for conception, pregnancy and post-natal fitness…

Are there any exercises that can help with conception?

The key to exercise and the preconceptual period is moderation. In an ideal world one would wish to put in place a programme of both exercise and healthy eating in the 6 months prior to attempting to conceive, as this will give you the best chances both of conception but also in terms of optimal conditions for your growing baby once you do conceive. Research has shown that excessively vigorous exercise – both for women and men – can have a negative impact on conception and that it is best to stick to moderate exercise. Having said this, it’s worth remembering that what is moderate for one person, will be hard for another and yet again, very gentle to someone else. In other words. “moderate” relates to the baseline fitness that you are starting at.

Are there any exercises that can help specific pregnancy symptoms?  Backache? Swollen Ankles?

Back pain can be greatly improved by certain exercises and forms of exercise in pregnancy. It is well known that simply keeping moving – walking, swimming, general activity – will help alleviate backache. Having said this, please be aware that pelvic pain may well be aggravated by walking. Pregnancy Pilates – with its combination of mobility, postural work, gentle stretching and – above all – toning of the deep abdominal muscles, is exceptionally good when it comes to managing back trouble in pregnancy. It should, however, be added that back trouble comes in many forms and certain exercises which work for some people, should be avoided for others.  One of my blogs gives you some exercises which are particularly helpful for managing back pain

Swollen ankles are a common problem in pregnancy and can be most unpleasant, not least because many land-based forms of exercise, such as walking, become unpleasant to take part in. Nevertheless you need to keep everything moving when you get swelling in the ankles. Swimming and aquanatal will relieve the symptoms, even if only temporarily, and will give you a wonderful feeling of lightness. On a daily basis try and incorporate some exercises for the ankles: flex and point your toes and rotate the ankles at regular intervals throughout the day. You could also consider getting one of those tactile (slightly spiky) rubber massage balls and rolling your feet over it. The aim is to keep everything flowing and the blood circulating.

What is the best exercise to prepare you for labour?

I don’t specialise in exercises which are specifically designed for labour itself but there is no doubt that a birthing ball (fitball) is a very useful tool to have both prior to and during labour. Towards the very end of pregnancy the sheer weight of your bump will cause the lower back to over-arch and the back muscles and become tight and uncomfortable. Once labour commences, back pain is often one of the main symptoms and any movement which can help alleviate it will be beneficial. Using a fitball/birthing ball, you can do pelvic tilts to ease and gently stretch the lower back and you can also do big pelvic circles whilst seated on the ball. Many women find this helps enormously in the early stages of labour. Some advice on using a birthing ball can be found here on my blog.

I love to run, but is there any point during my pregnancy that I should stop?  Any precautions I should take?

Running both during and after pregnancy has become quite a hot topic in recent years with people becoming quite judgmental about it! The fact that you tell me that you “love to run” suggests that this is something that you have been doing regularly prior to falling pregnant. This is key to my advice. If running is your usual form of exercise; if you feel 100% fine and you have no pregnancy contraindications; and if you feel absolutely fine when running, then there is no reason why you should not carry on running at a pace that feels comfortable and doesn’t leave you feeling exhausted or gasping for breath. If, on the other hand, you suddenly find that running feels incredibly hard and you are very breathless doing a run which – in the past – you found perfectly manageable, then that’s the time to slow down, and perhaps take to power walking or even aquajogging.

The key precaution that I would be taking is to listen to your body and to not try and override your feelings. If the body is tired, then don’t run. If you feel fighting fit and perfectly capable of running, then go for it. In my experience most mums-to-be will, at some point in pregnancy reach a point where they no longer feel comfortable running, whether it be due to tiredness or feeling that their bump is too heavy. Another precaution I’d also be taking is to make sure that you do your pelvic floor exercises both during and after pregnancy. Running is tough on the pelvic floor. Pregnancy is tough on the pelvic floor. So that’s not a great combination, so do your pelvic floor work.. every day! A blog post I wrote should be useful in terms of knowing how to judge what is/isn’t safe to do exercise-wise both during and after pregnancy.

Woman running

What’s the best way to get back into exercise after a caesarean?  How soon can I start exercising again?

The very best way to get back into exercise post C section is to start with your pelvic floor exercises. This might not sound too exciting but it will increase the flow of blood to pelvic region and will help speed up the healing process. The good thing is that you’ll be able to start up the pelvic floor work as soon as you want (and remember!) to. There is no too soon…  In terms of more formal exercise and fitness, you will need to wait a good 9-10 weeks and it is also important to see how your wound heals. You mustn’t, for example, start exercising 10 weeks after a C section if your wound hasn’t healed properly. So make sure you use your judgment on this front and ask your health practitioners for advice if need be – you will certainly need to have the green light from your GP.

Once you tentatively start exercising always be aware of how your scar feels : any exercises which pull, tug or cause discomfort should be avoided. In terms of the best way to get back into exercise it’s important to build your fitness from the foundations upwards. This applies to everyone in the postnatal period. If you skip the foundations you build a very shaky “fitness building” and the likelihood is that one day it will fall down. So what do I mean by this? It’s important to put in place the basics: pelvic floor work and strengthening the abdominals – the core – in the RIGHT way. These are your foundations. From there you can start to build up your general strength and cardiovascular fitness step by step gradually increasing the intensity.

I’d really like to get into an exercise routine now that my little girl has arrived, but I don’t want to leave her, what are the best ways to get fit at home to help lose my pregnancy weight?

I find this is really common – many mums don’t fancy leaving their little ones at a crèche and are then left wondering how to get fit again. Don’t worry – there are lots of options. First things first: get out walking with the buggy or even a sling (pack pain permitting) and build things up from a gentle potter to some serious power walking. If possible, include hills in your weekly walks and incorporate intervals too. You may well also find that there are local mother-and-baby fitness classes in your area: they could be buggy workouts, baby yoga or mother-and-baby postnatal Pilates. These are all great options both on the fitness front and in terms of meeting other new mums. I’d definitely suggest making sure that you go to an instructor who is fully qualified to teach postnatal fitness. You can search on this website. if you’d like to also fit exercise in at home when your baby is napping, then online postnatal fitness is a great option. That happens to be what I specialise in, and you are welcome to give it a go to see how you get on. It takes you week by week through the postnatal period with a new video workout every week and there’s an online community too, so it’s sociable! Here’s the link for you: http://www.joannahelcke.com/whats-on-offer/

Will exercise affect my ability to breastfeed/the amount of milk I produce? Is it considered beneficial to breastfeeding mums?

The jury is out on this one. I don’ think any research has definitively shown that exercise affects breastfeeding either positively or negatively and so the general recommendation is to not overdo things. One thing I’d say is that it’s really important to drink regularly when you are exercising and breastfeeding. On another related matter consider investing in a good maternity sports bra. Normal sports bras tend to compress the breast which is something you need to avoid when breastfeeding as you don’t want to give yourself a bout of mastitis. Nevertheless you need the support of a good sports bra, all whilst been able to feed.

Are there any exercises that I should avoid during pregnancy? Are sit-ups ok?

During the first trimester it is fine to carry on doing sit-ups if this is an exercise you are used to doing. Once your uterus grows out of the pelvis in the second trimester, the outer abdominals (the six pack!) which are worked by doing sit-ups, will start to stretch and lengthen to accommodate your growing bump. This is both a necessary and inevitable process and trying to strengthen and shorten them by doing sit-ups is both futile and unnecessary. On the other hand, it is most definitely worth keeping the deep layer of abdominal muscle gently toned – think pregnancy Pilates – as this will help protect against back pain, will improve posture and will also enable you to recover your abdominal tone more quickly postnatally.

I have a history of miscarriage and am concerned that exercising in the early stage of this pregnancy may have a negative impact.  What kind of exercise would you recommend?

To be honest if you have a history of miscarrying and if exercising makes you feel anxious and nervous – which is a perfectly understandable reaction – then I wouldn’t be doing it. Ultimately, one of the key aims of pregnancy exercise is to make you feel better in yourself, so if exercise if having the opposite effect, then it is not worth doing. In instances of multiple miscarriage I always ask mums-to-be to talk things through with their health care practitioners and ask whether or not exercise is advisable. I also ask them to specify exactly what exercise they are considering taking part in (eg swimming, pregnancy Pilates) and to ask their health care practitioners what they think about this specific form of exercise. I am always of the opinion that it’s best to take the belt and braces approach when it comes to safety.

I’ve never been big on fitness, but want to make sure my pregnancy is as healthy as possible and that I’m as prepared as I can be for the birth.  How can I build my fitness levels during pregnancy?

In general pregnancy is not a time to suddenly go on a fitness drive and to start taking up new forms of exercise. So if you’ve never really done much in the way of exercise then you are going to have to ease yourself into exercise gently and I would encourage you to take part in activities which are designed specifically for the antenatal period rather than mainstream forms of exercise. So go for things like walking, pelvic floor exercises (because we all should be doing those1), swimming, aquanatal, pregnancy Pilates and pregnancy yoga.

I love to exercise, but as my pregnancy is progressing I’m getting more and more breathless  – what’s the best way to keep fit without putting too much strain on my breathing?

In general if the exercise you are doing makes you breathless then you need to bring down the intensity. So this might just be a case of taking things more easily in a class that you are going to eg remove the impact, keep the movements smaller and less vigorous etc. See how you feel once you have adapted your current exercise. If it feels OK, stick with that. If not, you’ll need to reconsider the exercise you’re taking part in. If, for example, you are a runner, take things down to a brisk walk. Try shifting over from “mainstream” exercise to pregnancy-tailored exercise. It is usually more gentle and will be designed specifically for the antenatal period.

I have a gym membership which I love and take part in Spin, Body Burn and hot Yoga classes – are any or all of these ok to carry on with during pregnancy?

Spin ClassThere’s no need to put your gym membership on hold. I’d be so sorry if you stopped exercising but you are going to have to reconsider the workouts and classes that you take part in. Let’s start with Spin: I am OK with your doing this class just so long as you keep the intensity at a comfortable level. We all know that it’s possible to go crazy in spin and really work very hard. Now is not the time. So ease off the resistance and don’t go full out when the instructor tells you to sprint. You now have licence to take things steadily. That is the safe thing to do. There will come a point when spin won’t be comfortable anymore because – yes you guessed it! – there’ll be a bump in the way. Once that happens you’ll have to start using the reclining bicycle in the gym area as it will provide you with more room for the bump!

Let’s look at hot yoga (Bikram yoga) now. The short answer is this: don’t do hot yoga in pregnancy. Why? Because your body will heat up – of course – but whilst YOU can regulate your body temperature your foetus cannot. If your growing baby overheats and cannot cool down this can be harmful and could do damage. In short, hot yoga is off the agenda for now.

Body Burn is not a class that I am familiar with but you should apply the same principles as mentioned above when judging whether or not you can and should take part in this class i.e. does it make you excessively breathless? Does it make you feel terribly hot and sweaty? Does it exhaust you? Does it involve lots of abdominal exercises like planks, side planks, crunches and sit-ups?

How does pregnancy exercise impact on my baby?  If I’m out of breath, will the baby suffer at all?

There has been some research suggesting that if you exercise at an extremely high level of intensity that your baby may have reduced levels of oxygen going to him or her but this work is not clear cut and further research is required. In general the recommendation is that moderate exercise has a positive impact on both you and your  baby, so as long as there are no specific contraindications then do carry on exercising at a reasonable level of intensity. Breathlessness is common in pregnancy and you might well find yourself feeling breathless simply going up a flight of stairs. Rest assured that this is not going to cause your baby to suffer. However, I wouldn’t advise your taking part in a prolonged activity that leaves you breathless throughout.

Are there specific exercises I can do to get rid of my post pregnancy tummy? How soon can I start them?

Yes, there are exercises that you SHOULD be doing to help your postnatal tummy, as well as exercises that you should be avoiding. Your very first step is to check whether or not you have an abdominal separation and if so, to what extent. Having ascertained whether or not you have an abdominal separation you’ll then be able to judge what exercises to do/not do. If you have a gap of 2+ fingers then it’s vital that you do not do traditional abdominal work such as sit-ups, rotation sit-ups, planks and side planks. These exercises will make matters worse. By contrast, you can help things by combining the right sort of deep core abdominal work alongside eating a balanced healthy diet.

Some of the machines at the gym measure heart rate.  What should your heart rate be during exercise and should it be higher in pregnancy or the same as before pregnancy?

In general it’s not advised to use the heart rate monitor during pregnancy. Instead we use the “talk test” which is easily done – simply see if you can talk whilst performing your exercise. If you find yourself gasping for breath half way through a sentence then slow down and take things more easily.

Is there any clothing or equipment that you can recommend for exercising when pregnant or breastfeeding to support the bump/boobs?

Investing in a good maternity sports bra is a good idea. Normal sports bras tend to compress the breasts which is something you need to avoid when breastfeeding as you don’t want to give yourself a bout of mastitis. Nevertheless you need the support of a good sports bra, all whilst been able to feed . In terms of fitness clothes, many mums-to-be tend to go down the baggy T shirt route (I’ve noticed) but if you’re a fitness fiend and want to feel good about yourself and your changing shape, then I’d definitely encourage you to invest in some maternity fitness wear that you feel good in. I think it’s worth it psychologically. It’s not so easy seeing your body change shape so having some lovely maternity wear when exercising will make you feel great.

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