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By Dr Dane Vishnubala MBBS MRCGP PGCME DipSEM (UK&I) MFSEM PGDipSEM FHEA

I see a number of pregnant women in my clinic and it’s one of the few times in medicine where it’s a truly happy occasion. From a health point of view, this is also a great time for behaviour change. How can we help the expectant mother to be more active? How can we encourage her to eat better? How can we support her to stop smoking or change any other poor lifestyle habits?

I feel pregnancy is one of the best times for all health care professionals and fitness professionals to really influence and change the behaviours of the mother-to-be. With this in mind, the latest infographic released in June 2017 showing physical activity and pregnancy is important. As with the other infographics, the key aim here is to provide evidence-based guidance to health care professionals. The infographics have been a huge success in terms of exposure. In case you haven’t seen them, here are the adult and children’s infographics on physical activity (click the images for larger versions):

The pregnancy and physical activity infographic is the latest in the line of infographics. The infographic is shown below (click the image for a larger version):

The development of this infographic involved two phases of work. The phases of work involved doing a review of the current research and a scoping exercise of current advice given. As a fitness professional, understanding the reasoning and decision-making process behind guidance is key.

We all know physical activity has multiple benefits but many of these are thrown around without significant evidence. The review found four key outcomes with definite positive effects in pregnancy. These outcomes were:

  1. Reduction in hypertension disorders
  2. Improved cardio respiratory fitness
  3. Lower gestational weight gain
  4. Reduction in the risk of gestation diabetes.

A key thing to note is that the review found physical activity had NO significant effect on the duration of labour. This is still a commonly used reason in our industry to promote physical activity in pregnancy. So, while it’s important and has many benefits, we must take care and constantly re-evaluate what we ‘sell’ to ensure we can back up our statements.

From the report linked to the infographic, there are five key safety messages:

Safety message 1: No evidence of harm (maternal or infant)

This is an important thing to get across to any newly pregnant patient or client. Reassuring them that they cannot harm their baby is a key message that must be understood before further progress can be made.

Safety message 2: Listen to your body and adapt

Regardless of recognising and being aware of key ‘dos and don’ts’, any programming or advice should have the patient or client at the centre of it. Pregnancy is not a good time to encourage them to ‘push through’. Listen carefully to maternal feedback and adapt and react accordingly with programming.

Safety Message 3: Don’t bump the bump

Trauma to the baby is always a risk. We must look at our programming and consider the environment, equipment and training methods to ensure we have reduced risk where possible.

Safety Message 4: Obstetric and Medical Complications

If a client has a complication or they are higher risk due to having an absolute contraindication or a relative contraindication, then further health care input and advice need to be sought before proceeding. Check out the American College of Obstetrics and Gynaecology (ACOG) Committee opinion on exercise and pregnancy.

Safety message 5: Keep cool, comfortable & hydrated

Hydration and maintaining normal body temperatures are important. Overheating could be harmful to the unborn baby. Therefore, we must always consider temperature, humidity as well as hydration and the effect they may also have on the intensity we can programme for that session.

All the infographics go back to the key message that as a largely inactive population we need to be encouraging the basics first. This includes free accessible and easy to carry out activity. This does not need to be ‘over medicalised’ as long as some key safety aspects are considered. In a fitness industry environment however we have a responsibility to our clients to ensure we understand not just the benefits and the basic safety tips but rather all the finer details that allow us to programme effectively and adapt classes.

Key Fitness Instructor Tips

  1. Ensure you take a detailed history about the pregnancy
  2. Find out about the client’s ideas, concerns and expectations
  3. Reassure early where appropriate
  4. Ask about all absolute and relative contraindications to exercise (see ACOG)
  5. Keep a secure record of your consultation, programmes and client responses.

If you would like to learn more there are also some fantastic consensus statements published in the British Journal of Sports Medicine

As with all our qualifications, the Active IQ team, including myself, are happy to discuss any aspect of pregnancy and physical activity in more detail with you,

Dr Dane Vishnubala MBBS MRCGP PGCME DipSEM (UK&I) MFSEM PGDipSEM FHEA
Active IQ Chief Medical Advisor
@danevishnubala

 

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