Health and Fitness During Pregnancy

Pregnant woman drinking water

Regular exercise is perfectly safe for most women well into their pregnancy. Paula Radcliffe was in the press a lot when she was pregnant. She told one newspaper that she was running 14 miles a day, the Daily Telegraph reported her 10km charity run while seven months pregnant.

The NHS advise to carry on doing your usual fitness activities for as long as it feels comfortable. This really makes sense as prehistoric women would not have had the luxury of putting their feet up for 6 months, they would have been hunting, gathering, migrating and generally very active.


So if you are fit already then the best advice is to stay active. Exercise during pregnancy is safe, with the exception of some extreme exercise (force marching for example) . Heavy lifting and stomach exercise should be avoided though, we discuss this further below.

As for nutrition, women should not “eat for two”. Many women gain weight during pregnancy simply because they eat far too much food and excessive weight can make child birth more difficult. So eat normally, with a few extra snacks, but do not consume vast amounts of food  – definitely do not eat 2 portions of each meal!

What is more important during pregnancy is that you follow a healthy and balanced diet that consists of a variety of fruits, vegetables, dairy, fish and meat to give you all the nutrients that you and your baby require.

There are some foods you should avoid though as these pose greater risk of infection. Generally patés, raw eggs, mould-ripened soft cheeses, liver, raw shellfish, unpasteurized milk, peanuts, coffee, unwashed vegetables and some cold meats and smoked fish should be avoided.

Nutritional Considerations During Pregnancy

During pregnancy your body requires a rich supply of protein, vitamins and minerals to nourish both yourself and your developing child.

It is important for an expectant mother to eat a good healthy diet that is well balanced and contains foods from all the major food groups.

Eating for two is an old wives tale, and is not recommended. But eating well is essential. Quality of food is far more important than quantity.

Weight gain during pregnancy is expected, and the optimum weight gain in pregnancy is 12.5 kg (27 lbs). However, in practice different women gain different amounts and many women who don’t fall within this range still go on to give birth to healthy babies.

Weight gains substantially more than 12.5 kg in women of normal weight before pregnancy are unlikely to reflect an increase in fetal weight, maternal lean tissue or water. Rather, the excess weight is a gain in maternal fat.

Because of this, concerns have been expressed that excessive weight gain can lead to overweight and obesity. Your doctor or midwife will advise you about weight gain, but it’s important that you don’t ‘diet’ during pregnancy.

Key Health Nutrition Advice for Pregnant Women

  1. Take a folic acid supplement providing 400µg per day for the first 12 weeks of pregnancy.
  2. A healthy balanced diet provides all the nutrients that most pregnant women need, but some may require supplements.
  3. If supplements are used, the best choice is a specially-prepared formula for pregnancy.
  4. Supplements containing vitamin A should be avoided.
  5. Pregnant women should not eat liver, dishes containing raw or partially cooked eggs, or soft or blue-veined cheese, and should limit alcohol to 1 to 2 units once or twice a week. Preferably it is best to avoid alcohol all together.
  6. Be scrupulous about food hygiene.
  7. The average weight gain during pregnancy is 12.5 kg, but there’s a huge variation among individuals. Watch your weight gain, and speak to your midwife if you’re concerned. Do not diet while pregnant.

A Balanced Diet for Pregnancy

Most of the additional nutrient needs of pregnancy can be met by eating a well-balanced and varied diet. With a few exceptions, you can continue to eat a normal, healthy diet. This includes regular meals and snacks. A sensible healthy eating regime containing:

  1. Plenty of starchy carbohydrates – bread, rice, pasta, breakfast cereals, chapattis, couscous and potatoes.
  2. Plenty of fruit and vegetables – at least five portions a day.
  3. Lots of milk, yoghurt, fromage frais and pasteurised cheeses.
  4. Enough protein, such as meat, fish, eggs (well-cooked), beans and pulses.
  5. Not too many fat-rich and sugary foods.
  6. Aim to have at least eight glasses of fluids per day.

Really, your diet during pregnancy should not differ to greatly from a health well balanced diet at any other time in your life. People that follow a healthy lifestyle do not need to make many changes when becoming pregnant.

It is those who smoke, drink a lot of alcohol, and eat a very unhealthy diet, that have to make a lot of changes, and feel that they are making sacrifices.

It is also worth remembering that if you are planning to conceive, then a healthy diet is also essential. Healthy people generally conceive quicker than unhealthy people – and that rule applies to male partners too!

Heavy Exercises During Early Pregnancy Associated With Miscarriage

Danish research shows that women who practice heavy exercise during early pregnancy are at a higher risk of miscarriage then women who do not exercise at all.

This research took place at the University of Southern Denmark, where scientists questioned more than 90,000 women about their exercise routine and associated it to the result of their pregnancy.

The research suggests that practicing high impact exercises, such as jogging, ball games and racket sports during pregnancy can increase the risk by three and a half times, compared to women who do not practice any exercise. Also women that exercise for more than seven hours a week are also putting themselves at an increased danger of miscarriage according to the research.

Miscarriage is more likely to happen during the first trimester of pregnancy, so after eighteen weeks into the pregnancy the association between exercise and miscarriage recedes.

This research was published in the British Journal of Obstetrics and Gynaecology, where authors confirmed that the results of this study suggested that “leisure time exercise during pregnancy, and particularly high-impact exercise, is associated with an increased risk of miscarriage in the early stage of pregnancy.”

In spite of this, the guidelines from the government in the UK are for women to carry on with moderate exercise throughout the pregnancy if possible. This issue is controversial, as some experts in the UK have disputed this research by saying that running is safe during pregnancy after all.

Although, it is not recommended to perform any sport activity, which involves a high impact to the abdomen of a pregnant woman, some experts say that women can continue to run or jog during early pregnancy. It is all about keeping the balance and do not do take up any new activity, which may strain the body.

The research concluded that not all type of exercises contribute to miscarriage, swimming for instance is considered to be a suitable type of physical activity very popular between pregnant women.

The government in the UK recommends that pregnant women should continue with their normal exercise practice as long as they feel comfortable, women should listen to their bodies and respect their limits in order to avoid any physical strain during pregnancy.

So, women that did not do any exercise before getting pregnant should start some moderate daily exercise, in order to increase their health and fitness, as well as improve their cardiovascular system and maintain the muscle tones, which can be helpful during labor.

But, women should not at any point start a laborious exercises regime, which is new to them, as this can be harmful to their health and the baby’s health putting their pregnancy at risk.

Pregnant Women are Advised to Stop Drinking Alcohol Entirely

Official advice on alcohol consumption for pregnant women seems to change every year. Not so long ago women were advised that a glass of wine a day was not a problem, then the advice changed to say that drinking during the first three months was not recommended, as no-one really knew what effect alcohol may have on the developing fetus. In 2007 the UK government suggested that alcohol consumption should cease completely.

“In May 2007 the Chief Medical Officer made two essential points. First, that pregnant women, or women trying to conceive, should avoid drinking, and I wish the evidence was much clearer because it would make the discussion around alcohol consumption generally easier, not just for pregnant women, but then he went on to say that if they choose to drink they should really try and minimize risk by not drinking”. Dawn Primarolo, 2007.

Ethanol (from alcohol) does affect the mental and physical development of the developing fetus and around 1 in every 1000 birth defects are thought to be related to alcohol consumption.


Some doctors say there is evidence that even very small amounts of alcohol can damage the health of the unborn child. Dangers include fetal alcohol syndrome, which affects around 100 babies a year, causing low birth weight, flattened features, heart and kidney abnormalities, deafness and brain damage. In addition, as many as 7,000 British babies a year are affected by the less serious fetal alcohol spectrum disorder, which causes attention deficit disorder, hyperactivity and poor co-ordination.”

We at Motley Health have always stuck by the rule of no alcohol while pregnant, and will be glad when government guidelines follow suit and make it clear that any amount of alcohol could potentially harm an unborn child. For those that always like a drink, just ask yourself, how would you feel if you gave birth to a child with learning difficulties, and later found out it was because of one glass of wine too many while you were pregnant.

Is one drink worth the risk? We do not think so. Celebrate after you have given birth to a health baby by all means, but while carrying your child, do all that you can to keep healthy. To some extent everything that you consume is passed on to your baby, so make sure you only consume healthy food and drinks.

Obesity and Pregnancy – More Women Putting Themselves At Risk

Research from the Centre for Maternal and Child Enquiries (CMACE) has found that women who are obese are putting both themselves and their unborn babies at risk. Latest statistics show that around 5% of all pregnant women in the UK are class 2 or 3 obese (BMI over 35). Increased obesity raises risk of still births, blood clots, high blood pressure and excessive bleeding after birth.

There is still the outdated idea that when pregnant a woman needs to “eat for two”. Some women take this seriously and end up eating far too much. Many women are obese before they get pregnant too.

Obese Pregnant Women Suffer Health Risks

If a woman’s BMI is over 30 then she is at greater risk from several different conditions which can be very dangerous during pregnancy.

Blood clots during pregnancy are one of the greatest risks, as well as severe bleeding after birth. High blood pressure also poses risks to the health of the baby and mother. 38% of women with a BMI over 35 suffered postpartum haemorrhaging (PPH), which is 4 times the rate of an average mother.

The most common problems amongst obese pregnant women are pregnancy-induced hypertension and gestational diabetes.

More Time in Hospital

Obese women spend on average up to a week recovering in hospital, compared to 1 or 2 days for healthy women.

46% with BMI over 50 Deliver by Caesarean Section

As well as the ongoing health problems during pregnancy, 46% of women with a body mass index over 50 fail to deliver naturally and instead have to have a caesarean section. This process becomes more difficult when obesity increases, with greater risk of surgical problems. Also, not all hospitals cater for women over 150kg with many delivery beds not being able to take such a large weight.

Increased Risk of Still Birth

With each 1 point increase in BMI there is a 7% increase in the risk of a still birth.

“BMI categories 35.00-39.99, 40.00-49.99 and ≥50 had stillbirth rates of 7.9, 8.8 and 15.8 per 1000 singleton births”

CMACE Recommendations for Improved Health

Preconception counseling and support, both opportunistic and planned, should be provided for women
of childbearing age with a BMI ≥30. This advice and support should be available in both Primary care and
Secondary care. Pre-pregnancy counseling should include:
  • Accurate height and weight measurement and BMI calculation
  • Consideration given to screening for type 2 diabetes
  • Provision of information about the risks of obesity in pregnancy and childbirth
  • Advice and support to lose weight prior to conception
  • Advice on appropriate supplementation prior to conception (5mg folic acid and 10µg vitamin D), as recommended by NICE.

Really everyone should make an effort to lose weight and get fit. It is however especially important for pregnant women. Many people cannot receive life saving surgery until they lose weight, however pregnant women have no option but to go into surgery when their baby is due. This means that C-sections have many risks which are not seen to a great extent amongst healthier women.

Reminder: Do Not Eat For Two!

It is important that the message is spread that most people are already eating too much food everyday, so becoming pregnant does not mean you should eat even more. When the “eat for 2” advice was first given people were more likely to be malnourished than overweight. We now live in a land of plenty, in fact it is too plentiful for our health.

References

Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort” by M Madsen,a T Jørgensen,a ML Jensen,a M Juhl,a J Olsen,b PK Andersen,c and A-M Nybo Andersen. BJOG. 2007 November 1; 114(11): 1419–1426.

National Institute for Health and Clinical Excellence – Health Committee Contents – Examination of Witnesses (Questions 720 – 739)” 8 November 2007. www.parliament.uk

Exercise in pregnancy” NHS Choices, reviewed on 4 March 2011.

Have a healthy diet in pregnancy” NHS Choices, reviewed on 25 Feb 2011.

Paula Radcliffe finishes 10km charity run while seven months pregnant” Telegraph.co.uk. 5th July 2010.

CMACE release: National enquiry into maternal obesity – Implications for women, babies and the NHS

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