It is no secret that the health benefits of routine physical exercise are many. Working out improves your mental health, helps with weight control, boosts your energy levels, improves sleep, and can prevent the onset of many medical conditions like diabetes, hypertension, and high cholesterol. These health benefits continue even during pregnancy, with evidence that working out can improve both antenatal and postnatal health of the baby and mother.
Despite the known benefits of exercise in pregnancy, I am continually asked one specific question by friends and patients. Is childbirth going to be easier because I am working out?
While every woman, every labor, and every postpartum course are different, here is what we do know about exercise and childbirth:
1. Being in good shape before and during pregnancy may decrease time in labor.
The first stage of labor is that period of time between the onset of labor and complete cervical dilation. The first stage of labor can be influenced by many factors, including maternal age, how many babies you have had, and the weight of your baby.
One factor that has a negative impact on the length of labor and can be modified by routine exercise in pregnancy, especially in first-time moms, is a higher maternal weight at the time of delivery. In other words, routine exercise can limit the possibility of excessive maternal weight gain during pregnancy and potentially shorten the first stage of labor. Finally, a recent study from Spain in 2016 looked at 166 pregnant women, with half participating in an exercise program for 55 to 60 minutes, three days per week. The results of this study showed that a routine exercise program alone during pregnancy is associated with a shorter first stage of labor.
2. Routine exercise during pregnancy can improve your endurance during labor.
Labor, whether short or long, can be very physically and mentally stressful. Having the ability to manage the long hours, pain, and uncertainty of such an important life event is essential. Oftentimes labor is a marathon and not a sprint. This can seem daunting and intimidating to many women, especially first-time moms.
Routine physical exercise, particularly cardiovascular exercise, can have a significant impact on your ability to tolerate the labor process. Many women who maintain routine physical activity are no stranger to vigorous activity and pushing their limits, which takes both endurance and a strong mindset. Both of these qualities can be extremely beneficial during childbirth.
3. Maintaining a movement practice during pregnancy can improve your postpartum recovery.
Being in good physical shape before and during pregnancy does have an effect on your postpartum recovery. Not only will you seem to bounce back quicker than your non-physically active counterparts, but the baby weight will come off faster and your mood will be better. You will most likely be able to resume your workout routine after clearance by your doctor and pick up close to where you left off even if you had to modify your routine or even stop working out altogether near the end of your pregnancy.
More importantly, there is some evidence that routine physical activity during pregnancy may decrease the risk of antenatal and postpartum depression, which can have a significant impact on both maternal and baby health in those first few months after delivery.
4. Having a strong pelvic floor can either help or hinder your birth, depending on the person.
The pelvic floor muscles support the rectum, vagina, bladder, and urethra. As a woman labors, it is necessary for the pelvic floor muscles to relax in order to facilitate passage of the baby through the birth canal. In fact, when coaching a woman while she is pushing, an important component is encouraging her to relax those muscles in order to make pushing more effective.
There is some thought that if you work out routinely, the pelvic floor muscles will become too strong and potentially affect the progress of labor and impede pushing the baby out. In addition, it has been suggested that having strong pelvic floor muscles may increase the risk of tearing during delivery. On the contrary, there is another school of thought: Having strong pelvic floor muscles helps labor and pushing. The truth is that there is no definitive answer—the data is conflicting. What we do know is that having strong pelvic floor muscles decreases the risk of urinary and fecal incontinence after childbirth, especially after having multiple babies.
If you are interested in starting an exercise program or wishing to maintain one, it is always important to let your doctor know exactly what you are doing. There are some conditions in pregnancy that make working out unsafe. If you already have an established routine, please pay attention to your body and make adjustments as needed. This will be necessary as your pregnancy progresses. Finally, if you experience bleeding, fluid leakage, contractions, or just generally don’t feel good while working out, stop and let your doctor know. Remember, you are working out for two and are the gatekeeper for the both of you.