Obstetric & Gynaecology Malaysia



Is it safe to exercise during pregnancy?

If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity. Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery (except avoid squats till 36 weeks of pregnancy). However, it is important to discuss exercise with your obstetrician during your prenatal visits after 16 weeks of pregnancy, where you start to feel better after the pregnancy's symptoms have resolved.

What precautions should I take when exercising during pregnancy?

Stay well hydrated by drinking plenty of water (50mls water x body weight in kg) every day. Add flavor and jazz to your water with lemon slices  and Himalaya salt  or honey with ginger tea. Signs of dehydration include dizziness, headache, mild fever, a racing or pounding heart, and urinating small amounts or dark yellow urine. 

Avoid lying flat on your back or standing still as much as possible. When you lie on your back, your uterus presses on a large vein that returns blood to the heart, reduce placenta perfusion to fetus. Standing motionless can cause blood to pool in your legs and feet. These positions may cause your blood pressure to decrease in a short time, causing fainting attack.

Avoid becoming overheated. Wear loose-fitting clothing, and exercise in a temperature-controlled room. Do not exercise outside when fever, very hot or humid.
Some bodily ache or short sharp pain can be a a common pregnancy symptom that last less than an hour such as round ligament pain, sciatica pain or pelvic diastasis pain. It is safe to use local analgesic ointment or gel containing Salicylate such as  Salon Pas, Yoko Yoko, Counterpain.  Essential oil such as  Peppermint oil, Eucalyptus oil, or the local "Minyak Cap Kapak" is safe to apply on the area of skin for comfort.

Leg cramps is common in the second and third trimesters. Leg cramps are short painful involuntary muscle spasms that strike your calf or foot suddenly.   Leg cramps during pregnancy might be caused by fatigue, dehydration, the uterus pressing on certain nerves, or decreased circulation in the legs from the pressure of the baby on blood vessels. Commonly caused by calcium, magnesium and vitamin D deficiency especillay among Malaysian women. Restless leg syndrome is less common.

Wear a sports bra that gives lots of support to help protect your breasts. Later in pregnancy, a belly support belt or kinesio tape may reduce discomfort (pelvic diastasis) while walking

Are there certain conditions that make exercise during pregnancy unsafe?

Women with the following conditions or pregnancy complications should not exercise during pregnancy:

  • Certain types of heart and lung diseases, severe anemia (Hb<8gm/dL)
  • Preeclampsia or pregnancy-induced high blood pressure
  • Cervical insufficiency or cerclage or preterm labor
  • Being pregnant with twins or triplets (or more) with risk factors for preterm labor
  • Placenta previa after 26 weeks of pregnancy

What are the benefits of exercise during pregnancy?

  • Regular exercise during pregnancy benefits you and your fetus in these key ways:
  • Reduces back pain
  • Eases constipation
  • May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery
  • Promotes healthy weight gain during pregnancy
  • Improves your overall general fitness and strengthens your heart and blood vessels

How much should I exercise during pregnancy?

As long you still can talk normally, you are fine to continue your exercise regime.

Begin with walking at least 4000 steps a day=3.2km, especially after meal. If you were very active before pregnancy, you can keep doing the same workouts with some reductions in intensity. However, if you start to lose weight, you may need to reduce the intensity of exercise.

What changes occur in the body during pregnancy that can affect my exercise routine?

Your body goes through many changes during pregnancy.

  • Joints—The hormones made during pregnancy cause the ligaments that support your joints to become relaxed. This makes the joints more mobile and at risk of injury. Avoid jerky or high-impact motions that can increase your risk of being hurt, eg jogging-risk of osteoarthritis in future, therefore advisable to wear knee guard.
  • Balance—The extra weight in the front of your body shifts your center of gravity. This places stress on joints and muscles, especially those in your pelvis and lower back. Because you are less stable and more likely to lose your balance, you are at greater risk of falling.
  • Breathing—When you exercise, oxygen and blood flow are directed to your muscles and away from other areas of your body. While you are pregnant, your need for oxygen increases. 

What are some safe exercises I can do during pregnancy?

Experts agree these exercises are safest for pregnant women:

Walking—Brisk walking gives a total body workout and is easy on the joints and muscles.
Swimming and water workouts—Water workouts use many of the body’s muscles. The water supports your weight so you avoid injury and muscle strain.
Stationary bicycling—Your growing belly can affect your balance and make you more prone to falls, so it can be risky riding a bicycle during pregnancy. Cycling on a stationary bike is a better choice.
Modified yoga and modified Pilates- You also should avoid poses that require you to be still or lie on your back for long periods.
Kegel/pelvic floor exercises- To prevent weakness of pelvic support system.

If you are an experienced runner, jogger, or racquet-sports player, you may be able to keep doing these activities during pregnancy.

What exercises should I avoid during pregnancy?

While pregnant, avoid activities that put you at increased risk of injury, such as the following:

  • Contact sports and sports that put you at risk of getting hit in the abdomen, eg hockey, basketball
  • Activities that may result in a fall, such as downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics & horseback riding
  • Hot yoga” or “hot Pilates,” which may cause you to become overheated
  • Scuba diving or skydiving
  • Activities performed above 6,000 feet (if you do not already live at a high altitude)

What are warning signs that I should stop exercising?

Whether you’re a seasoned athlete or a beginner, watch for the following warning signs when you exercise. If the symptoms are severe and persist, go to emergency department. If you are more than 24 weeks pregnant, you need to go to delivery suite:

Regular, painful contractions of the uterus 
Bleeding from the vagina or fluid leaking from the vagina (urinary leakage can occur)
Feeling dizzy or faint, headache, muscle weakness- if persists, see neurologist
Shortness of breath before starting exercise or chest pain (consider if  gastric reflux and safe to take Gaviscon)- if persists, see cardiologist.
Calf pain or swelling due to deep vein thrombosis-TED stocking if at risk eg. flying long distance of after surgery.