The aim of the project was to develop Australian guidelines for physical activity (PA)/exercise during pregnancy and the postpartum period. The guidelines are designed to encourage women to begin or continue PA/exercise during pregnancy and postpartum, and to provide evidence-based guidance and information about risks and contraindications for health professionals.
Research Team
Prof Wendy Brown, Dr Melanie Hayman, Prof Lene Haakstad, DrTayla Lamerton, Gabriela P. Mena, Dr Anita Green, Dr Shelley Keating, A/Prof Grace A. O. Gomes, Prof Jeff Coombes, Dr Greg Mielke,
Funding Source
Australian Governement Department of Health
Outputs
The guidelines, which were commissioned by the Australian Government Department of Health, were developed by an interdisciplinary team of researchers (with backgrounds in epidemiology, exercise physiology, medicine, sports science and psychology) from the Universities of Queensland and Central Queensland, in consultation with leading international researchers, representatives from a wide range of health professions, and policy makers in government departments of Health, Sport and Recreation and Maternity Services.
The guidelines were developed using an ‘umbrella’ review (review of reviews) of the relationships between physical activity during pregnancy and 27 health outcomes, and of recently published guidelines from other countries.
Our team submitted a full report which can be accessed here: https://www.health.gov.au/resources/publications/evidence-based-physical-activity-guidelines-for-pregnant-women.
Outcomes
Our report was used to develop web-based and print resources for public use and a brochure.
Impact
Health impact
The guidelines have been incorporated into clinical practice guidelines on pregnancy care and we anticipate that they will be be used by pregnant women (including elite athletes and those who play serious competitive sport) and by Health Professionals.
Knowledge impact
We add to the knowledge base in this area by clarifying the answers to questions which are commonly asked by pregnant women and the health professionals who provide care during pregnancy. Examples include:
- What is meant by ‘moderate intensity’ and ‘vigorous’ activities and are vigorous activities safe during pregnancy? Women without pregnancy complications can continue to do vigorous activities for as long as they feel comfortable, provided they were accustomed to doing vigorous activities prior to pregnancy). One systematic review of the effects of vigorous intensity PA/exercise during pregnancy has concluded that vigorous exercise is safe, but that further research in the earlier stages of pregnancy is required. We recommended that athletes who do high intensity training should consult with informed health professionals and review training loads throughout pregnancy on an individual basis. As many activities become more uncomfortable in the later stages of pregnancy, it is likely that activities will decrease in intensity and duration as pregnancy progresses.
- What about muscle strengthening activities? In line with the current Australian Physical Activity Recommendations, we recommended that pregnant women should do muscle strengthening activities (including functional and postural exercises) on at least two days each week. These exercises will help to reduce musculoskeletal discomfort (eg low back and pelvic girdle pain) as pregnancy progresses. There is little research on the types of resistance training that are now commonly included in gym-based programs, but use of light weights or resistance bands appears to be safe. Heavy lifting and intense repetitive isometric exercises should be avoided.
- What about pelvic floor muscle (PFM) exercises? The review found that the evidence on PFM strengthening and prevention of UI is strong, and all women are encouraged to learn correct technique and practice before and during pregnancy, then re-commence pelvic floor exercises as soon as possible after the birth. For treatment of UI, supervised PFM exercise has greater effects.
- Joint decision making. The final guideline encourages women and their health professionals to discuss PA/exercise during ante-natal and post-natal visits. Women who are healthy and already active do not need to seek medical clearance to start or continue with PA/exercise, but those who are considering exercise and training at levels above those recommended in the PA guidelines (ie high intensity, prolonged duration, etc) should seek advice and guidance from a knowledgeable health professional. All health professionals should be familiar with contraindications and warning signs to stop PA/exercise.
Project members
HMNS Researchers
