Healthy Mothers, Healthy Babies
Having studied physical activity during pregnancy for over 25 years, I am amazed at how far we have progressed. When I began to research this area in the late 1980's, information was scarce, and recommendations were very conservative. This only makes sense, as "first do no harm" is even more important than normal when you are talking about protecting the maternal-fetal unit. As more research was performed, it became obvious that there were few, if any reasons that a woman having a normal healthy pregnancy could not continue to perform vigorous activities (such as running and swimming) if she did so prior to becoming pregnant. The 2008 Physical Activity Guidelines specify the details. Indeed, there have been a number of media stories describing pregnant women who perform significant exercise during pregnancy, all with the blessing of their health care providers.
While the unusual usually garners the most media attention (such as completing a marathon the same day as giving birth, or being on an Olympic team while pregnant), from a public health perspective, it is the inactive woman who is of most concern. For example, recent research has shown that women who are sedentary during pregnancy have an increased risk of gestational diabetes mellitus, as well as pregnancy hypertensive disorders, compared to women who participate in physical activity on a regular basis. Perhaps even more importantly for long term health, a woman's body mass index (BMI) going into pregnancy, and postpartum, is related to a number of chronic conditions, including heart disease and diabetes, to name just two.
Recent studies have shown the postpartum period to be an excellent time for a woman to begin a regular physical activity program that she can maintain for the long haul. Combined with a healthy diet, women can lose most, if not all of the weight they gained during pregnancy, as well as increase their fat free body mass. Longitudinal studies have shown that this significantly reduces a woman’s risk of chronic disease later in life. While there is no doubt that the postpartum period is filled with challenges, women need to try their best to find time for physical activity, for themselves, as well as their families.
Given what is now known about the importance of exercising during pregnancy and the postpartum period, we need to develop more effective strategies to inform women of the benefits of performing physical activity during these two critical times in their lives. One logical approach would be to work with obstetric health care providers and enhance their ability to take a more active role in encouraging their healthy patients to become, or remain physically active during these times. If it takes a village to raise a child, the same should be true for the woman who brings this new life into the world.
**Jim Pivarnik, Ph.D., PCFSN Science Board member, is a professor of Kinesiology and Epidemiology at Michigan State University, where he also directs the Center for Physical Activity and Health.