The thought of exercising when a woman is expecting can be scary as some people think it poses a danger for both the mother and the baby’s health. This is however not necessarily true because medics actually advise expecting mothers to carry out physical exercises.

When a woman is expecting, there are some hormonal changes that occur in the body and that’s why some start to hate certain scents, experience vomiting, or avoid eating, while others’ will want to eat all the time. Aside from hormonal changes, the physical aspect of the body experiences its own set of changes too.

Dr Eric Mutabazi, a physiotherapist at King Faisal Hospital, Kigali, explains that pregnant women experience hormonal changes which also lead to an increment in their body weight.

He explains that pregnant women can gain weight up to 12.5kgs per trimester and that those changes can also affect the normal biomechanics of the spine because there is muscle imbalance between abdominals and lower back as a result of the pull of the uterus. When such changes happen, the pregnant woman will start experiencing abnormal changes, including the posture.

He explains that the heart rate of pregnant women will increase by 3 to 5 per cent and with this; the diaphragm will be compressed because they start breathing rapidly, which affects their performance.

These changes will also be happening on the blood system when the uterus is growing. For example, in the third trimester, the inferior vena cava which is passing around the pelvis will be compressed by the weight of the baby and this will lead to having swollen legs because the blood and the emphatic fluids are not moving well, Mutabazi explains.

"The effect of having to sleep on one side is that the muscles and ligament will start hurting and the woman will complain of pain; this is when the essence of exercising comes in,” he says. Why exercising is important

Dr Wilbur Bushara, a general practitioner, explains that exercising for pregnant women is very vital because it helps in relaxing the whole body and also eases fatigue.

He says that they also help in muscle stretching, improving blood circulation and strengthening the heart.

"Exercises help to relieve swollen ankles and also reduce pressure on the spine and limbs. Exercises like squats mainly help to strengthen the pelvic muscle area which makes delivery easy,” Bushara says.

He stresses that it is safe for pregnant women to have exercises if they don’t have any serious complications like bleeding in pregnancy. However, they should engage in simple to moderate exercises and should avoid exercises that require them to lie on their backs.

Bushara recommends exercises like walking for thirty minutes, doing stretches, squats, lifting, swimming and cycling, but emphasises that the exercises have to be done in company of someone.

"Pregnant women should do exercises in the company of a spouse, friend or relative because of the shortcomings such as muscle pull, loss of balance and extreme fatigue. They should also seek advice from their doctors before switching to another or new form of exercise,” Bushara warns.

Dr Mutabazi echoes a similar view stressing that exercising helps to cure backache because it helps maintain the stability of the lumbar, meaning that the pregnant woman will have a strong and solid lower back even though the centre of gravity has shifted.

Certain instances call for exercises, for example when the contractions are coming, the woman might feel like the pelvis is really fracturing; so physiotherapy can help to restore the stability of the pelvis, he says.

Mutabazi further points out that isometric exercise like knee pumps, straight leg rays, walking, aerobic exercises, hydrotherapy and kegel exercises as some of the exercises that can be done by expectant mothers.

Exercising helps to work on the stability of the hip because as the uterus is growing up and as the baby reaches week 31 or 32, it tends to push the pelvis, and some ligaments are weakened, Mutabazi explains.

"We teach our patients to do breathing exercise, which is very important. They learn how to control breathing patterns by active cycle breathing techniques to relax the diaphragm which was compressed,” he says.

Mutabazi cautions women to always ensure they sit on a proper chair instead of half-lying that could hurt their lower back.

"They need to sit with pillows to support the back just to maintain an upright position. The limbs should be on a small stool at a level of 45 degrees so that one keeps moving the ankle joints, as well as to keep the blood flowing.”

The medic also says that it is also equally important to work out after delivery and that the objective of this is to make the muscles which had been stretched to come back to their normal position.

"One can start working out after three months as they will be fairly fit for training. One can start doing some gentle exercises like working on the legs, upper limbs and abdominal muscles.”