‘Stop running, kill the wild swimming and be careful about cycling.” I like my GP – he is a funny, hardworking man, practising in a diverse community with stretched resources. But when I walked into his office, six weeks pregnant, his advice on exercise during pregnancy felt a little like being wrapped in a vacuum bag. I didn’t want to stop exercising. I can’t really afford to stop cycling (thank you Transport for London) and I would genuinely fear for my mental health if I gave up running overnight.
Exercise during pregnancy is controversial. Serena Williams, winner of 23 tennis grand slams, made headlines worldwide on Monday, simply for declaring her plans “to keep exercising for as long as possible while pregnant”. For much of recent history, write the authors of Exercise During the Childbearing Year, “pregnant women were treated as if they had an illness and were subjected to a state of confinement. They were advised to relax, avoid strenuous exertion, and minimise stretching and bending for fear of strangling or squashing the baby”. Even in the first few months, when your body remains bumpless, some people will knit their brow and take a sceptical breath if you say you intend to remain active. You will be warned off lying on your back, swimming anywhere but a pool, lifting anything heavier than a feather and putting any sort of pressure on your joints. But is this advice based on evidence?
Modern scanning techniques, longitudinal studies, improvements in public health and monitoring all mean that we now better understand women’s bodies and the effects of pregnancy. The NHS, the Royal College of Obstetricians and Gynaecologists, the National Childbirth Trust and the National Institute for Health and Care Excellence all recommend moderate exercise during pregnancy, to alleviate or reduce the risk of gestational diabetes, pregnancy-induced hypertension, high gestational weight gain, type 2 diabetes and cardiovascular disease. Yet, according to the charity Tommy’s (which funds research into miscarriage, stillbirth and premature birth), many women still fear that exercise can lead to miscarriage. Tell someone that you are going for a run in even your first trimester and you will be warned to “take it easy” and “be sensible”.