Pregnancy is recognised as a unique time for behaviour modification and is no longer considered a condition for confinement. It is currently recognised that habits adopted during pregnancy could affect a woman’s health for the rest of her life. For the first time, the recommendation suggests a possible role for exercise — walking, jogging/running, swimming, cycling, dance therapy etc — in the prevention and management of gestational diabetes among pregnant women.

The health benefits of physical activity are well recognised, and conversely sedentary habits and low levels of cardiorespiratory fitness are leading risk factors for subsequent development of cardiovascular disease. After the first trimester, the supine position results in relative obstruction of venous return and therefore decreased cardiac output. For this reason, supine positions should be avoided as much as possible during rest and exercise. In addition, motionless standing is associated with a significant decrease in cardiac output, thus this position should be avoided. During prolonged exercise, loss of fluid as sweat may compromise heat dissipation. Maintenance of euhydration, and therefore blood volume, is critical to heat balance.

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Exercise prescription for the development and maintenance of fitness in non-pregnant women consists of activities to improve cardiorespiratory (aerobic exercise) and musculoskeletal (resistive exercise) status.

Exercise prescription in pregnancy should include the same elements. Aerobic exercise can consist of any activities that use large muscle groups in a continuous rhythmic manner—for example, activities such as walking, hiking, jogging/running, aerobic dance, swimming, cycling, rowing, cross country skiing, skating, dancing, and rope skipping. Because control of exercise intensity within rather precise limits is often desirable at the beginning of an exercise programme, the most easily quantified activities, such as walking or stationary cycling, are particularly useful.

Dance therapy is also recommended by some, after doctor’s green signal to you.

A few changes to the dance routine to accommodate your growing belly, your shifting centre of gravity, and your potentially decreased energy level will be required. These may include:

Marching instead of jumping

Steps in place of leaps

Amended twists and turns

Keeping one foot on the ground at all times

There are no data to support the restriction of pregnant women from participating in some specific activities, although these activities carry more risk than others, such as scuba diving and exertion in the supine position.

Swimming, however, has not been associated with adverse effects and has the advantage of creating a buoyant condition that is well tolerated.

Activities that increase the risk of falls, such as skiing, or those that may result in excessive joint stress, such as jogging and tennis, should include cautionary advice for most pregnant women, but evaluated on an individual basis with consideration for individual abilities. Certainly, the risk of related injuries is difficult to predict.

Pregnant women with diabetes, morbid obesity, or chronic hypertension should have individualised exercise prescription.

Despite the fact that pregnancy is associated with profound anatomical and physiological changes, exercise has minimal risks and confirmed benefits for most women.

Dr Aruna Kalra is Director and Senior Gynaecologist Surgeon at CK Birla Hospital