High-impact exercise does not affect childbirth

Strenuous physical exercise and training at the elite level by pregnant women does not appear to increase the chances of delivery complications, according to new research by Icelandic and Norwegian scientists published in the September issue of the British Journal of Sports Medicine. The research has attracted the attention of the major US paper, The New York Times.

The primary author of the article is Þorgerður Sigurðardóttir, PhD student in biomedical sciences at the University of Iceland Faculty of Medicine. Her supervisors, Professor Kari Bø of the Norwegian School of Sport Sciences in Oslo and Professor Þóra Steingrímsdóttir of the University of Iceland Faculty of Medicine, also collaborated on the research, along with three other professors at the University of Iceland – Reynir Tómas Geirsson, Thor Aspelund and Þórhallur Ingi Halldórsson.
Þorgerður's PhD research project is an investigation into whether physical exertion by pregnant women could potentially affect their delivery. Þorgerður works as a physiotherapist and is one of Iceland's leading specialists in physiotherapy related to women's health.

Experts have generally agreed that moderate exercise, such as brisk walking or other moderate activity, is healthy in pregnancy and pregnant women have been advised to exercise for at least 2.5 to 3 hours per week. Several studies have also suggested that female athletes are more likely to experience complications in childbirth, such as caesarean sections or perineal tears.

The study reported in the British Journal of Sports Medicine looked at 130 elite female athletes in Iceland, many of whom competed on the national team for their sport, who had continued to train into the second trimester or longer. All the women had already delivered and the researchers asked them about their physical training over at least a 3-year period before the birth. Subjects included women in a wide variety of sports, such as football and running, which are high-impact and strenuous activities, and equestrian sports, golf and swimming, which are low-impact activities. A control group of 120 women who did not participate in competitive sports were also asked about their exercise habits. Information gleaned from the questionnaire was compared with information from the Icelandic Medical Birth Registry, which records several metrics regarding childbirth, such as the frequency of caesarean sections, length of pregnancy and so forth.

It emerged that there was no difference between the athletes and the control group in the frequency of delivery complications, such as caesarean section or prolonged labour. The athletes were also shown to be less likely to experience perineal tears, especially those in high-impact sports such as football or running.

"The lesson of these results is that elite athletes should not expect more difficulties in childbirth than other women," said Þorgerður Sigurðardóttir, talking to The New York Times which recently reported the research. "Physical activity before and during pregnancy is very good for the mother, the child and the process of childbirth. It is important to assess training during pregnancy on an individual basis and talk to your healthcare providers if there is anything you are concerned about," added Þorgerður. 

Þorgerður has also conducted research focusing on women's pelvic floors before and after childbirth. "Women experiencing problems with their pelvic floor may stop exercising when they suffer urinary incontinence – they put on weight, their blood pressure goes up and so on. These problems are very treatable and the sooner women seek help, the better. There are far too many women who do not seek help, but it is good to discuss these matters. Help and support is available from physiotherapists, doctors and midwives," said Þorgerður in an interview on her PhD research published in the Magazine of the University of Iceland last year. 

The research is available in the British Journal of Sports Medicine.