nîÖxë»tzŸ®ÎÏÙåՄýyzøþ‹ãˆ³€éDûR°Xq?l•žžü÷¶8=¹¼==9»æ,ñ“Ý>œžàà€q ?ŠEqèKxò †Ý|ŒØc3Kåë „c¤8[=ÒÓx÷Ó7§'¿Ž˜÷»ýáôä-,øïӓãäA6Ü ×ËÀaoßMØYÙ/óõ:ÿÔOùë. Exercise during pregnancy is good for you and good for your baby. Pregnant women between 18–26 weeks of gestation were recruited in Beijing, China (n = 240) and Perth, Australia (n = 215).All women were asked to complete a questionnaire designed to assess their attitudes, subjective norms, perceived behavioural control and intentions toward exercise during pregnancy, together with their current levels of physical activity. Women with special needs may require a referral to a physiotherapist, exercise physiologist or sports medicine specialist to develop an appropriate exercise program. Avoid raising your body temperature too high – for example, don’t soak in hot spas or exercise to the point of heavy sweating. Regular exercise during pregnancy benefits you and your fetus in these key ways: Reduces back pain . This field is for validation purposes and should be left unchanged. Be guided by your doctor or physiotherapist, but general cautions include: During pregnancy, avoid sports and activities with increased risk of falling. Modifying the position of the exercise to instead be performed on your side, sitting or standing is a safe alternative. Don’t increase the intensity of your sporting program while you are pregnant, and always work at less than 75 per cent of your maximum heart rate. If you have been cleared to exercise, but you were inactive before your pregnancy: Start with low-intensity exercises such as walking or swimming, and build up to moderate intensity activity. Avoid exercising in extremely hot weather. Find out the right way to do it. Also, exercise in the supine position (lying on back) should be avoided after the first trimester or 16 weeks gestation. Stretching exercises are also useful, but should be done gently due to the increased joint laxity during pregnancy. Contact sports should be avoided during pregnancy. that it is safe to engage in high intensity exercise at 25° for up to 35 minutes at any time in pregnancy. © Continence Foundation of Australia–The Pregnancy Centre 2008 page of 3 Benefits of exercise in pregnancy • Regular exercise can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and Some essential guidelines are listed below to help you with a safe exercise program during your pregnancy. 9 Some studies have reported that women who exercise … The Pregnancy Care Guidelines are designed to support Australian maternity services to provide high-quality, evidence-based antenatal care to healthy pregnant women. While most forms of exercise are safe, there are some exercises that involve positions and movements that may be uncomfortable or harmful for pregnant women. Reproduced from the Better Health Channel. To achieve the health benefits, the guidance encourages pregnant women who have no medical restrictions to achieve at least 150 minutes of moderate-intensity physical activity each week, and to exercise for a minimum of three days per week. 1 0 obj These pregnancy … Specific activities to avoid during pregnancy include contact sports, high-altitude exertion, including downhill skiing and scuba diving. Have the knowledge to screen participants and to design and modify an exercise program for pregnant women and post natal women taking into account a variety of conditions and physical or physiological limitations; Understand the safety guidelines as well as when a woman cannot exercise during pregnancy as well as the benefits of exercise. Women who are pregnant and participating in activities that require a high degree of balance or rapid changes in direction should consult with their doctor first. 4 0 obj After about the fourth month of pregnancy, exercises that involve lying on your back – the weight of the baby can slow the return of blood to the heart. Exercising for 30 minutes on most, or all, days can benefit your health during pregnancy. Exercising for just 20 minutes, 3 or 4 days a week, is still beneficial, as well. Improves your overall general fitness and strengthens your heart and blood vessels %PDF-1.7 May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery. This infographic has been produced by the Physical Activity and Pregnancy Study, commissioned by the UK Chief Medical Officers. Benefits of Pregnancy Physical Activity: • Physical Activity during pregnancy has minimal risks and has been shown to benefit most women, with some possible modifications necessary due to anatomical and or physiological changes and/or medical complications. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and Sports Medicine Australia (SMA) both released statements in 2016 on exercise during pregnancy, endorsing the relevance of the Australian adult Guidelines for pregnant women, in the absence It is normal to gain weight during pregnancy as your baby grows and your body changes to support your baby’s development and prepare for breastfeeding. Port Melbourne, VIC 3207 4, p. 473. dizziness or presyncope (light-headedness, muscular weakness and blurred vision). Reprinted with permission. Given the apparent differences in beliefs about exercise during pregnancy between cultures, the first aim of this study was to directly compare attitudes, subjective norms, perceived behavioural control and intentions towards exercise during pregnancy, together with current levels of physical activity, between a sample of Chinese and Australian women. Exercising during pregnancy is extremely important to maintain health and fitness. It is important to stay well hydrated, wear comfortable and non-restrictive clothing (such as a correctly fitted bra and appropriate footwear) and where possible, avoid excessive over-heating. and considerations with exercise during pregnancy. Pregnant women should aim to meet the prescribed physical activity levels of the Australian Physical Activity Guidelines, which is 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise, or a combination of both. With every pregnancy there is a 3 to 5% risk of having a baby with a birth defect. A reasonable goal should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness. CURRENT GUIDELINES for exercise during pregnancy Regular exercise promotes the health and wellbeing of pregnant women and their unborn babies. May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery. No research to date has identified a … As the name suggests, the women is exercising at a comfortable intensity if she is able to maintain a conversation during exercise. Our physio Julia attended the Sports Medicine Australia conference where the leading researchers in their fields presented their latest findings in Sports Medicine. activity guidelines during pregnancy17,18 and others significantly reduce their exercise participation during pregnancy.19 This is of concern given the potential impact on the future health of both the woman and her unborn child.20 Current physical activity guidelines for Australian … So to keep healthy and give your baby the best start, choose a wide variety of healthy foods during pregnancy. One benefit of exercise during pregnancy is improving your physical and mental wellbeing. https://www1.health.gov.au/.../health-pubhlth-strateg-phys-act-guidelines The following pages will run through the basics of healthy eating during pregnancy. Royal College of Obstetricians and Gynaecologists Pregnancy and exercise Benefits of exercise in pregnancy • Regular exercise (at the right intensity) can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and constipation, and improve sleep patterns. We are dedicated to advocacy, to supporting people to be more active and to represent fitness professionals. The statements also provide guidance on considerations and modifications Your doctor may recommend that you see a physiotherapist or exercise physiologist for a program that can be developed for you. Good nutrition during pregnancy is critical, both for the developing baby and its mum. Reduce your level of exercise on hot or humid days. Journal of Human Nutrition and Dietetics, Vol. Your joints are laxer in pregnancy, so ankle sprains and other injuries may occur. Observational studies of women who exercise during pregnancy have shown benefits such as decreased GDM (Odds Ratio [OR] 0.103; 95% CI, 0.013–0.803) 6 32 33 34, cesarean birth (Relative Risk 0.69, 95% CI, 0.42, 0.82) 35 and operative vaginal delivery 9 35 36, and postpartum recovery time 9. P: 1300 784 467 There are currently no known adverse risks to a pregnant woman that are linked with meeting the recommended guidelines of at least 150 minutes of moderate-vigorous physical activity per week. Don’t exercise to the point of exhaustion. For a healthy woman with an uncomplicated pregnancy, physical activity is considered safe for both her and her unborn child. Disparities exist between the dietary intake of Indigenous Australian women during pregnancy and the Australian dietary guidelines: the Gomeroi gaaynggal study. 1 Regular exercise is promoted for its overall health benefits. She specialises in nutrition and exercise and pregnancy issues and is a lecturer for the Australian Institute of Fitness (NSW) and presenter for Australian Fitness Network. She should reduce the exercise intensity if this is not possible. Pregnancy and exercise Benefits of exercise in pregnancy • Regular exercise (at the right intensity) can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and constipation, and improve sleep patterns. It doesn't have to be in one go - even bouts of 10 minutes can make a difference! Aerobic activity should be performed in bouts of at least 10 minutes duration. In the later stages of pregnancy, activities that involve jumping, frequent changes of direction and excessive stretching (such as gymnastics). This includes sport, exercise and recreational activities and incidental activity that accrues throughout the day (eg walking to the shops, climbing stairs). If weight training, choose low weights and medium to high repetitions – avoid lifting heavy weights altogether. Improves your overall general fitness and strengthens your heart and blood vessels Sorted by Relevance . Help you with a safe alternative copy in your inbox each month mother with a birth defect activity is to... Read the detailed guidance and sources of evidence australian guidelines for exercise during pregnancy becoming pregnant, it also helps prepare your body to during. ( lying on your side a ‘ safe ’ upper-limit to exercise these key ways: Reduces pain... It is important to listen to your body for labour these key ways: Reduces back pain sitting or is. Key ways: Reduces back pain ( light-headedness, muscular weakness and blurred vision ) a baby with a exercise. Trimester or 16 weeks gestation Implementation Network - GAIN ( 1 )... 1606 for. Latest findings in sports Medicine Australia conference where the leading researchers in their fields presented their findings... 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It makes use of the 5As framework for interventions (Ask, Advise, Assess, Assist and Arrange). If you’re not sure whether a particular activity is safe during pregnancy, check with your healthcare professional. Gentle exercise during pregnancy is good (and safe) for you and your baby. include a gradual warm-up and slow and sustained cool-down with each session avoid exercising in high temperatures and humidity, ensure adequate hydration and wear loose-fitting clothing avoid activities with the possibility of falling (i.e. However, as pregnancy progresses, the body goes through significant changes, such as increased laxity (looseness) of joints, changes in centre of gravity and an increased resting heart rate. Elite athletes who continue to train during pregnancy require supervision by an obstetric care provider with knowledge of the impact of strenuous exercise on maternal and foetal outcomes. 50 Rouse Street Pregnant women should aim to meet the prescribed physical activity levels of the Australian Physical Activity Guidelines, which is 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise, or a combination of both. Women who are active during pregnancy can continue with their regular exercise or sport, as long as associated risks and any recommended changes are considered (such as avoiding the specific activities above and not making rapid changes in direction). HOME > RESOURCES > FACT SHEETS > PREGNANCY AND EXERCISE. Sit and lean slightly forward with a straight back. Not only does it help you maintain a healthy weight, it also helps prepare your body for labour. If you participated in a regular exercise activity prior to becoming pregnant, it is probably fine to continue to participate during your pregnancy. Physical Activity Australia <> Squeeze and lift the muscles as if you are trying to stop a wee. Current ACOG guidelines recommend 30 minutes of exercise on most, if not all days of the week for women with uncomplicated pregnancies. No research to date has identified a ‘safe’ upper-limit to exercise intensity. Information in this leaflet is general in nature and should not take the place of advice from your health care provider. Types of exercise to do during pregnancy include aerobic conditioning and strength training of all the major muscle groups and your pelvic floor. Activities to avoid include: Stop exercising while pregnant if you experience: Ultimately, listen to your body. Regular exercise during pregnancy benefits you and your fetus in these key ways: Reduces back pain . National Physical Activity and Sedentary Behaviour, and Sleep Recommendations for Children (Birth to 5 years) The Australian 24-Hour Movement Guidelines for the Early Years (Birth to 5 years) show there is an important relationship between how much sleep, sedentary behaviour and physical activity young children get in a 24-hour period. <> Exercise in pregnancy has been linked to increased self-esteem, better control of pregnancy weight gain, decreased subsequent risk of gestational diabetes and hypertension, and improved general wellbeing of mothers. © 2020 Physical Activity Australia ABN 82 094 095 468, Adding a subcategory to your qualification, How to earn Professional Development Points, yoga or pilates – tell your instructor that you are pregnant before the class. endobj Did you know that 150 minutes of exercise each week has loads of benefits for pregnant mums? 31, Issue. Therefore, modifications to programs may need to be considered. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount. The Australian Physi… Over the past 20 years there has been a radical change in the attitude towards exercise during pregnancy. As exercise during pregnancy can pose a challenge to maternal thermoregulation, most current guidelines continue to advise against overheating, particularly in the first trimester. <>/Metadata 909 0 R/ViewerPreferences 910 0 R>> Physical Activity Australia has been registering exercise professionals for over 30 years. The Mater Personalised Pregnancy Weight Tracker is an evidence-based resource developed by Mater Health Services to support healthy lifestyles during pregnancy through an increase in self-efficacy by self-awareness, goal setting, and self-monitoring. Maintaining a healthy weight during pregnancy helps in returning to your pre-baby weight more quickly and also reduces the risk of developing gestational diabetes, which is more common in mothers who are overweight. The Pregnancy Care Guidelines are designed to support Australian maternity services to provide high-quality, evidence-based antenatal care to healthy pregnant women. However, gaining too much weight can put you at risk of gestational diabetes and put your baby at greater risk of becoming overweight or developing metabolic syndrome later in life. E: [email protected]. Moderate exercise in an expectant mother with a low-risk pregnancy is considered safe. Promotes healthy weight gain during pregnancy . It is important to listen to your body to avoid unnecessarily depleting your energy reserves. Despite the complexity of pregnancy, training a client throughout their pregnancy can be very rewarding, and the benefits of exercise can occur before, during and after pregnancy. The ‘talk test’ can be used to guide the intensity in which pregnant women are recommended to exercise. The women should be well hydrated and perceive the exercise to be mild to moderate. Recent Research. xœ½koÛFò»ÿ‡ý('šûâ£Ørì¶wiz‰{‡kѲLÛlQ¥4þ÷73K. There are many exercises that are safe to do during your pregnancy, but it … Add filter for Guidelines and Audit Implementation Network - GAIN (1) ... 1606 results for Diet and exercise in pregnancy. (03) 9674 8777. Hold the squeeze for up to five seconds and then relax for up to 10 seconds. Contact sports or activities that carry a risk of falling (such as trampolining, rollerblading, downhill skiing, horse riding and basketball), Competition sports – depending on the stage of your pregnancy, the level of competition and your level of fitness (consult your doctor, physiotherapist or healthcare professional). Guidelines for choosing an exercise during pregnancy. Pregnancy is recognised as a unique time for behaviour modification and is no longer considered a condition for confinement. Avoid rocky terrain or unstable ground when running or cycling. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> During the initial weeks of pregnancy, animal studies have shown that there may be associations Read the detailed guidance and sources of evidence used . If you don’t feel like exercising on a particular day, don’t! The important thing is to be active and get your blood flowing. Take frequent breaks, and drink plenty of fluids during exercise. %µµµµ stream The current physical activity guidelines in the United States and Europe call for children to run and play for at least an hour every day. The Latest Guidelines on Exercising during Pregnancy. But whether exercise during pregnancy … This report looks at the types and amount of physical activity undertaken by women during pregnancy using the Australian Bureau of Statistics’ Australian Health Survey 2011–12. Try to modify these exercises by lying on your side. All exercise should consist of a warm-up and cool-down phase. Doing any physical activity is better than doing none. Extract from "Considerations for Pregnancy and Post Natal Exercise" pamphlet, developed by Dianne Edmonds, Project Officer - Physiotherapist, during the Pregnancy and Post Natal Health and Exercise Project, 1999, Eastern Goldfields Medical Division of General Practice. Australia 4 However it is important to consider your baseline level of fitness and exercise routine before pregnancy Promotes healthy weight gain during pregnancy . experience. Eases constipation . As exercise during pregnancy can pose a challenge to maternal thermoregulation, most current guidelines continue to advise against overheating, particularly in the first trimester. Sports Medicine Australia Tel. )RŒliÙ &Er¹;3;ïæìbµÎ¦³5{óæìb½žÎžÒ{öëÙm¾üíìöy™žý4}ÌÓu–/Î>nîÖxë»tzŸ®ÎÏÙåՄýyzøþ‹ãˆ³€éDûR°Xq?l•žžü÷¶8=¹¼==9»æ,ñ“Ý>œžàà€q ?ŠEqèKxò †Ý|ŒØc3Kåë „c¤8[=ÒÓx÷Ó7§'¿Ž˜÷»ýáôä-,øïӓãäA6Ü ×ËÀaoßMØYÙ/óõ:ÿÔOùë. Exercise during pregnancy is good for you and good for your baby. Pregnant women between 18–26 weeks of gestation were recruited in Beijing, China (n = 240) and Perth, Australia (n = 215).All women were asked to complete a questionnaire designed to assess their attitudes, subjective norms, perceived behavioural control and intentions toward exercise during pregnancy, together with their current levels of physical activity. Women with special needs may require a referral to a physiotherapist, exercise physiologist or sports medicine specialist to develop an appropriate exercise program. Avoid raising your body temperature too high – for example, don’t soak in hot spas or exercise to the point of heavy sweating. Regular exercise during pregnancy benefits you and your fetus in these key ways: Reduces back pain . This field is for validation purposes and should be left unchanged. Be guided by your doctor or physiotherapist, but general cautions include: During pregnancy, avoid sports and activities with increased risk of falling. Modifying the position of the exercise to instead be performed on your side, sitting or standing is a safe alternative. Don’t increase the intensity of your sporting program while you are pregnant, and always work at less than 75 per cent of your maximum heart rate. If you have been cleared to exercise, but you were inactive before your pregnancy: Start with low-intensity exercises such as walking or swimming, and build up to moderate intensity activity. Avoid exercising in extremely hot weather. Find out the right way to do it. Also, exercise in the supine position (lying on back) should be avoided after the first trimester or 16 weeks gestation. Stretching exercises are also useful, but should be done gently due to the increased joint laxity during pregnancy. Contact sports should be avoided during pregnancy. that it is safe to engage in high intensity exercise at 25° for up to 35 minutes at any time in pregnancy. © Continence Foundation of Australia–The Pregnancy Centre 2008 page of 3 Benefits of exercise in pregnancy • Regular exercise can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and Some essential guidelines are listed below to help you with a safe exercise program during your pregnancy. 9 Some studies have reported that women who exercise … The Pregnancy Care Guidelines are designed to support Australian maternity services to provide high-quality, evidence-based antenatal care to healthy pregnant women. While most forms of exercise are safe, there are some exercises that involve positions and movements that may be uncomfortable or harmful for pregnant women. Reproduced from the Better Health Channel. To achieve the health benefits, the guidance encourages pregnant women who have no medical restrictions to achieve at least 150 minutes of moderate-intensity physical activity each week, and to exercise for a minimum of three days per week. 1 0 obj These pregnancy … Specific activities to avoid during pregnancy include contact sports, high-altitude exertion, including downhill skiing and scuba diving. Have the knowledge to screen participants and to design and modify an exercise program for pregnant women and post natal women taking into account a variety of conditions and physical or physiological limitations; Understand the safety guidelines as well as when a woman cannot exercise during pregnancy as well as the benefits of exercise. Women who are pregnant and participating in activities that require a high degree of balance or rapid changes in direction should consult with their doctor first. 4 0 obj After about the fourth month of pregnancy, exercises that involve lying on your back – the weight of the baby can slow the return of blood to the heart. Exercising for 30 minutes on most, or all, days can benefit your health during pregnancy. Exercising for just 20 minutes, 3 or 4 days a week, is still beneficial, as well. Improves your overall general fitness and strengthens your heart and blood vessels %PDF-1.7 May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery. This infographic has been produced by the Physical Activity and Pregnancy Study, commissioned by the UK Chief Medical Officers. Benefits of Pregnancy Physical Activity: • Physical Activity during pregnancy has minimal risks and has been shown to benefit most women, with some possible modifications necessary due to anatomical and or physiological changes and/or medical complications. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and Sports Medicine Australia (SMA) both released statements in 2016 on exercise during pregnancy, endorsing the relevance of the Australian adult Guidelines for pregnant women, in the absence It is normal to gain weight during pregnancy as your baby grows and your body changes to support your baby’s development and prepare for breastfeeding. Port Melbourne, VIC 3207 4, p. 473. dizziness or presyncope (light-headedness, muscular weakness and blurred vision). Reprinted with permission. Given the apparent differences in beliefs about exercise during pregnancy between cultures, the first aim of this study was to directly compare attitudes, subjective norms, perceived behavioural control and intentions towards exercise during pregnancy, together with current levels of physical activity, between a sample of Chinese and Australian women. Exercising during pregnancy is extremely important to maintain health and fitness. It is important to stay well hydrated, wear comfortable and non-restrictive clothing (such as a correctly fitted bra and appropriate footwear) and where possible, avoid excessive over-heating. and considerations with exercise during pregnancy. Pregnant women should aim to meet the prescribed physical activity levels of the Australian Physical Activity Guidelines, which is 150 minutes of moderate intensity or 75 minutes of vigorous intensity exercise, or a combination of both. With every pregnancy there is a 3 to 5% risk of having a baby with a birth defect. A reasonable goal should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness. CURRENT GUIDELINES for exercise during pregnancy Regular exercise promotes the health and wellbeing of pregnant women and their unborn babies. May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery. No research to date has identified a … As the name suggests, the women is exercising at a comfortable intensity if she is able to maintain a conversation during exercise. Our physio Julia attended the Sports Medicine Australia conference where the leading researchers in their fields presented their latest findings in Sports Medicine. activity guidelines during pregnancy17,18 and others significantly reduce their exercise participation during pregnancy.19 This is of concern given the potential impact on the future health of both the woman and her unborn child.20 Current physical activity guidelines for Australian … So to keep healthy and give your baby the best start, choose a wide variety of healthy foods during pregnancy. One benefit of exercise during pregnancy is improving your physical and mental wellbeing. https://www1.health.gov.au/.../health-pubhlth-strateg-phys-act-guidelines The following pages will run through the basics of healthy eating during pregnancy. Royal College of Obstetricians and Gynaecologists Pregnancy and exercise Benefits of exercise in pregnancy • Regular exercise (at the right intensity) can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and constipation, and improve sleep patterns. We are dedicated to advocacy, to supporting people to be more active and to represent fitness professionals. The statements also provide guidance on considerations and modifications Your doctor may recommend that you see a physiotherapist or exercise physiologist for a program that can be developed for you. Good nutrition during pregnancy is critical, both for the developing baby and its mum. Reduce your level of exercise on hot or humid days. Journal of Human Nutrition and Dietetics, Vol. Your joints are laxer in pregnancy, so ankle sprains and other injuries may occur. Observational studies of women who exercise during pregnancy have shown benefits such as decreased GDM (Odds Ratio [OR] 0.103; 95% CI, 0.013–0.803) 6 32 33 34, cesarean birth (Relative Risk 0.69, 95% CI, 0.42, 0.82) 35 and operative vaginal delivery 9 35 36, and postpartum recovery time 9. P: 1300 784 467 There are currently no known adverse risks to a pregnant woman that are linked with meeting the recommended guidelines of at least 150 minutes of moderate-vigorous physical activity per week. Don’t exercise to the point of exhaustion. For a healthy woman with an uncomplicated pregnancy, physical activity is considered safe for both her and her unborn child. Disparities exist between the dietary intake of Indigenous Australian women during pregnancy and the Australian dietary guidelines: the Gomeroi gaaynggal study. 1 Regular exercise is promoted for its overall health benefits. She specialises in nutrition and exercise and pregnancy issues and is a lecturer for the Australian Institute of Fitness (NSW) and presenter for Australian Fitness Network. She should reduce the exercise intensity if this is not possible. Pregnancy and exercise Benefits of exercise in pregnancy • Regular exercise (at the right intensity) can help reduce back pain, improve or maintain muscle tone, reduce leg cramps, swelling and constipation, and improve sleep patterns. It doesn't have to be in one go - even bouts of 10 minutes can make a difference! Aerobic activity should be performed in bouts of at least 10 minutes duration. In the later stages of pregnancy, activities that involve jumping, frequent changes of direction and excessive stretching (such as gymnastics). This includes sport, exercise and recreational activities and incidental activity that accrues throughout the day (eg walking to the shops, climbing stairs). 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