Many expectant mothers develop physical problems that can restrict their daily activities considerably. Their blood pressure dips regularly. Back pain increases almost daily.

"In such cases, exercise is an effective way to reduce discomfort and counteract common pregnancy-related problems early on," said Sabine Meier, a 44-year-old midwife from the German town of Viersen.

"A pregnancy, and particularly labor, puts a big strain on the body," she said, adding that women who exercised regularly had more strength and endurance to cope with pregnancy's burdens.

Joachim Dudenhausen, director of the obstetrics clinic at Berlin's Charite hospital, agreed. "Exercising during pregnancy is very beneficial because it strengthens muscles, increases lung capacity and enhances overall well-being," he noted.

Exercise alleviates pregnancy-related complaints such as tension in the neck and shoulders, and problems in the area of the lower spine. Women who are physically fit usually recover from childbirth more quickly than those who are not.

Despite the benefits, few pregnant women exercise. In a recent survey of expectant mothers by the German Sport University in Cologne, 76 percent of the respondents said that they had cut down on their physical activities, either slightly or to a high degree.

Although a large majority of the women said they were aware that exercising was beneficial, just 15 percent reported staying in shape in a sport club or exercise studio.

"Because of the physical changes at the start of a pregnancy, a lot of women don't really feel up to it," Meier said. The women stop exercising even if they used to visit a fitness studio regularly. However, Meier noted, "Their discomfort usually diminishes in several weeks, after which pregnant women could resume exercising."

However, many women are unsure if they should work out while pregnant, and if so, in what way.

"Generally speaking, any pregnant woman can exercise so long as her belly doesn't get in the way," Dudenhausen remarked.

The only contraindications involve health risks. Women with a heightened risk of a miscarriage or preterm labor, who suffer from vaginal bleeding or an acute infection, or who are pregnant with more than one child should refrain from exercise until consulting their physician since exercise could overburden their body.

Many pregnant women can continue doing the kind of exercise they did before. Dudenhausen and Meier agreed that running (also over long distances), hiking, cycling, calisthenics, and yoga were good choices.

"Swimming of all sorts is excellent because water supports the weight of the belly and hence relieves the back," Dudenhausen added.

But expectant mothers should avoid weight training, horseback riding and fast-paced ball games like squash," he said.

The risk of injury is too high in tennis, Dudenhausen explained, and weightlifting drew too much blood away from the lower body to supply the arms and back.

Pregnant women who exercise should watch their stamina, however. "From a medical point of view, exercise is possible even on the day they give birth," Dudenhausen said. "But every woman, of course, must consider what she's still capable of, and gradually reduce her regimen if need be."

The "talk test" can help determine how much is enough. If the woman, while exercising, cannot speak without feeling out of breath, then she is overdoing it.

(China Daily April 6, 2007)