Many countries are battling higher than recommended c-section rates with nearly one in three mothers giving birth via surgery. Many pregnant mothers, especially first time mothers, hope to avoid a c-section birth. Even mothers who had a previous c-section, often hope to avoid a repeat and hope for a vaginal birth after a c-section (VBAC). We try to make informed choices and trust that our maternity care providers will provide the best care and information necessary to have a low-risk birth. However, more and more it seems that having a low-risk pregnancy and birth is in many ways in the hands of the mother.
A new study has found a connection between exercise during pregnancy and a reduced risk of c-section in first time mothers.
Certainly a connection isn’t a clear cause and effect, but it does show that the two are in some way connected. Regardless of exercise habits, there are certain situations which necessitate a c-section birth. These studies and goals of reducing c-section rates are about reducing unnecessary c-sections, not those which must be performed to keep mother and baby safe. The information is also used to help prevent some births from needing to become c-sections due to developing risks during pregnancy or due to the cascade of interventions.
How Did Exercise Impact C-Section Rates?
The study included 39,187 first time mothers pregnant with one baby. These women were surveyed regarding their exercise habits between 17 and 30 weeks of pregnancy and then followed up to see how they gave birth. Researchers found that women who regularly exercised had a reduced risk of c-section birth compared to women who didn’t exercise during pregnancy. The most significant reduction occurred in women exercising at least 5 times per week and choosing high impact exercises (e.g. jogging, ball games, running, any aerobic type exercise).
How Can Exercise Impact Pregnancy And Birth Outcomes?
Being active is important for many of our bodily functions, pregnant or not. Exercise helps keep our muscles, bones and immune system strong. It helps our metabolism, our digestion, it even helps to stabilise our post meal glucose levels. It’s also important for our cardiovascular system, and can even be protective against depression and other mood disorders.
During pregnancy, our body still needs good food and an active lifestyle to be its healthiest. In fact, in some ways it needs it even more. Due to hormonal changes from the placenta, our blood sugar tends to be elevated, and the increase in blood volume can make us prone to higher blood pressure.
Regular activity – even just a 30 minute walk per day – can help our body keep more stable blood sugars and reduce our risk of developing gestational diabetes.
And if we still develop gestational diabetes, regular activity can help us keep our blood sugar controlled. Uncontrolled gestational diabetes can lead to your baby being bigger than nature intended, thus increasing the risk of a c-section birth.
If you experience elevated blood pressure towards the end of pregnancy, sometimes an induction becomes necessary. Having an induction can increase the risk of needing a c-section birth due to the cascade of interventions and/or your body or baby not being ready for birth.
When blood pressure becomes elevated during pregnancy and isn’t responsive to rest, dietary changes or medications, often birth is necessary to keep you and baby healthy.
Certainly, there are women who will remain active and have a very well balanced diet, and still develop gestational diabetes or high blood pressure.
However, the evidence is clear that remaining active greatly reduces the risk of developing both. Unfortunately, reducing risk doesn’t eliminate risk 100%. Should a mother still develop pregnancy complications, often remaining active and having a good diet can reduce the severity or side effects of certain complications.
I’ve Always Been A Healthy Weight, Does This Still Apply To Me?
When we think about the benefits of exercise, we often assume that having a healthy BMI (or a healthy weight) is all that matters.
However, it’s very possible to be a healthy weight and still have insulin resistance or poorer health, due to a lack of exercise or an unhealthy diet.
The average Western diet contains a lot of processed carbohydrates, which can lead to many health issues. The average Western lifestyle is also often fairly sedentary, which we now know can cause many health issues. Some experts say a sedentary lifestyle is almost as bad for your health as smoking.
Even if you begin pregnancy low risk and with a healthy weight, being inactive or having a poor diet can lead to pregnancy complications.
Aware of the possibility that entering pregnancy with a healthy BMI could impact overall risk level, researchers looked at the results again, while only featuring women entering pregnancy as low risk. There was no change in c-sections risk level between active and inactive first time mothers, showing that being active during pregnancy is an important part of a healthy pregnancy regardless of your pre-pregnancy weight.
Again, a correlation doesn’t necessarily equal a cause and effect, but the results of this study do show that being active is an important part in a healthy pregnancy, and more research should be done to determine why and how that is.
It also seems that it’s important for maternity care providers to emphasise the importance of getting or remaining active during pregnancy (barring any serious pregnancy complications which might require activity restriction).
Before you start any new exercise program, please consult your midwife or doctor for the all clear.