Letter to the editor for this special issue on “Exercise during pregnancy”

The Barakat model (Guideline entitled “An exercise program throughout pregnancy: Barakat model” by Barakat, in this issue) presents an interesting program for professionally supervised exercise for pregnant women. It is a good supplement to what we already know is recommended and works for women who are pregnant. Women do not necessarily need supervised exercise programming unless there are known risks or they prefer to have a trainer. In those cases, their obstetrician could work with an American College of Sports Medicine (ACSM) certified personal trainer or an ACSM Certified Clinical Exercise Physiologist to carry out the training sessions. These would be rare occasions at least in the United States. Pregnant women should always consult with their obstetrician before beginning an exercise program anyway. Exercise is known to be beneficial to women who are pregnant and improve birth outcomes both in reducing complications during pregnancy, birth, and postnatal periods (Downs, Chasan-Taber, Evenson, Leiferman, & Yeo, 2012; Ferraro, Gaudet, & Adamo, 2012; Pivarnik et al., 2006; Tobias, Zhang, van Dam, Bowers, & Hu, 2011) and in the health of children born to these women (Prather, Spitznagle, & Hunt, 2012). In fact, exercise recommendations for women who are pregnant are the same for the healthy adult (150 min/week of moderately intense aerobic exercise on most days of the week) as long as there are no medical complications or concerns (ACSM, 2013 report https://www.acsm.org/docs/default-source/files-for-resource-library/pregnancy-physical-activity.pdf?sfvrsn=12a73853_4; Centers for Disease Control, https://www.cdc.gov/physicalactivity/basics/pregnancy/index.htm; and U.S. Department of Health and Human Services, 2008, https://health.gov/sites/default/files/2019-09/paguide.pdf). There are some modifications depending on the week of pregnancy. Exercise should always be modified for women who are pregnant based on symptoms, discomforts, and changes in ability across the course of pregnancy (ACSM's Guidelines for Exercise Testing and Prescription, 10th edition, 2018). A physical activity readiness questionnaire for pregnant women should be given before beginning an exercise program (https://www.chp.gov.hk/archive/epp/files/PARmed-X.pdf). Consistent with the letter to the editor by Dr. Antoine-Jonville (in this issue), a trainer is not necessarily needed and an autonomous exercising program would reach more people. Pregnant women might be more likely to start an exercise program if they knew that they can do it on their own and if they knew that just walking is great exercise by itself especially during pregnancy. Recommendations and practices in other parts of the world may differ. Exercise during pregnancy, for the most part, positively impacts maternal and fetal health and well-being. Even if initiating physical activity during pregnancy, that can set the stage for lifelong exercise habits that would benefit the mother, child, and family. The prenatal period is a valuable time for counseling regarding physical activity and discussing barriers to physical activity in order to promote healthy exercise levels during pregnancy and afterwards. Data sharing is not applicable to this article as no new data were created or analyzed in this study.