Physical activity in pregnancy and its impact on duration of labor and postpartum period
Anna Monika Brzęk 1  
,   Beata Naworska 2  
,   Kamila Plasun 1  
,   Anna Famuła 1  
,   Weronika Gallert-Kopyto 3  
,   Violetta Skrzypulec-Plinta 4  
,   Michał Michalski 1  
,   Zbigniew Sprada 5  
,   Ryszard Plinta 5  
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Department of Kinesiology Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of Gynaecology and Obstetrics, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of Physiotherapy Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of Women’s Disease Control and Prevention, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Department of Adapted Physical Activity and Sport Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland
Anna Monika Brzęk   

PhD, PT, Department of Kinesiology Chair of Physiotherapy, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, Poland, ul. Medyków 12, 40-754 Katowice, tel. +48 32 208 87 21
Ann. Acad. Med. Siles. 2016;70:256–264
The aim of the work was to assess the level of physical activity of women before and during pregnancy and to determine whether physical exercise influences the course and duration of labor and the postpartum period.

Material and methods:
The study encompassed 63 pregnant women aged 19–36, with a mean pregnancy weight gain of 7–27 kg, no contraindication to physical activity, and term birth. Physical activity was assessed at three stages: before and during pregnancy, and during the postpartum period, with the use of the seven-day international IPAQ questionnaire. The respondents’ physical condition in the postpartum period was assessed with an original 26-item questionnaire.

The self-assessed level of physical activity before pregnancy was moderate in most respondents (60.3%); only 12.7% of the respondents declared a low level of physical activity. During pregnancy the level of physical activity decreased in 25.4% of the respondents and significantly reduced in 11%. Women who were inactive before pregnancy remained inactive during pregnancy. The mean duration of the second stage of labor in women with moderate and high levels of physical activity was 43.61 min. The length of the entire postpartum period was the shortest (four weeks) in active women.

Physical activity before and during pregnancy has an impact on the duration of labor and the postpartum period.

Shloim N., Hetherington M.M., Rudolf M., Feltbower RG. Relationship between body mass index and women’s body image, self-esteem and eating behaviours in pregnancy: a cross-cultural study. J. Health Psychol. 2015; 20: 413–426.
Hegaard H.K., Damm P., Hedegaard M., Henriksen T.B., Ottesen B., Dykes A.K., Kjaergaard H. Sports and leisure time physical activity during pregnancy in nulliparous women. Matern. Child. Health. J. 2011; 15(6): 806–813.
Ning Y., Williams M.A., Dempsey J.C., Sorensen T.K., Frederick I.O., Luthy D.A. Correlates of recreational physical activity in early pregnancy. J. Matern. Fetal Neonatal Med. 2003; 13(6): 385–393.
Lindqvist M., Lindkvist M., Eurenius E., Persson M., Ivarsson A., Mogren I. Leisure time physical activity among pregnant women and its associations with maternal characteristics and pregnancy outcomes. Sex. Reprod. Healthc. 2016; 9: 14–20.
Gavard J.A., Artal R. Effect of exercise on pregnancy outcome. Clin. Obstet. Gynecol. 2008; 51(2): 467–480.
Domenjoz I., Kayser B., Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am. J. Obstet. Gynecol. 2014; 211(4): 401, e1–11.
Morgan K.L., Rahman M.A., Hill R.A., Zhou S.M., Bijlsma G., Khanom A., Lyons R.A., Brophy S.T. Physical activity and excess weight in pregnancy have independent and unique effects on delivery and perinatal outcomes. PLoS One 2014; 9(4): e94532.
Myers J. Exercise and Cardiovascular Health. Circulation 2003; 7: 1–4.
Czarkowska-Pączek B., Przybylski J. Zarys fizjologii wysiłku fizycznego [Physiology otline of physical exercises]. Elsevier Urban & Partner. Wrocław 2006.
Traczyk W., Trzebski A. Fizjologia człowieka z elementami fizjologii klinicznej [Human Physiology with applied physiology and clinical elements]. Wydawnictwo Lekarskie PZWL. Warszawa 2003.
Barakat R., Perales M. Pregnancy, Physical Activity, Functional Capacity and Adaptations to Exercise. Current Women's Health Reviews 2015; 11(1): 13–18.
Szumilewicz A., Wojtyła A., Zarębska A., Drobnik-Kozakiewicz I., Sawczyn M., Kwitniewska A. Influence of prenatal physical activity on the course of labour and delivery according to the new Polish standard for care. Ann. Agric. Environ. Med. 2013; 20(1): 380–389.
Dudzik I. Antenatal classes under special supervision. Infor. Warszawa 2010.
Bartelmus E. Kinezyterapia pozycyjna, oddechowa, techniki sprężystego odkształcania tkanek stosowane podczas pierwszej fazy porodu [Kinezytherapy positional and respiratory and techniques of elastic deformation of tissues used during I Phase of birth]. Rehabilitation in Practice 2010; 4: 24–27.
Baston Hall J. Podstawy położnictwa. Przed Porodem [Basics of obstetrics. Before birth]. Elsevier Urban & Partner. Wrocław 2011.
Ćwiek D., Augustyniak K., Branecka-Woźniak D. Szkoły Rodzenia [Antenatal classes]. Wydawnictwo Lekarskie PZWL. Warszawa 2010.
Pate R.R., Pratt M., Blair S.N., Haskell W.L., Macera C.A., Bouchard C. et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of American Medical Association 1995; 273(5): 402–407.
Leischik R., Dworrak B., Strauss M., Przybylek B., Dworrak T., Schöne D., Horlitz M., Mügge A. Plasticity of Health. German Journal of Medicine 2016; 1: 11–17.
Danielsen K.K., Svendsen M., Mæhlum S., Sundgot-Borgen J. Changes in body composition, cardiovascular disease risk factors, and eating behavior after an intensive lifestyle intervention with high volume of physical activity in severely obese subjects: a prospective clinical controlled trial. Hindawi Publishing Corporation J. Obes. 2013; 325464.
Wojtyla A., Kapka-Skrzypczak L., Paprzycki P., Skrzypczak M. Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations – adaptation of the hypothesis development origin of health and diseases. Ann. Agric. Environ. Med. 2012; 19(2): 315–326.
Royal College of Obstetricians and Gynecologists. Exerc. Pregnancy 2006; 4: 1–7.
Azzopardi D., Strohm B., Marlow N., Brocklehurst P., Deierl A., Eddama O., Goodwin J., Halliday H.L., Juszczak E., Kapellou O., Levene M., Linsell L., Omar O., Thoresen M., Tusor N., Whitelaw A., Edwards A.D. Effects of Hypothermia for Perinatal Asphyxia on Childhood Outcomes. N. Engl. J. Med. 2014; 371: 140–149.
Reed R.C. Mechanical traumas of childbirth include injuries to the newborn resulting from force. Semin. Perinatol. 2015; 39(1): 64–69.
Boulvain M., Senat M.V., Perrotin F. Winer N., Beucher G., Subtil D., Bretelle F., Azria E., Hejaiej D., Vendittelli F., Capelle M., Langer B., Matis R., Connan L., Gillard P., Kirkpatrick C., Ceysens G., Faron G., Irion O., Rozenberg P. Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial. Lancet 2015; 385, 9987: 2600–2605.
Artal R., O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br. J. Sports Med. 2003; 37: 6–12.
Ballard C.G., Stanley A.K., Brockington I.F. Post-traumatic stress disorder (PSTD) after childbirth. Br. J. Psychiatry 1995; 166: 525–528.
Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No 650. American College of Obstetricians and Gynecologists. Obstet. Gynecol. 2015; 126: e135–142.
Bloom S.A., Casey B.M., Schaffer J.I., McIntire D.D., Leveno K.J. Randomized trial of coached versus uncoached maternal pushing during the second stage of labor. Am. J. Obstet. Gynecol. 2006; 194(1): 10–13.
Harper L., Caughey A., Odibo A., Roehl K.A., Zhao Q., Cahill A.G. Normal Progress of Induced Labor. Obstetrics Gynecology 2012; 119(6): 1113–1118.
Abogamal A. Evaluating the effect of Valsalva maneuver on pain occurring during knee injection: A prospective, randomized study. Orthop. Reumatol. 2016; 5(2): 00176.
Pisarski T. Ginekologia i Położnictwo [Gynecology and Obstetrics]. Wydawnictwo Lekarskie PZWL. Warszawa 2002.
Suhitharan T., Pham T.P., Chen H., Assam P.N., Sultana R., Han N.L., Tan E.C., Sng B.L. Investigating analgesic and psychological factors associated with risk of postpartum depression development: a case–control study. Neuropsychiatr. Dis. Treat. 2016; 12: 1333–1339.
Merhi Z.O., Awonuga A.O. The role of uterine fundal pressure in the management of the second stage of labor: a reappraisal. Obstet. Gynecol. Surv. 2005; 60(9): 599–603.
Ćwiek D., Grochans E., Łuczyńska V., Szych Z. Wpływ edukacji przedporodowej na stosowanie metod zmniejszających odczuwalność bólu w czasie porodu [The influence of antenatal education on usage the reducting pain methods during the childbirth]. UMCS Sect. B 2004; 59, Supl. 14, 1: 375–380.
Currie S., Sinclair M., Murphy M.H. Reducing the Decline in Physical Activity during Pregnancy: A Systematic Review of Behaviour Change Interventions. PLoS One 2013; 8(6): e66385.
Foxcroft K.F., Rowlands I.J., Byrne N.M., McIntyre H.D., Callaway L.K. Exercise in obese pregnant women: the role of social factors, lifestyle and pregnancy symptoms. BMC Pregnancy Childbirth 2011; 11: 4.
Poudevigne M.S., O’Connor P.J. A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Medicine 2006; 36: 19–38.
Borodulin K., Evenson K.R., Wen F., Herring A.H., Benson A. Physical activity patterns during pregnancy. Med. Sci. Sports Exerc. 2008; 40(11): 1901–1908.
Evenson K.R., Savitz A., Huston S.L. Leisure-time physical activity among pregnant women in the US. Paediatr. Perinat. Epidemiol. 2004; 18: 400–407.
Dönmez Sevgul, Kavlak Oya. Effects of Prenatal Perineal Massage and Kegel Exercises on the Integrity of Postnatal Perine. Health 2015; 7(4): 495–505.
Lewicka M., Sulima M., Kanadys K., Stawarz B., Wiktor H. Indywidualne przygotowanie par do macierzyństwa i ojcostwa przez położne rodzinne [Individual Preparation of Couples to Maternity and Paternity]. Annals of Family Studies 2013; 5(60): 261–273.
Uppal E., Manley J., Schofield A. Pilates for pregnancy and beyond: a study. Pract. Midwife 2016; 19(5): 25–27.
Bribiescas Saleena. Yoga in Pregnancy. International Journal of Childbirth Education 2013; 28, 3: 99–102.
Yan C.F., Hung Y.C., Gau M.L., Lin K.C. Effects of a stability ball exercise programme on low back pain and daily life interference during pregnancy. Midwifery 2014; 30(4): 412–419.
Berk B. Recommending exercise during and after pregnancy: what the evidence says. International Journal of Childbirth Education 2014; 19: 18–22.
Fijałkowski W. Kinesiostimulation in obstetrics. [W:] Medical Rehabilitation. A. Kwolek. Urban & Partner. Wrocław 2003.