Despite strong evidence suggesting exercise can be advantageous for expectant mothers and their unborn babies, Hong Kong women find themselves told not to take part in such activities. Well- meaning mothers-in-law and even local doctors warn that strenuous workouts could harm the baby, induce early labour, or even trigger a miscarriage.

Karen Lee decided to avoid the lectures by keeping quiet about her weightlifting, circuit training, TRX (a form of suspension weight training) and the other workouts she did until her third trimester.

“These stereotypes [are thrown at you], that when you’re pregnant, you should lie down, take it easy, and, in terms of exercise, only do yoga or swimming,” she recalls. The 32-year-old says such outdated beliefs persist in the Asian community.

She turned to her more active friends and trainers for support, and others in the fitness community who had continued weightlifting and circuit training while pregnant. She also did extensive research.

“I took away from what I had read and learned from other people to trust your body, so if you’re exercising and you feel great, keep going, but if you’re out of breath, take a moment and rest,” she says.

Exercising during pregnancy offers health benefits for mother and baby

Lee stayed in tune with her body and adjusted her routines accordingly. She lifted 45kg (99lbs) to 60kg weights depending on how she felt on a training day, instead of the 95kg weights she was lifting before she was pregnant.

Lee credits trainer Tanya Young at Pherform – a gym in Hong Kong’s Central district – who is experienced in training pregnant women, for observing her and slowing or lowering the intensity of her workout if she appeared to be overexerting herself. Young sometimes adjusted Lee’s workouts to make them easier on her back.

Prior to pregnancy, Lee too part in weightlifting and Cross-Fit-style boot camps five to six times a week. During her pregnancy, the vegetarian worked out at Pherform’s women-only gym for boot camp, weightlifting and Cross-Fit-style activities. Her workouts also included the rowing machine, kettle balls, and burpees.

Lee stopped exercising in her sixth month due to pelvic pain, a common pregnancy symptom. By the seventh month, she was doing yoga and Pilates. In the final months, she stopped everything due to complications that left her bed-bound.

“The complications happened when I was doing yoga and Pilates,” she said, stressing her problem was unrelated to her workouts in the earlier stages of pregnancy.

Lee gave birth to her daughter last October by caesarean section. She’s convinced that exercise sped up her recovery and return to form; within a week of her delivery, she could fit into her regular clothes again.

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Studies suggest exercise during this milestone period of a women’s life is safe and beneficial for mother and baby.

Researchers at Camilo José Cela University in Spain did an analysis of previous studies involving thousands of women, and found numerous benefits from exercising while pregnant: less maternal weight gain, lower risk of fetal macrosomia (babies weighing more than 4kg, 8.8lbs); pre-eclampsia; gestational diabetes; lower back pain; and more.

The study, published in The Journal of The American Medical Association last year, also noted that exercise did not introduce a risk of premature delivery, lower birthweight or fetal distress, provided the mother-to-be didn’t have a medical or obstetric complication.

Cindy Cheung continued working out three to four times a week – as she had been doing for years – during much of her pregnancy. The 33-year-old veterinary surgeon enjoys jogging, gym workouts, yoga and her favourite, aerial silk – a variation of pole dancing in which participants do routines in mid-air while hanging from a long silk fabric.

“You climb up using all your muscles to hold your body position,” she says. It strengthens your legs, arms and core, but feels more like dancing with choreography and music.

Her husband did not find it amusing that his wife was doing twists, turns and splits in mid-air while pregnant. “He thought I would fall and injure myself and the baby … he was fine with all my other exercises,” says Cheung. Her doctor cleared this workout as long as she didn’t fall during the exercise.

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With the help of her coach, she modified the routine to reduce risk of injury, performing the moves at a lower height. She stopped the dramatic ceiling-to-bottom drop-then-hold moves. She continued aerial silk until 36 weeks into her pregnancy, when she could no longer climb up the fabric.

Cheung gave birth naturally in October last year, a quick delivery. All those core strengthening exercises came in handy during pushing in labour, she says.

“Exercise does help with pregnancy, physically and mentally,” she says.

Dr Leung Wing-cheong, president of the Hong Kong College of Obstetricians and Gynaecologists, encourages exercise during pregnancy. He says it has many benefits, including the mother’s well-being, control of sugar levels, and it helps strengthen lower pelvic floor muscles in preparation for labour.

He also advises women to be careful of misconceptions and long-held beliefs in Asian culture that mums-to-be should rest, not work, cease exercise, and sleep as much as possible.

“In general, these are misconceptions. For a great majority of women, exercise is encouraged but there are exceptional cases,” says Leung. Pregnant women with heart disease or other chronic problems would not be good candidates for strenuous exercise, he adds.

He prescribes a common-sense approach. “If the woman has been doing those recreational exercises – such as swimming, gym, jogging etc – before getting pregnant, she can continue to do them,” he says. If she has been weightlifting for years, she can continue such exercise, as that is her fitness norm.

The frequency and activity level may need to be adjusted according to how a mother-to-be feels, to ensure she is not overtired, overheated or out of breath.

“It’s not recommended to step up her exercises,” he says, adding that this is not the time to train for a major contest. The added weight from her expanding belly, and increased hormones during pregnancy mean joints tend to become looser. Exercises may need to be adjusted.

Leung advises women to drink plenty of water. Those with gestational diabetes should exercise after meals, Dr Leung says, to control blood-sugar levels.

The doctor discourages any high-impact sports that may result in falls or jabs at the abdominal area, such as horse-riding, skiing, kick-boxing, rugby and Judo.

“It’s about common sense: if the exercises have been built into their daily habit, there is no [reason] to stop it, unless it’s inappropriate exercises like Judo.”