A passion for women's health
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For much of recent history, pregnant women have been told to dial back the exercise – keep it simple and safe, and nothing too intense in case it harms the baby.
Childbearing women “were treated as if they had an illness and subjected to a state of confinement”, say the authors of Exercise During the Childbearing Year. “They were advised to relax, avoid strenuous exertion, and minimise stretching and bending for fear of strangling or squashing the baby.”
“These days, the research shows that some of those fears were misguided,” says ACU researcher Courtney Giles, an accredited exercise physiologist with an interest in women’s health.
“Fitspo mums pushing their bodies right up to delivery can create quite a stir, but our own published research has shown that even vigorous physical activity is perfectly safe for mum and bub and can actually have a range of positive effects.”
In some quarters, however, it seems the old thinking lives on.
Take the example of tennis great Serena Williams. In April 2017, she posted a selfie on social media showing her in a one-piece swimsuit with the caption “20 weeks”. As observers soon pointed out, this was less than three months after she won the Australian Open, meaning she would have been around eight weeks into her pregnancy during the tournament.
Cue widespread amazement that she’d even competed while pregnant, an indication that – at least amongst some people – the belief that pregnancy and vigorous physical activity are incompatible persists.
The good news is that thanks to a growing body of research, childbearing women now have some official physical activity guidelines to refer to; a step in the right direction, says Courtney, who is currently pursuing her PhD on the effects of exercise on blood flow and cardiovascular function during pregnancy.
“We now know much more about the effects that exercise can have – what is safe and what might not be,” she says. “So the knowledge is growing and the guidelines are more evidence-based, but at the same time, there’s lots more to explore.”
Expanding the knowledge-base
With this in mind, Courtney Giles embarked on a higher degree by research at ACU and is currently studying the effects of light, moderate and vigorous intensity exercise during each trimester of pregnancy.
More specifically, she wants to see if exercising at a higher intensity may be more beneficial to vascular function in childbearing women.
“For almost any other physical conditions, we know that bouts of vigorous to high-intensity exercise will have greater effects on blood pressure and heart rate,” Courtney says. “If you think about it, labour itself is an intense workout, so it makes logical sense to be as fit and healthy as possible to prepare for that.”
To date, the research is promising. In 2019, Courtney was co-lead author of a study exploring the effects of vigorous intensity exercise in the third trimester of pregnancy. It showed that activities like running, swimming, interval training and weight-lifting were safe for most low-risk pregnancies, even during this late stage, when the needs of the foetus are greater.
Courtney is currently collecting data for another study that will take her research a step further, comparing the effects of exercise on women in healthy pregnancies with those who have risk factors including gestational diabetes and obesity.
Along with her co-researchers, she aims to test the hypothesis that vigorous-intensity exercise could be as beneficial in pregnancy as it is in other cohorts, potentially warding off conditions like preeclampsia – a serious medical complication that affects up to eight per cent of all pregnancies in Australia.
“We know that vigorous exercise can help to reduce blood pressure levels in all other populations, so putting two and two together, we’re looking to see if regular exercise at a high enough intensity might help to prevent the onset of preeclampsia,” she says.
Participants will put through their paces on the treadmill and in a series of resistance and bodyweight exercises and then tested for blood pressure, arterial stiffness and foetal heartrate.
While it’s too early to tell what effects these sweat-inducing activities will have on preeclampsia and the overall health of these women, it will at the very least give researchers a greater understanding of the potential risks and benefits.
“We know there are numerous benefits to continuing exercise in pregnancy, but we’d like to know more about how much, and how intense, so we can give the right advice to pregnant women,” Courtney says.
“In the end, that’s what this is all about – giving women accurate, evidence-based information so that they, and the medical professionals they’re consulting through pregnancy, know more about what is ideal for them, to ensure that both mum and baby are safe.”
A bright future
Courtney Giles came off a good base into her thesis studies, having previously completed her Master of Clinical Exercise Physiology at ACU.
Midway through her master’s degree, her course coordinator invited her to act as a research assistant, and she soon developed a strong interest in the effects of exercise during pregnancy.
“The fact that half the world’s population is female and many of them will get pregnant means that it’s a topic that affects a lot of people,” she says.
“It’s also an area where more research is needed, and if our research can inform the guidelines in the future and enable health professionals to give pregnant women more specific, evidence-based advice on exercise, I think that would be an important contribution.”
As for her own future plans, Courtney Giles has her sights set on a career that will balance research with clinical and academic work.
“Women’s health is the area I’m passionate about, with a focus on pregnancy, and ideally that will be the area I specialise in,” she says. “These are areas that have been neglected in the past, and I think it’s great that we’re now putting more focus on the health and wellbeing of women, which in turn has a positive effect on society as a whole.”
Courtney Giles is a PhD candidate at ACU. Her thesis seeks to determine the effects of different modes of exercise on vascular function, arterial stiffness, and blood pressure throughout pregnancy in healthy women and women with clinical conditions related to their pregnancy.
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