Exercise & Women’s Health

As we celebrate ESSA’s 30 year anniversary, we will be looking at the different health areas of the exercise and sports science industry that have significantly grown over the last decade or two.

This includes the rapidly evolving role of physical activity in supporting women’s health, no matter their age, as well as before, during and after pregnancy.

To assist with this story, we refer to the June 2020 issue of Activate, where Esme shared her expertise on the history of exercise and women’s health.

Esme Soan is an Accredited Exercise Physiologist at Pear Exercise Physiology: Pregnancy & Women’s Health in Brisbane. When not working as a clinician, she teaches multidisciplinary practice with the Women’s Health Collective. Esme was also selected by ESSA as a 2018 Female Leader in Exercise & Sports Science for her crucial work within women’s health.

“Is it safe to do this exercise now that I am pregnant?”
This is one of the hottest questions I get in my clinical practice, usually from newly expectant mums in their first trimester.

Exercise during pregnancy is still viewed as controversial at times. From professional athletes like Serena Williams or Alysia Montaño (Alysia ran the 800-meter race at the 2014 U.S. track and field championships while eight months pregnant), to the regular gym attendee – there is still a very public misunderstanding of the risks, and the practical how-tos of pregnancy exercise. It’s understandable when you consider how much information has changed around exercise in pregnancy in just the last 30 years.

Stephen Stone, AEP

Richelle Street, AEP
Let’s rewind the clock
Historically, pregnant women were treated as if they were ill – wrapped in cotton wool, told to relax, avoid strenuous exertion, and minimise stretching for fear of squashing the baby or knotting the umbilical cord. It was only in 1985(!) that the American College of Obstetrics and Gynaecology (ACOG) published its first guidelines for exercise during pregnancy.

These very first ACOG guidelines, albeit conservative and not entirely evidence based, were at least a starting point for women who wanted to be physically active during pregnancy, and they provided some guidance for the health care professionals who would advise them. The guidelines contained very specific exercise heart rate max and duration of 140 beats/minute and 15 minutes, respectively – which didn’t get you very much or very far with an exercise program.

We now know that heart rate response is augmented by the additional blood volume and consequential increased cardiac output in pregnancy, and that a better indicator of exercise intensity is using the ‘talk test’ – an indicator of RPE (rate of perceived exertion) and level of breathlessness.

In the 1990s, pregnancy exercise researchers like James Clapp (considered one of the OGs of pregnancy exercise research) helped to expand on the understanding of the safety of exercise in pregnancy, clearing up the myths of miscarriage and placental growth. In fact, Clapp and his researchers helped us better understand how the multiple physiological changes that occur in pregnancy on the cardiovascular and metabolic systems work to protect mother and developing placental unit from risk.

Comprehensive position statements from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), Canadian Society for Exercise Physiology (CSEP) and ACOG have supported how the multiple benefits of exercise in pregnancy far outweigh the risks – it is actually considered a ‘window of opportunity’ to begin exercising and it is actively encouraged for women to exercise at a moderate intensity throughout pregnancy.
A gap in exercise & women's health literacy
Noticing that an easily accessible and coherent resource was needed to share the importance of exercise for women’s health, not just for pregnancy but the wide range of other conditions and life stages, ESSA published its Exercise & Women’s Health eBook in early 2019.

This eBook is a free resource for Australians that includes contributions from experts working in the women’s health space. The eBook covers a range of the more common women’s health conditions and life stages and outlines how exactly exercise is beneficial and the critical role Accredited Exercise Physiologists play in the care team.

In fact, ESSA’s general public platform, Exercise Right has been championing the importance of exercise and physical activity in women’s health for quite some time. With its wide range of blogs, resources and handy videos focusing on self-care, postnatal recovery and mental health. Exercise Right’s recent Women’s Health Week campaign from earlier this month encouraged Australian women to exercise for the right reasons. Find out more here.

“It's about self-care, not the scales. About health, not weight loss. About mental health, not the shape of your body.”

Pregnancy pre-screening tool released
In May of this year, the ‘Screening Tool for Physical Activity/Exercise During Pregnancy’ was launched, supported by ESSA and Sports Medicine Australia (SMA) and Fitness Australia. 

“This screening tool is evidence-based and aligns with the newly released Australian Department of Health physical activity during pregnancy guidelines. It is designed to be used by pregnant women themselves, or by health professionals to support conversations about physical activity during pregnancy,” explained Dr Melanie Hayman from Central Queensland University who led the development of the screening tool.

The screening tool acknowledges that doing any physical activity is better than doing nothing whilst pregnant. The screening tool also covers how much physical activity a pregnant woman should undertake, what sort of activities they should or shouldn’t do, as well what intensity of exercise should be completed. You can find it online here.

ESSA Exercise & Women's Health eBook

Screening Tool for Exercise and Pregnancy

Anna-Louise Moule and Esme Soan
Women’s Health Accredited Exercise Physiologists
At ESSA, we have seen an increase in ESSA accredited professionals dedicating themselves to promoting women’s health. From women’s health programs, to dedicated exercise physiology clinics, as well as educational providers supporting health professionals in the area of women’s health! Educational providers just like Esme and Anna-Louise Moule who are the co-Directors of the Women’s Health Collective.

Labelled as “No clunky metaphors, just multidisciplinary, sometimes cheeky and inclusive education in women's health” on their website, the Women’s Health Collective is an education platform that brings together women’s health clinicians from all areas of allied health, midwifery and medicine.

When interviewed in mid-2020, Esme and Anna-Louise both echoed the importance of Accredited Exercise Physiologists working in the women’s health space:

How important is the role of an Accredited Exercise Physiologist (AEP) in the area of women’s health?

Esme: "Super dooper important! Women’s health is such a broad umbrella term, and where it was once considered niche, we now understand that 50% of the population are female, and that female physiology is unique."

Anna: "So many women’s health conditions, chronic disease and injuries require a long-term and multidisciplinary approach, and that’s where AEPs really shine in supporting our clients."
Moving forward
Within even the last five years, understanding and public interest in exercise during pregnancy has absolutely soared, with access to social media, growth in supporting research in exercise as a preventative health measure for pregnancy induced complications (such as Gestational Diabetes Mellitus), and an increase in knowledgeable health care providers who can educate pregnant clients on how to keep/get moving (such as women’s health AEPs and physiotherapists).

We still have a lot to do in public perspective of ‘safety’ of exercise in pregnancy and have more to learn on the optimal exercise prescription for pregnant/postpartum athletes. With the rapidly expanding understanding of unique female physiology, and the demand for gender equality in research, we might see even further progressions in pregnancy exercise in years to come.

For women's health in general, Esme puts its perfectly by saying "it's tied up with politics, media, religion and rights, and due to this, to talk about it is often considered taboo. We need to acknowledge these links – to not do so only addresses half the problem – and break down the taboos that can delay women seeking help."

If you'd like to find an ESSA Accredited Exercise Physiologist in your area who specialises in women's health, visit our online search function today.

Click here

Elisha Silcox, AEP

Supporting health through exercise for 30 years 

To celebrate 30 years of Exercise & Sports Science Australia (ESSA), we are reflecting on 30 stories which commemorate the profound impact the exercise and sports science industry and its professionals have had on our communities, and how they have benefited the health landscape in Australia.

Click here to read more like this one