Last week we discussed gestational diabetes, what it is, risks for developing and will it affect you and baby long term. We briefly discussed how to manage GDM and how it should be managed with diet modifications, exercise/physical activity, fetal health monitoring and medications if required. This week we are going to talk about specifically how a physiotherapist can help you.
Physiotherapists are experts in physical activity and exercise prescription. So, it just makes sense that we would be involved in the medical team to help you on your journey.

It’s important that we, as physiotherapists, are using the most up to date evidence guidelines, so you can continue to safely exercise throughout your pregnancy. It has been found that women who exercise within the first 20 weeks of pregnancy decrease their likelihood of developing gestational diabetes by 48-78% compared to women who didn’t exercise (Dempsey JC et al 2015). Even better is that women who participated in exercise for at least one year prior to falling pregnant reduced their risk of developing GDM by 56-76% (Dempsey JC et al 2015).

Unmanaged gestational diabetes is likely to lead to; (Padayachee C, Coombes JS 2015)

  • Emergency caesarean sections
  • Preeclampsia
  • Longer labour times
  • Instrumental vaginal delivery
  • Perineal tearing
  • Postpartum hemorrhage
  • Longer hospital stays (due to the above)

Because of these factors, for the future health of mother and baby it is critical that the management of GDM is taken seriously.

For women who were previously sedentary (did not participate in exercise) prior to getting pregnant it is advised they consult their GP before participating in exercise. The below conditions have been identified by the American Congress of Obstetricians and Gynecologists as being unsafe to exercise while pregnant;

  • Restrictive lung disease
  • Ruptured membranes
  • Preeclampsia
  • Pregnancy induced hypertension
  • Premature labour
  • Persistent bleeding
  • Incomplete cervix of cerclage
  • Placenta previa after 26 weeks
  • Significant heart disease
  • Multiple gestation (triplets)

Benefits of exercise during pregnancy;

  • Lower birth weight
  • Easier labour
  • Increased foetal oxygenation

How much exercise should I do?

  • Aged 20-29 and 30-39 heart rates between 135-150 and 130-145 respectively
  • Aerobic exercise 30min, 4 times a week @ moderate intensity
  • Strength exercise 3 times a week, not on consecutive days 2-3x 8-10reps of each exercise @ moderate intensity
  • Aerobic exercise includes: walking, swimming, cycling, pilates, yoga.
  • Strength training 3 times a week @ moderate intensity

If at any time while exercising you experience vaginal bleeding, dizziness, headache, chest pain, muscle weakness, decreased fetal movement, amniotic fluid leakage, calf pain, or shortness of breath you need to stop exercising as speak to your GP.

Working with your medical team and physiotherapist is important to effectively manage your gestational diabetes. Exercise has been shown to not only help your health but the health of bub. Your physiotherapist has the skill and expertise to develop an individualised program to keep you safely exercising throughout your pregnancy. Reach out today to find out where you can get started.


Dempsey JC, Butler CL, Sorensen TK, Lee IM, Thompson ML, Miller RS, Frederick IO, Williams MA. A case-control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Res Clin Pract. 2004;66:203–215.

(Padayachee C, Coombes JS. Exercise guidelines for gestational diabetes mellitus. World J Diabetes. 2015 Jul 25;6(8):1033-44. doi: 10.4239/wjd.v6.i8.1033. PMID: 26240700; PMCID: PMC4515443.)