Cycling and pregnancy: your questions answered

Dr Ruth-Anna Macqueen, specialist in obstetrics and gynaecology, provides answers to the most common questions

We've gathered the most commonly asked questions asked about cycling and pregnancy for cyclist and doctor Ruth-Anne Macqueen, such as is it safe to cycle during pregnancy and how quickly after birth can you get back on the bike, to get you some answers.

How many times a week do you think Ruth-Anna Macqueen gets asked if it’s okay to cycle when pregnant? (And how okay, precisely? You might add).

Well, given that she’s a doctor that specialises in obstetrics and gynaecology, with a whole load of letters after her name (MBBS BSc MRCOG), the answer is… a lot.

There is no evidence of harm to the baby from moderate cycling

She scours the medical journals for the latest research and is on top of all the official advice; it's just part of her job — looking after women during pregnancy and labour, delivering babies who need extra assistance, and caring for women with gynaecological problems. So she’s absolutely the right person to answer questions about cycling in pregnancy.

In the interests of transparency, we should also point out that she’s mum to three children (aged six, four and eight months) and a keen supporter of family cycling and being physically active in pregnancy. In fact, from her east London home, when she’s not doctoring (an official term), she runs a family cycling group and equipment library.

With her doctor hat on, we asked Dr Macqueen how she answers the most frequently posed questions about cycling while pregnant, and here is what she told us…

Got a question about cycling and pregnancy? Our expert is on hand to answer them
Got a question about cycling and pregnancy? Our expert is on hand to answer them

1. Should I stop cycling now I'm pregnant?

There is no need to stop cycling just because you are pregnant. Indeed there is growing evidence of the benefits of exercise in pregnancy, including cycling.

These include reduced risk of gestational (pregnancy induced) diabetes, a reduced risk of blood pressure problems, reduced weight gain and improved fitness, among others.

Recent guidance from the Chief Medical Officers (CMO) of Scotland, England, Wales and Northern Ireland specifically mentions cycling as a way of getting the recommended 150 minutes per week of moderate exercise during pregnancy. With mountain biking, there is a concern about the risk of falls and therefore it is generally advised to avoid this.

Scotland’s chief medical officer Catherine Calderwood says: “My advice to pregnant women is to listen to their body and adapt their exercise regime accordingly. If you’re not already active, start gradually — and if you are active, just keep going. If anything feels uncomfortable, then stop and seek advice.”

2. Will cycling harm my baby?

There is no evidence of harm to the baby from moderate cycling in a normal, uncomplicated pregnancy (“moderate” is defined as activity that “makes you breathe faster, while still being able to hold a conversation”).

Specifically there is no evidence to show any increased risk of miscarriage in the early months or risk of premature labour later on in pregnancy. There is no difference in incidence of small babies or any other complications to newborn babies.

Women report many benefits, including reduced nausea, aches and pains, better sleep and improved mood

If you are new to cycling, the advice is the same as with any form of exercise in pregnancy — start gradually and build up. It is recommended to start with 10 minutes at a time and build this up.

Warning signs to be aware of are those which should prompt medical attention regardless of exercise. They include breathlessness before or following minimal exertion, headaches, dizziness, chest pain, muscle weakness affecting balance and calf pain or swelling.

Women may also be advised to reduce or stop physical activity if they develop any pregnancy complications, for example bleeding from the vagina or leaking amniotic fluid.

3. Do I need to modify my bike now I'm pregnant?

This is entirely up to you. Many women find a more upright frame more comfortable in the later months of pregnancy, but there is no medical reason this is necessary if you are comfortable on a road bike.

Some women also find a wider saddle more supportive and comfortable in pregnancy.

4. Will being pregnant affect my balance?

Again, this is a very individual.

There is some evidence that postural balance can be affected during pregnancy, however this varies from woman to woman. Research done recently surveying women who cycled in pregnancy found that there was a huge variety of experiences of different women, with some finding significant difference in their balance and spatial awareness, and others finding no difference at all.

5. Should I avoid the bumpiness of cycling off road?

The CMOs guidance specifically advises to avoid “off road” cycling. However this is due to risk of falls, and there is no evidence that cycling on bumpy terrain per se will harm your baby or send you into premature labour.

6. How can I cycle safely now I'm pregnant?

This is more related to overheating, rather than falling off.

For pregnant women who are extremely active and perform very vigorous activity, the CMOs report recommends being careful not to exercise for long durations (over one hour) especially in hot, humid conditions, to avoid the risk of overheating.

Sensible precautions also involve staying well hydrated and wearing cool, comfortable clothing especially in hot weather.

Don’t feel under any pressure to leap back on your bike

7. What are the benefits of cycling while pregnant?

There is good evidence that exercise in pregnancy is associated with reduced weight gain during the course of the pregnancy. Increased weight gain in pregnancy is linked to more complications of pregnancy and interventions including induction of labour, Caesarean section and pre-eclampsia.

There is also a growing consensus that avoiding excess weight gain in pregnancy has longer term health benefits for the baby, including risk of obesity, type 2 diabetes and heart disease in later life.

For the mother, exercise in pregnancy is also shown to reduce the risk of developing pregnancy-related diabetes and pregnancy-related blood pressure problems (including pre-eclampsia), which are both associated with a range of problems for mother and baby.

Women report many other benefits, including reduced nausea, aches and pains, better sleep and improved mood. There is also good evidence that exercising in pregnancy improves cardiovascular fitness, which will have long term health benefits.

And, of course, there are all the other benefits of cycling — such as convenience, speed, independence, cost savings and contributing to reduced air pollution.

8. How quickly can I get back to cycling after I give birth?

When you feel ready, and this will vary hugely depending on all kinds of factors including the type of birth you have had (vaginal or Caesarean), whether you had any complications (especially any tears or stitches) and whether you even have time to think about cycling in the fog of looking after a newborn!

Don’t feel under any pressure to leap back on your bike. However, if you listen to your body and avoid doing anything that is painful or puts strain on areas that have been worked incredibly hard, you will not do yourself any damage if you do want to cycle.

If you have had any tears or stitches, it would be sensible to allow these to heal fully before contemplating riding. It may then be more comfortable to use a fat, padded saddle or gel cover for the first few weeks, or wear padded shorts even if you don’t usually.

If you have delivered by Caesarean section, the main thing is to avoid putting strain on the abdominal muscles, which may affect how far and fast you ride, and also your position when you cycle.

If at all unsure, then wait until your six week check-up and discuss it with your GP.

If you are breastfeeding, your breasts may be much heavier and larger than usual and it may be more comfortable to wear a well-fitting sports bra.

9. What should I wear? My bike shorts don't fit! Is it safe to cycle without padded shorts?

Yes! Padded shorts are just for comfort and have no safety benefits.

If you want cycle-specific clothing there are now brands bringing out specific maternity wear for cycling as well as other types of exercise. 

So there you have it. But just because there are guidelines telling you it’s okay to cycle when you’re pregnant, it just might not feel right, and that's okay too. All women experience pregnancy differently and all pregnancies are different to some degree.

Got any other questions about cycling and pregnancy that we haven't answered above? Pop them in the comments section below and we'll do our best to answer them for you.

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