For Alice Kamanzi Muberarugo, staying active during pregnancy became a lesson learned through painful experience. Her first pregnancy ended in miscarriage after months spent sitting for long hours in her shop. I did not think much about it because my work required me to sit in the shop the whole day, recalls the 33-year-old businesswoman. During the second trimester, I became extremely fatigued and exhausted. I started developing complications because before pregnancy I had gained considerable weight. My sugar levels and blood pressure also started going up. Doctors suspected that prolonged inactivity, alongside other health factors such as excess weight, elevated blood sugar and high blood pressure, may have contributed to the pregnancy loss, among other possible causes. The loss devastated her. When she conceived again, her doctor recommended a different approach. ALSO READ: Why mental health is important during pregnancy I was advised to completely change my routine, become more active every day and improve my diet. I even hired someone to help me run the business so I could walk more instead of sitting the whole day. She followed the advice throughout her pregnancy by taking regular walks, cutting down on sugary foods and exercising with four other expectant mothers. A few months ago, she delivered a healthy baby. I encourage women to prioritise their health during pregnancy, Muberarugo says. Being treated like a queen is wonderful, but sitting or sleeping for long hours also has a downside. From tradition to today's workplace Her experience reflects an issue that health professionals say deserves greater attention. For generations, pregnancy in many Rwandan families has been accompanied by the familiar expression muteteshe—meaning treat her gently. Expectant mothers are often encouraged to rest, eat well and avoid strenuous work. In many homes, mothers-in-law or relatives temporarily move in to help with household chores, while friends and family urge pregnant women to avoid exertion. ALSO READ: Fitness: The benefits of stretching your body While these practices stem from love and care, health experts say one important element is sometimes overlooked: staying physically active. Today, as more women spend long hours behind office desks, bank counters or shop tills, physical inactivity has quietly become part of modern pregnancy. Combined with work-related stress, unhealthy diets, and rising rates of overweight and obesity, specialists warn that inactivity can increase the risk of pregnancy complications. Moderate exercise, they say, offers significant physical and mental health benefits. That message is increasingly being promoted through initiatives such as the Car Free Day programme for pregnant women, organised by the City of Kigali in partnership with the Rwanda Biomedical Centre (RBC), UNFPA Rwanda and Health Development Initiative (HDI). The programme offers guided walks, stretching sessions and health screenings for expectant mothers. More movement, fewer complications Prof. Stephen Rulisa, Professor of Obstetrics and Gynaecology at the University of Rwanda and consultant obstetrician, says pregnancy should not be viewed as a reason to stop moving unless advised otherwise by a healthcare provider because of a specific medical condition. Physical activity is very important during pregnancy, he says. According to Rulisa, regular exercise helps relieve common pregnancy discomforts such as headaches, constipation, swollen legs and general body aches. It can also contribute to shorter and easier labour, improve mood and help prevent gestational diabetes. ALSO READ: Midwife on empowering colleagues, why pregnant women need prenatal counselling There is no single prescribed exercise, he explains. Women are encouraged to remain active through activities such as walking and swimming. His advice aligns with growing international evidence showing that moderate physical activity benefits both mother and baby. The World Health Organisation says regular physical activity during pregnancy can reduce symptoms of anxiety and depression, improve mental well-being and contribute to healthier pregnancies. Mental health has become an increasingly important aspect of maternal healthcare as women balance pregnancy with work, financial responsibilities and family obligations. Moving beyond myths For years, many African communities associated physical activity during pregnancy with danger. Some women believed that walking long distances, stretching or exercising could trigger miscarriage or cause the baby to fall. While experts continue to advise against high-risk activities and contact sports, they emphasise that moderate exercise during uncomplicated pregnancies is both safe and beneficial. The misconception is gradually fading as healthcare workers provide more education during antenatal care visits. Rwanda's national antenatal care guidelines encourage healthcare providers to assess a woman's nutrition, physical activity, weight and mental well-being throughout pregnancy, recognising that these factors influence maternal and newborn health. The country has also expanded routine antenatal visits from four to eight, giving health workers more opportunities to counsel expectant mothers on healthy lifestyles. Exercise as family support Nelson Mukasa, founder of Youth and Children Sports Academy, which organises sports activities for expectant mothers, says many women discover that exercise helps them enjoy pregnancy rather than fear it. Now in its third edition, the initiative encourages pregnant women to engage in simple physical activities throughout pregnancy. Some women experience many physical changes, especially during the third trimester, Mukasa says. Exercise is important not only for the expectant mother but also for the unborn child because it helps the mother remain healthier and more comfortable. ALSO READ: More Rwandans diagnosed with diabetes as care expands Beyond pregnancy, he says regular physical activity can help women manage obesity, reduce the risk of blood clots, improve self-esteem and lower the risk of postnatal depression. Mukasa believes employers should also rethink how they support pregnant workers. Many women continue working until the final weeks before delivery, often spending entire days seated in offices, shops or banks. Institutions, both public and private, should encourage pregnant employees to take short walks or do simple stretching exercises during the workday, he says. It helps reduce fatigue and allows them to remain productive. He also encourages husbands and families to play a more active role. Even taking regular walks together makes it easier for women to stay consistent and enjoy exercising. Small steps, lasting benefits Health experts emphasise that staying active during pregnancy does not require intense workouts or expensive gym memberships. Simple activities such as brisk walking, swimming, prenatal stretching and other moderate exercises approved by healthcare providers can make a meaningful difference. National guidelines also promote healthy lifestyles alongside routine antenatal care, including maintaining a healthy weight, eating a balanced diet and engaging in regular physical activity. ALSO READ: Your child is growing – but are they developing? As Rwanda continues investing in safer motherhood, organisations such as UNFPA are supporting efforts to strengthen antenatal care, raise community awareness and improve access to quality reproductive health services. For women like Muberarugo, the message is straightforward. Looking after yourself doesn't mean staying still, she says. Sometimes, the healthiest thing you can do for yourself and your baby is simply to get up and move. Today, I encourage every pregnant woman I meet to make time each day to move whenever they can.
