Exercise During Pregnancy
Congratulations on your pregnancy! This is a very exciting time in your life and it is natural to wonder what steps you can take to remain healthy, feel energetic, and optimize your ability to cope with labor, as well as aid postpartum mental and physical recovery.
Regular activity and exercise helps keep you active, positive, and fit during your pregnancy. There is also data suggesting that exercise may be beneficial in preventing complications of pregnancy such as excessive weight gain and gestational diabetes. Added benefits include improved posture, reduced backaches, less constipation and bloating, and improved sleep.
This article will outline some guidelines that can be helpful in finding an exercise routine that is best for you. As always, it is advisable to consult with your doctor about your particular ability to exercise during pregnancy before you begin a new fitness plan.
Who can exercise in pregnancy?
Almost all healthy women can and are encouraged to exercise during pregnancy. Your goal should be 30 minutes or more of moderate exercise a day, most days of the week. Your initial prenatal appointment is a good time to ask your doctor if you have any special restrictions that would make exercise unsafe for you during pregnancy. For example, women with these conditions are usually not advised to exercise during pregnancy:
- Significant heart disease
- Severe anemia
- Severe lung disease such as COPD or severe asthma
- Incompetent cervix/cervical cerclage
- Undiagnosed vaginal bleeding
- Placenta previa after 26 weeks gestation
- Premature labor
- Ruptured membranes
- Preeclampsia or pregnancy-induced hypertension
What types of exercise are best during pregnancy?
In general, participation in a wide range of activities is safe during pregnancy. However, some types of exercise involve positions and movements that may be uncomfortable, too tiring, or harmful. Some activities will need to be modified as the pregnancy progresses. It is always best to avoid activities with a high risk of falling, high impact, or potential for abdominal trauma. Ask your doctor about how to modify your specific routine.
Safe exercises – even for first time pregnancies:
- Brisk walking
- Swimming
- Cycling (stick to a stationary or recumbent bike)
- Low-impact or water aerobics
Safe exercises, if done in moderation with pre-pregnancy experience:
- Jogging
- Some racquet sports –avoid high speed competitive tennis or racquetball due to falling risk
- Strength training – usual maximum weight 15-20lbs
Exercises to avoid:
- Scuba diving
- Contact sports
- Downhill snow skiing and water skiing
- High speed racquet sports
- Any exercise at altitudes greater than 6000 feet
- Gymnastics
- Horseback riding
- Exercises that require you to lie flat on your back (especially after the first trimester)
A word about Yoga:
Many women find Yoga to be an extremely comforting and relaxing exercise during pregnancy. It strengthens muscles, improves flexibility and can ease back pain. However, there are many poses which should be avoided, especially ones that require you to lie flat on your back or belly. Consider using a chair or the wall for extra balance during standing poses. It is a good idea to choose yoga classes or videos that are geared especially for pregnant women. It is usually a good idea to avoid Bikram (hot yoga).
What about crunches or sit-ups?
Any direct abdominal exercises or exercise flat on your back should be avoided, especially after the first trimester. Some sit-ups or crunches done in moderation during the first trimester may be appropriate for you, but ask your doctor before you begin.
How do I get started?
If you are feeling tired during the first trimester or it has been a while since you exercised, start slowly. If you begin with as little as 5 minutes a day you can add 5 minutes each week until you reach your goal of remaining active for 30 minutes. Most pregnant women should exercise indoors in hot weather and it is mandatory to pay attention to proper hydration. It is usually advised to carry a water bottle with you. If you are already an elite or competitive athlete you should speak to your doctor about what your restrictions and modifications should be. Most pregnant women, whether athletes or not, benefit from exercising with a partner or group to help stay motivated, increase enjoyment and promote safety.
How much is too much?
While you exercise, pay attention to your body! Do not exercise to the point where you are totally exhausted and drink plenty of fluids to remain hydrated. Your goal should never be weight loss while you are pregnant. A good rule of thumb is the ‘talk test.’ If you are able to carry on a conversation while exercising, that is a sign your heart rate is at an acceptable level. If you wear a heart rate monitor, keeping your heart rate no higher than 140-150 beats per minute is usually appropriate. (This may be different if you are an elite athlete.)
Warning signs to stop exercising and call your doctor:
- Vaginal bleeding
- Dizziness, feeling faint
- Increased shortness of breath/unable to catch your breath
- Chest pain
- Severe headache
- Muscle weakness
- Calf pain or swelling
- Contractions
- Decreased/absent fetal movement
- Fluid leaking from the vagina
I had the baby! When can I resume exercising?
It has been shown that a return to physical activity postpartum can relieve stress, decrease the risk of postpartum depression and help in returning to pre-pregnancy weight. It is important to remember though, that many of the pregnancy-related changes in your body persist for four to six weeks postpartum. Pre-pregnancy exercise routines may be resumed gradually as soon as it is safe. For you, this will depend on the particulars of your delivery and any complications you may have encountered. Ask your doctor when you can resume your activities and remember to build back up slowly.
