Pregnancy was once considered a time during which women should avoid strenuous activity, focusing instead on “eating for two” and resting in preparation for childbirth.
Now, of course, we know otherwise.
Exercise is not only safe for most pregnant women, but it is a valuable tool for easing stress, strengthening the muscles used during childbirth, and increasing one’s chances of a swift return to pre-pregnancy shape once the baby has arrived.
Many of the rules from the American College of Obstetrics and Gynecology have been revised in recent years – and doctors do not always agree with following those rules to the letter, if only because each woman’s situation is so different. So be sure to talk to your doctor before beginning any exercise program, as well as about any exercise program you are currently involved in to ensure what you are doing will continue to be safe for as your pregnancy progresses.
Keep in mind, though, that this may not be the best time to begin exercising if you have been sedentary for some time. So save that triathlon training for post-pregnancy!
If you are already athletic and worried about easing up on the workouts, keep in mind that you cannot avoid the changes through which your body will go. Your shape, strength, flexibility will change whether you like it or not. Try to accept that your program will be different from what you did before you became pregnant.
By continuing to exercise, particularly with resistance, you can maintain or increase muscular strength. This is important for a host of reasons: Stronger core muscles (back, abdominals, hips) will help ease discomfort in the back as pregnancy progresses, as well as assist during birth, and keep your upper body strong (the better able to lug all that baby stuff later!).
During the first trimester, for an otherwise healthy woman, most activities will be restricted only by initial symptoms such as fatigue or nausea. Some women may feel too tired to exercise – although this must be weighed against the fact that exercise might actually increase energy levels.
The ACOG guidelines advise against exercises in which you might be lying prone (on your back) for long periods, particularly once into the second trimester. This is prevent the belly from slowing or cutting off blood supply to the fetus. You may also experience a drop in blood pressure when standing back up.
Some doctors still follow the ACOG’s guideline to avoid getting your heart rate above 140 beats per minute, however for an already active woman this may not be sufficient challenge. Talk to your doctor and personal trainer. You should, however, avoid allowing your body temperature to raise too high because there is a risk to the fetus. Avoid exercising in a very warm environment if possible.
Once into the second trimester you may feel more energetic and less nauseous. During this time, you may continue exercising with appropriate modifications. Consider using exercise bands, stability balls and even body weight in addition or instead of dumbbells and weight machines. It’s best, however, to avoid exercises performed while standing to prevent blood from pooling in the lower extremity and causing blood pressure to drop.
The specific exercises you perform will vary, but try to work the whole body during your workout, beginning with large muscle groups (legs, back) and working to smaller groups (arms, shoulders). Remember that upper body work is important – particularly the entire back for better support during and after pregnancy.
Many pregnant women, even those in top cardiovascular health, report feeling short of breath. This is likely caused by the growing fetus exerting pressure against the diaphragm, making it difficult to get a good, full breath. This is only temporary, but may continue until the baby begins to drop in the third trimester.
Another concern with pregnancy is flexibility.
During pregnancy, the body releases a hormone called relaxin, which softens the ligaments and increases flexibility to better allow the baby to pass through the birth canal. In other words, you may feel your hips widening slightly as well as unusual flexibility.
Flexibility in and of itself is not necessarily a good thing, however. An extremely flexible joint also needs to be in control through its entire range of motion. This is why it is very important that while you’re pregnant you work to strengthen muscles to better support your joints. It’s a good idea to meet with a trainer to discuss how best to strengthen muscles without compromising the joints. And if you participate in yoga or Pilates, be sure to tell your instructor and she can help you modify.
Certain activities, of course, should be avoided altogether throughout most of the pregnancy. Any activity that puts you at risk for falling -- horseback riding, for instance – or being struck in the stomach should be put on hold until after the baby is born. Pregnant women are also not to scuba dive, because changes in pressure could be harmful.
You may also want to be careful about activities that might put you off balance, particularly as your abdomen begins growing. Your center of gravity changes throughout your pregnancy, moving away from your core and thus giving some pregnant women the sensation of pitching forward. Any exercise program should be adjusted to keep this in mind.
If you experience any unusual symptoms while exercising, stop activity immediately and call your doctor. This might include unusual or bloody discharge, sharp abdominal pain, or significant changes in blood pressure.
It’s always a good idea to work with a qualified personal trainer in addition to your doctor to ensure your exercise program is safe and effective.
Most importantly, be kind to yourself. You will not be able to maintain your training for a marathon or get in shape for rock climbing. Do not chastise yourself for not exercising as much as pre-pregnancy: Just do what you can. Something is better than nothing. There will be plenty of time – well, maybe not that much time --- to train hard after the baby is born.