Exercise safely while pregnant
July 24, 2018 | by Jeremy D. Johnson MD, MPH, RMSK

The following suggestions are meant to help you design a safe and rewarding exercise program before or during your pregnancy.

Pregnancy is an ideal time to start or continue healthy lifestyle habits like exercise. Years ago exercise during pregnancy was thought to be "dangerous." Women were advised to "avoid all strenuous exertion."

Thankfully a lot has changed. Exercise in uncomplicated pregnancies is now recognized for its numerous benefits for both mom and baby.

Benefits of Exercise During Pregnancy

  • Increased fitness for the "work of labor and delivery" as well as carrying around a new baby
  • Lower risk of gestational diabetes
  • Lower risk of cesarean section and vacuum-assisted delivery
  • Lower risk of pre-eclampsia
  • Decreased likelihood of varicose veins
  • Faster return to pre-pregnancy fitness and weight
  • Improved mood
  • Better sleep

In healthy pregnancies, exercise does not increase the risk of miscarriage, premature delivery, poor fetal growth, or skeletal muscle injury.

Body Changes in Pregnancy

Your body changes to prepare you for delivery and support the growing fetus. Body changes you may notice include: loosening joints, weight gain, and major shifts in your center of gravity. To stay healthy during pregnancy, adapt your workouts to accommodate these major changes

How much exercise is recommended?

A goal of 20-30 minutes of moderate exercise, most days of the week, according to the American Congress of Obstetricians and Gynecologists (ACOG).

What is considered "moderate"?

You should be able to talk but not sing easily. If you are very active before pregnancy, you should be able to continue high intensity workouts as long as you follow the guidelines below for safe exercises.

5 Tips for Exercise During Pregnancy

  • Adjust your goals: Rather than focusing on gaining muscle and losing weight, aim to maintain fitness and gain a healthy, but not excessive, amount of weight.
  • Keep track of your body temperature: Hydration and workout environment are the most important strategies for temperature control. Keep your body temperature under 100.4 degrees, especially in the third trimester. Try exercising in a temperature-controlled area and avoid exercising in hot or humid conditions (including hot yoga, hot tubs, saunas). Have a goal of drinking 2-5 cups of water per hour of workout.
  • Keep track of your heart rate: You should be able talk without getting short of breath. This is less than 70-75 percent of your maximum heart rate (estimated by HR max = 220-age). If you already perform a high volume of exercise, you can continue up to nine hours of exercise per week.
  • Modify your workouts as your body changes: Exercise should be comfortable. Major changes occur to your center of gravity and joint laxity during pregnancy. Therefore, choose activities with low joint stress such as swimming, stair climbing, walking, elliptical and stationary bikes.
  • Weight training is okay: Contrary to popular belief, weight training can be very beneficial as long as you follow some principles:
    • Breathe naturally. Avoid the Valsalva maneuver. This occurs when you exhale without letting air out. The Valsalva maneuver may temporarily decrease blood and oxygen flow to the baby.
    • Work your core. Your core includes stabilizing muscles from your lowest rib to your knees. These muscles are on your front, side and back of your body, not just your abs! Back and hip pain tend to increase during pregnancy, exercises that brace the core can reduce pain.
    • Use your muscles rather than momentum. Try not to “jerk” weights up, rather lift in a controlled way, being mindful of maintaining your core support.
    • Decrease weight and increase reps. A good goal is 10-15 reps at 65-75 percent maximum lifting potential. This level helps maintain natural breathing and decreases stress on joints.

    Exercise Activities to Avoid in Pregnancy

    • High-impact activities such as contact sports, skiing and plyometrics
    • SCUBA diving
    • Altitudes greater than 6,000 feet, if you are not acclimated to this height
    • Lying flat on your back (i.e. bench press) after the first trimester and pressure on the stomach
    • Biking in the second and third trimesters. Your center of gravity and balance control changes. Try: a stationary bike. It's a safer choice after the first trimester.

    What If I am New to Exercise?

    It’s safe to start an exercise program during most pregnancies, but you should talk to your doctor about types of exercise, as well as the recommended intensity, frequency and duration.

    Exercise is one of the best medicines for you and your baby. A daily dose of 20-30 minutes of exercise can keep you fit and ready for delivery and beyond!

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