Exercise During Pregnancy?

Pregnancy is one of the most remarkable life experiences a woman can go through.  I know…ironic coming from a guy.  And while I obviously don’t have first hand experience, I do have two beautiful kids and have had the pleasure of training clients during their journey.  And while pregnancy can bring a wide range of physical and emotional changes, on the right day I know all of them would agree with me J  So if you are pregnant and reading this it stands to question…can I really exercise throughout my pregnancy?  And the answer is yes for the vast majority.  Grant it, in some cases there are contraindications to exercise (see list below), but according to The American Congress of Obstetricians and Gynecologists (ACOG), “30 minutes or more of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.”  In fact, this is actually the same exercise recommendation theAmericanCollegeof Sports Medicine uses for improving health and well being of non-pregnant women (i.e. General Population).

While all of this is great news, you may be wondering, “Why should I workout during pregnancy?” Well first off, consistent exercise during pregnancy will help better prepare you for childbirth and, later, as you return to pre-pregnancy activity levels.  Specific benefits include:

  • Reduction in back pain
  • Increased energy
  • Improved strength and cardiovascular capacity which can facilitate labor and delivery
  • More endurance, preparing for the possibility of longer labor
  • Improved mood states
  • Faster postpartum recover time

So the question for us now is what types of activities are beneficial and what precautions need to be taken?

Well first and foremost, you should always get physician approval prior to exercise and maintain an open dialogue throughout your pregnancy and postpartum period.  Once you are cleared here are the precautions you will need to take according to ACOG guidlines:

  • Avoid exercises in the supine position (flat on your back) after the first trimester.  This position can lead to a reduction of maternal heart rate and decrease the flow of oxygenated blood to the baby.  So for example if you are performing a chest press, you would simply modify the exercise by adjusting the bench to an incline position.
  • Always use the “talk test” to gauge intensity.  If you cannot hold on a conversation while exercising, the intensity is too high.
  • Choose activities that minimize the loss of balance.  Pregnancy can affect your center of gravity do to the changes in the body.  So it is best to avoid any single leg movements or exercises on uneven surfaces.  Better alternatives include non-weight exercises such as cycling or swimming to minimize risk of injury.
  • Avoid any type of activities that carry the potential for even mild abdominal trauma (e.g. downhill skiing, contact sports).

Recommended Exercises and Activities

What exercises and activities considered to be most appropriate will depend greatly on fitness levels pre-pregnancy.  If you were previously inactive, it is best to start off slowly and progress gradually.  Starting off with swimming and other aquatic exercise is great because it provides the benefit of buoyancy, taking weight off the joints and increasing comfort.  Other possibilities include yoga and Pilates (specific to pregnancy), walking, or a stationary cardio machine like the elliptical or bike.

Resistance exercise should also be implemented into the mix as well.  Training sessions can be done 1-2 times per week, with the focus being on maintaining strength during pregnancy.  Include exercises that cover basic movements that provide adequate support and balance.  A basic routine may include 1-2 sets x 10-15 reps of the following:

  • Modified (knee) Pushups
  • Seated Row
  • Body Weight Squats
  • Standing Dumbbell Bicep Curl to Overhead Press
  • Quadruped (Hands & Knees) arm/leg lift

Ideally, a mixture of activities will serve you best during your pregnancy.  The bottom line is to listen to your body and stay within your limits, communicate with your physician, enjoy the benefits that come with exercise during pregnancy, and to facilitate a safe delivery for your new addition!

Remember to consult with your physician prior to exercise and during pregnancy.  See ACOG Contraindications below.

Absolute Contraindications to Aerobic Exercise During Pregnancy

  • Hemodynamically significant heart disease
  • Restrictive Lung Disease
  • Incompetent Cervix/Cerclage
  • Multiple gestation at risk for premature labor
  • Persistent second or third trimester bleeding
  • Placenta previa after 26 weeks of gestation
  • Premature labor during the current pregnancy
  • Ruptured membranes
  • Preeclampsia/pregnancy-induced hypertension

Relative Contraindications to Aerobic Exercise During Pregnancy

  • Severe anemia
  • Unevaluated maternal cardiac arrhythmia
  • Chronic bronchitis
  • Poorly controlled type 1 diabetes
  • Extreme morbid obesity
  • Extreme underweight (BMI <12)
  • History of extremely sedentary lifestyle
  • Intrauterine growth restriction in current pregnancy
  • Poorly controlled hypertension
  • Orthopedic limitations
  • Poorly controlled seizure disorder
  • Poorly controlled hyperthyroidism
  • Heavy Smoker

Warning Signs to Terminate Exercise While Pregnant

  • Vaginal bleeding
  • Dyspnea prior to exercise
  • Dizziness
  • Headache
  • Chest Pain
  • Muscle Weakness
  • Calf pain or swelling (need to rule out thrombophlebitis)
  • Preterm labor
  • Decreased fetal movement
  • Amniotic fluid leakage