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Exercise and Pregnancy
Is it safe to exercise during pregnancy?
If you are experiencing a healthy pregnancy, the American College of Obstetricians and Gynecologists (ACOG) recommends 150 minutes (2 ½ hours) of moderate-intensity physical activity each week during pregnancy (ACOG 2015). Despite these recommendations, only 40% of women get enough physical activity during pregnancy (Cooper 2017). Experts say you can spread the activity throughout the week – and even break it into 10 minute chunks. It’s important to just get moving.
Being active will allow you to adjust to your changing pregnant body. Regular physical activity:
- can reduce low back pain and constipation (both common complaints of pregnancy), may decrease the risk of gestational diabetes, preeclampsia, and cesarean birth, and may improve weight loss after your baby’s birth (ACOG 2015);
- may decrease the chance of having a larger baby, as well as limit pelvic girdle pain and urinary incontinence (Cooper 2017);
- will reduce bloating and swelling, improve your energy, mood and sleep quality, and may help your labor and birth (Hinman 2015, Mayo Clinic 2004).
While your healthcare provider may discuss other lifestyle issues with you - such as smoking cessation or alcohol avoidance - researchers say that 60% of providers caring for pregnant women aren’t familiar with the ACOG exercise guidelines (Hinman 2015). You should always discuss your fitness routine, however, to be sure that you don’t have any pregnancy-related conditions that would make exercise dangerous for you or for your growing baby.
Whether you were active before pregnancy or not, you need to be sure to stay hydrated when exercising and consume enough calories each day. Wear loose fitting clothing and try to stay cool during workouts. If you’re feeling fatigued, dial down the intensity of the exercise – make sure you don’t overdo any exercise routine.
Is there any reason I shouldn’t exercise?
According to the ACOG (2015), it may be unsafe to exercise if:
- You are pregnant with multiples,
- You have been diagnosed with ‘incompetent cervix’ or placenta previa,
- You have any bleeding after the first trimester,
- You have experienced preterm labor or ruptured membranes,
- You have severe anemia, pregnancy induced hypertension, or chronic heart or lung disease, or
- You are extremely underweight or overweight.
If you experience any of these warning signs, you should discontinue your exercise routine and check with your healthcare provider:
- vaginal bleeding or fluid leaking from the vagina,
- dizziness or headaches
- shortness of breath apart from exercise or chest pain,
- muscle weakness,
- calf pain or swelling, or
- uterine contractions.
Keep in mind that pregnancy causes changes in all your body’s systems. Pregnancy hormones relax your ligaments, which may make injury more likely with high-impact movements. Aim for low impact sports or exercises always. As your baby grows, your center of gravity is changed. This can cause changes in your back alignment, as well as your balance. Be cautious with any sudden movements. Lying flat on your back can cause compression of a major blood vessel supporting the uterus. Avoid these positions after the first trimester. Standing motionless for an extended period (as with some yoga poses) can cause blood to pool in your legs and feet. So, limit your time in any single position. Because of the pressure your growing baby puts on your diaphragm, you may find you’re out of breath more often. If this happens, decrease the intensity of your workout.
I used to run 5 miles a day, but now I’m pregnant. Can I continue?
If you were active before pregnancy, you can likely keep up your normal routine, as long as you discuss it with your healthcare provider first. You may have to adjust the intensity or duration as pregnancy progresses, or you may need to add calories to your diet if you start to lose weight. Watch for signs of overexertion.
I wasn’t active before pregnancy. Can I start now?
If you are typically sedentary, start any new exercise routine slowly and gradually increase the time and intensity. You might start with 5 minutes a day of light activity, adding 5 minute increments until you can handle 30 minutes of activity. Then increase the intensity. A good gauge of whether you’re doing intense enough exercise is the ‘talk test’ - if you can’t talk during activity, you’re likely overdoing it and need to decrease the intensity.
What are some good pregnancy exercises?
Walking, yoga, swimming, stationary biking, low-impact aerobics, and Pilates are great types of physical activity for pregnancy.
Avoid high-impact aerobics, contact sports, downhill snow skiing, water skiing, surfing, off-road cycling, gymnastics, horseback riding, scuba diving, and sky diving. In addition, avoid ‘hot yoga’ or “hot Pilates,” as these may raise your core body temperature too much.
Strengthening your core is still important during pregnancy. Abdominal exercises will help relieve back pain and will support the weight of your growing baby. Be sure to avoid any of these exercises that require you to be flat on you back. Two great core exercises are:
- Pelvic tilt: on your hands and knees, tighten your abdominal muscles as you breath out, then relax them as you breathe in. Arch your back and round your bottom with the inhale, and return to a neutral or flat back with the exhale.
- Squatting: hold a chair or the wall for stability, then contract your abs and relax your shoulders as you lower your tailbone toward the floor, bending at the knees and hips. Hold briefly, then return to standing. Be sure your feet are a little wider apart than your hips.
Don’t forget to add pelvic floor exercises to your routine. Sometimes referred to as Kegels, these muscular contractions can decrease urinary and fecal incontinence, prevent hemorrhoids and pelvic organ prolapse, and may give you more control when you are pushing your baby out during childbirth.
American College of Obstetricians and Gynecologists (ACOG). (2015). Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstet Gynecol, 126(6), e135-142.
Cooper D, Yang L. Pregnancy, Exercise. [Updated 2017 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017 Jun-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430821/
Hinman, S. K., Smith, K. B., Quillen, D. M., & Smith, M. S. (2015). Exercise in pregnancy: a clinical review. Sports health, 7(6), 527-531.
Mayo Clinic. (2004) Guide to a Healthy Pregnancy. New York, NY: HarperCollins Publishers Inc.