How to Exercise When Pregnant
From part one in my healthy pregnancy series, we now know that exercise will help benefit mother (and baby) when pregnant, but how do we do it? Here are some basic guidelines to get you started!
Mothers with any of the following conditions should be evaluated by a health care provider to determine if exercise is advisable.
- Pregnancy-induced hypertension
- Preterm rupture of membranes
- Preterm labor (current or previous)
- Incompetent cervix/cerclage
- Persistent second or third trimester bleeding
- Intrauterine growth retardation
- Severe anemia
- Placenta previa
- 1st Trimester: Maintenance of pre-pregnancy activity level
- 2nd Trimester: Increase training, if desired, by 5-10%
- 3rd Trimester: Maintain exercise level and reduce impact
Warm-up and cool-down exercises are recommended with each exercise session, including range of motion exercises and static stretching for major joints and muscle groups (e.g., 10-15 minutes of slow walking or stationary cycling on low resistance followed by gentle stretching). This will activate the neural and cardiovascular pathways, reduce the risk of ligament and back strain, and slowly bring blood in to the exercising muscles. After exercising, rise gradually from the floor to prevent dizziness.
FREQUENCY: 3-5 times per week
For those of you who have been exercising prior to pregnancy, you may continue your regular exercise regimen during pregnancy, by following the PARmed-X guidelines. Women who did not exercise regularly prior to pregnancy should not start an exercise program until the second trimester. It is currently recommended to exercise at a frequency of 3 times per week, progressing to a maximum of 4 to 5 times per week.
INTENSITY: Talk Test
Your heart rate is not reliable in pregnancy for determining exercise intensity. Instead, the easiest way to stay at an adequate intensity is to use the “talk test.” If you are able to carry on a verbal conversation during exercise, you are golden.
TIME: 20-30 minutes of moderate aerobic activity
If you are currently active, you can continue your sessions as normal. If you are just beginning an exercise program, it is recommended that you begin with 15 minutes of continuous exercise. As pregnancy progresses, the duration of exercise may be gradually increased to 30 minute sessions. Exercise sessions should be short enough to prevent fatigue, discomfort, and hypoglycemia (blood glucose/sugar being depleted and going to low, for pregnancy demands greater glucose from your muscles already).
Type of Activities Considered Safe During Pregnancy
Aerobic and strength-conditioning exercises are recommended in pregnancy. Choose exercises that do not require a high degree of balance and coordination, quick movements, or involve the risk of falling or fetal trauma. When strength training, use lighter weights and fewer repetitions. Choose less strenuous but continuous aerobic exercise (i.e. brisk walking, stationary cycling, cross-country skiing and swimming). If you enjoy running, do it for shorter distances, at slower speeds, on flatter terrain, and with more frequent rest periods.
Examples of Activities Considered Safe During Pregnancy
- Power walking
- Prenatal exercise classes
- Cross country
- Water aerobics
- Water jogging
- Low impact aerobics
- Stationary cycling
- Resistance training
- pelvic tilt (will help strengthen abdominal muscles, and decrease round ligament pain and lumbar lordosis). Stand or sit with feet hip-distance apart and knees slightly bent, while the muscles of the abdomen and buttocks are contracted. The pelvis is thrust forward and the pelvic bone is rolled upward.
Activities to AVOID During Pregnancy
Certain exercises may impose unnecessary risks and should be avoided. Therefore do not do any exercises which:
- strain the lower back,
- stress ligaments,
- cause knee trauma, or
- promote separation of the pubic bone.
- exercises in supine position (lying on back) after the fourth month of pregnancy. Pressure exerted on the vena cava by the enlarging uterus may result in decreased cardiac output and reduced blood flow to the uterus when exercising on the back after the first trimester. Symptoms may include dizziness and shortness of breath.
- jerking motions,
- sudden changes in direction,
- breath-holding during weight-training exercise, and
- aerobic activities with increased risk of blunt abdominal trauma and loss of balance.
Examples of Activities to AVOID During Pregnancy:
Abdominal Exercises (if diastasis recti develops, abdominal wall starts to separate)
- full sit-ups
- double leg lifts
- side leg swings
Poor Circulation Exercises
- sitting cross-legged
- standing toe touches
- no downhill skiing
- no horse-back riding
- no gymnastics
- no water skiing (could result in forceful entry of water into the uterus, which could result in miscarriage)
- no scuba-diving (may be associated with decompression disease, gas embolism, and in the first trimester, risk of fetal malformation)
Exercise During Pregnancy “Duh’s”!
Don’t Forget Hydration!
Ample fluid intake is essential to prevent dehydration, which occurs more readily in pregnancy (10-12 cups per day, including 2 cups before exercise, 1 cup every 15 minutes during, and 2-3 cups after exercise). Thirst may be depressed during exercise and cannot be relied upon to assure an adequate fluid intake. Exercising in light clothing during a cooler time of day outdoors or with a fan indoors will help prevent dehydration and hyperthermia in hot weather.
When to Stop!
Stop exercising and contact a health care provider if any of the following occur:
- Muscle weakness
- Shortness of breath
- Chest pain or tightness
- Vaginal bleeding or fluid loss
- Uterine contractions
- Abdominal pain
- Absent fetal movement
Just Do IT!
Regular exercise in pregnancy may prevent excessive gestational weight gain and reduce postpartum weight retention all which contributes to less chances of miscarriage and a happier you.
Remember: it is not only beneficial for your growing baby’s genome, but it also:
- reduces the incidence of your own muscle cramps, lower limb edema, fatigue, and shortness of breath,
- reduces the increase in baseline maternal heart rate that occurs in pregnancy,
- improves bone density, heart rate, stroke volume, and blood glucose levels,
- reduces total maternal weight gain and fat stores, and
- produces higher endorphin levels (better pain tolerance) during labor.
No doubt, regular exercise is an important component of a healthy pregnancy.
*if you’d like a more specific, custom-made plan designed especially for you (or a loved-one) to meet your pregnancy level of fitness, your trimester, and your equipment access, then contact me for more information.
So now what about diet? Does it really matter? How does it really affect the growing baby? Are there things a pregnant mother should not eat? Find out how what you eat programs your baby’s genes for life in part 3!
Photo Credits: Tamarindo Family Photos