Exercise During Pregnancy
From the moment you find out you're pregnant until well after the birth of your baby, exciting and overwhelming changes characterize your life and body. Many women worry about their ability to maintain an active lifestyle during pregnancy or hope to prevent excessive weight gain. Other women consider beginning an exercise program as part of an effort to make better lifestyle choices and deliver a healthy baby.
What do we know about the safety of exercise during pregnancy?
Every woman and every pregnancy is completely different. That's why it's critical to work with your obstetrician to decide on your activity plan. Listen to your doctor. Pregnancy is NOT the time to charge into a vigorous regimen of exercise, especially if you've been a couch potato! However, there is good evidence to suggest that a healthy woman can begin or maintain a program of regular moderate exercise during her pregnancy. If you're an athlete, athletic performance doesn't seem to be affected during the first 2-3 months of pregnancy. Work with your doctor to modify your exercise intensity and training schedule. Women who exercise regularly report feeling better during their pregnancies than sedentary women and may gain less weight.
Guidelines for Exercise
Cardiovascular activities that are low-impact or non-weight bearing (swimming, walking, cycling) have the best potential to be carried on throughout your entire pregnancy. Water aerobics or swimming not only minimize joint stress but can reduce fluid retention. Other forms of regular aerobic exercise might include aerobics classes (particularly low impact), stairstepping, jogging, hiking and elliptical trainers.
How hard?
Standard target heart rate formulas are probably somewhat flawed due to cardiovascular and blood flow changes during pregnancy. There is some evidence that vigorous intensity exercise (above 150 bpm) causes bursts of rapid heart beats in the fetus which may be an indicator of stress. It's probably best to exercise at a moderate level based on your own feelings of exertion. Standard recommended intensities are 60-75% maximum heart rate for the unfit woman and 70-85% for the regularly exercising woman. Subjective feelings of exertion have been shown to be a more reliable indicator of work intensity during pregnancy than heart rate. Listen to your body! Pregnant women often naturally lower exercise intensity during late pregnancy. Smart move, ladies!
How often and how long?
Avoid the "weekend warrior" syndrome. Ideally, a pregnant woman should perform cardiovascular exercise at least 3-4 days per week. If you exercise more frequently, consider a variety of activities (to reduce overuse injuries) and drink plenty of fluids. Short aerobic exercise intervals, 15-20 minutes, may help prevent heat stress to you or your baby. However, there is no evidence to suggest that a more typical 30-60 minute workout is harmful.
Strength Training:
Strong muscles will prepare you for the lifting required when your new baby arrives, along with the associated paraphernalia you'll be lugging around like car seats, strollers, and the diaper bag. Depending upon your intended delivery position you'll need good strength in your "squatting" muscles. Low back pain, a common complaint of pregnant women, can be helped by specific strengthening and flexibility exercises. A physical therapist who understands your body's changes during pregnancy is in the best position to suggest specific exercises. Correct posture, breathing and lifting technique are very important. The use of exercise machines rather than free weights is probably smarter in later pregnancy when normal balance is disrupted. The American College of Obstetrics and Gynecology recommends that women avoid exercise while lying on their backs after the first trimester because this position can decrease blood flow to the baby. For example, pelvic tilt exercises can be performed in the side-lying, sitting, standing or "all fours" positions. Prolonged, motionless standing should also be avoided.
Balance/Coordination:
If you play tennis, squash, ski, dance or participate in other activities requiring agility or balance, remember that hormone changes after 28-30 weeks will loosen your joints and make you more susceptible to injury. Increased body size, altered center of gravity and changing posture will also begin to slow your movements, affect your balance, change your body mechanics and make you work harder. Use common sense! Consider cross-training or adopt some alternative, safer exercise activities during the latter stages of your pregnancy.
GENERAL TIPS
During the first trimester, excessive fatigue and low energy levels may increase your risk for injury. Make sure you get adequate sleep and that your food intake meets your body's needs for increased calories, vitamins and minerals.
A gradual cool down after vigorous endurance activity helps maintain adequate blood flow to your baby. Take 5-10 minutes at the end of your exercise session to perform light cardiovascular activity.
Make SURE you are getting enough fluids, necessary for the increased blood volume and amniotic fluid your body is making! Don't wait to feel thirsty.
Increase fluid intake to 2-3 quarts per day. Drink plenty of extra fluids before, during and after an exercise session.
Wear loose-fitting, breathable clothing and supportive shoes during exercise. Also choose supportive bras and undergarments to support your breasts and tummy.
Adapted from content written by The Hospital for Special Surgery.
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