Exercise Recommendations from Dr. Linsey Monaghan
Pregnancy is an exciting time for many women, but it can also be full of worries, questions, and confusion. Pregnant women often find themselves wading through a lot of conflicting advice from the internet, talking with friends or family, and sometimes even from nosy strangers.
As a family doctor who cares for pregnant women, I am often asked about exercise recommendations during pregnancy. The good news is that for the vast majority of pregnant women exercise is safe, beneficial, and recommended throughout pregnancy.
Exercise has some amazing benefits in pregnancy that you don’t want to miss out on:
- Preventing excessive weight gain
- Increased fitness for the hard work of labor and delivery
- Lower risk of gestational diabetes
- Lower risk of pregnancy related high blood pressure and preeclampsia
- Reduced likelihood of a cesarean section
- Reduced back pain
- Faster return to pre-pregnancy fitness and weight
- Improved mood
- Better sleep
In the past there was concern that exercise could be harmful in pregnancy, but the latest evidence shows that in healthy pregnancies, exercise does not increase the risk of miscarriage, premature delivery, or low birth weight.
There are conditions where exercise is not recommended. Women with significant heart disease, placenta previa, severe anemia, cervical insufficiency or cerclage, risk of premature labor, or preeclampsia should not exercise during pregnancy.
For healthy women, exercise recommendations from the American College of Obstetricians and Gynecologists encourage pregnant women to get at least 20 to 30 minutes of moderate intensity aerobic exercise on most days of the week. Moderate intensity means moving enough where you can still talk comfortably but not sing during the activity.
You can choose to exercise in increments of 30 minute workouts on 5 days a week, or you can divide this into smaller 10 minute workouts throughout each day. If you’re new to exercise, start with as little as 5 minutes a day, then gradually increase your activity as you get stronger. Women who were very active before pregnancy can often keep doing the same workouts, but should discuss with their healthcare provider first.
As you choose your form of exercise be aware of some of the many changes your body goes through during pregnancy. Your body produces hormones during pregnancy that cause the ligaments supporting your joints to relax. This can cause joints to be more mobile and therefore at risk for injury. Avoid overstretching or activities that increase your risk of being hurt.
Your balance will also be shifted in the second and third trimesters as the uterus grows, shifting your center of gravity forward. Be aware that you will be less stable and more likely to lose your balance.
Your breathing also changes during pregnancy and your need for oxygen increases. You may become more short of breath as pregnancy progresses from increased pressure on your lungs from the growing uterus. This can affect your ability to do strenuous exercise.
Safe examples of exercise in pregnancy include brisk walking, swimming and water workouts, stationary bicycling, modified yoga and modified Pilates.
Whatever form of exercise you choose, be sure to drink plenty of water before, during and after working out to avoid dehydration.
Wearing an extra supportive sports bra will also make exercise more comfortable for pregnancy related breast changes. A pregnancy support belt can be helpful for abdominal or back discomfort later in pregnancy as the uterus grows larger.
You should stop exercising and call your doctor if you are feeling dizzy or faint, experience bleeding or leakage of fluid from the vagina, chest pain, headache, calf pain or swelling, or regular, painful contractions of the uterus.
The following exercises should be avoided during pregnancy:
- Getting overheated, such as during hot yoga, especially in the first trimester
- Lying flat on your back after the first trimester (When the uterus gets larger it can press on a large vein returning blood to the heart when you are in this position)
- Avoid heavy lifting that requires the valsalva maneuver (exhaling without letting air out – like when trying to pop your ears)
- Too intense or strenuous exercise, like long distance running, which can lead to dehydration and divert blood flow away from the placenta
- Contact sports that would put you at increased risk of being hit in the abdomen such as hockey, boxing, soccer, and basketball
- Non-stationary cycling during second and third trimesters
- Activities that could result in a fall such as skiing, surfing, or horseback riding
- Activities or altitudes greater than 6,000 feet
- Scuba diving
The takeaway is that exercise is safe and recommended for most pregnant women. Tune out all that overwhelming, conflicting advice (especially from that nosy stranger), talk with your healthcare provider and listen to your body.
Exercise will make your pregnancy journey happier and healthier. What are you waiting for? Let’s get moving!
