Exercise During Pregnancy

Regular exercise builds bones and muscles, gives you energy, and keeps you healthy. It is just as important when you are pregnant. This pamphlet will explain:

Benefits of Exercise

You’re tired. You’re gaining weight. You may not feel your best. Although most of the time these symptoms are normal during pregnancy, exercise may help provide some relief. Becoming active and exercising at least 30 minutes on most, if not all, days of the week can benefit your health in the following ways:

Regular activity also helps keep you fit during pregnancy and may improve your ability to cope with the pain of labor. This will make it easier for you to get back in shape after the baby is born. You should not, however, exercise to lose weight while you are pregnant.

Changes in Your Body

Pregnancy causes many changes in your body. Some of these changes will affect your ability to exercise.

Joints

The hormones produced during pregnancy cause the ligaments that support your joints to become relaxed. This makes the joints more mobile and more at risk of injury. Avoid jerky, bouncy, or high-impact motions that can increase your risk of injury.

Balance

Remember that during pregnancy you are carrying extra pounds—as much as 25–40 pounds at the end of pregnancy. The extra weight in the front of your body shifts your center of gravity and places stress on joints and muscles, especially those in the pelvis and lower back. This can make you less stable, cause back pain, and make you more likely to lose your balance and fall, especially in later pregnancy.

Heart Rate

The extra weight you are carrying will make your body work harder than before you were pregnant. Exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it’s important not to overdo it.

Try to exercise moderately so you don’t get tired quickly. If you are able to talk normally while exercising, your heart rate is at an acceptable level.

Getting Started

Before beginning your exercise program, talk with your doctor to make sure you do not have any obstetric or health condition that would limit your activity. Ask about any specific exercises or sports that interest you. Your doctor can offer advice about what type of exercise routine is best for you.

Women with one of the following conditions will be advised by their doctors not to exercise during pregnancy:

• Risk factors for preterm labor
• Vaginal bleeding
• Premature rupture of membranes

Pregnant women with certain other medical conditions, such as high blood pressure, will be advised by their doctors when and if exercise is appropriate.

Choosing Safe Exercises

Most forms of exercise are safe during pregnancy. However, some types of exercise involve positions and movements that may be uncomfortable, tiring, or harmful for pregnant women. For instance, after the first trimester of pregnancy, women should not do exercises that require them to lie flat on their backs. Standing still for long periods of time also should be avoided as much as possible.

Certain sports are safe during pregnancy, even for beginners:

• Walking is a good exercise for anyone. Brisk walking gives a total body workout and is easy on the joints and muscles. If you were not active before getting pregnant, walking is a great way to start an exercise program.
• Swimming is great for your body because it works so many muscles. The water supports your weight so you avoid injury and muscle strain. It also helps you stay cool and helps prevent your legs from swelling.
• Cycling provides a good aerobic workout. However, your growing belly can affect your balance and make you more prone to falls. You may want to stick with stationary or recumbent biking later in pregnancy.
• Aerobics is a good way to keep your heart and lungs strong. There are even aerobics classes designed just for pregnant women. Low-impact and water aerobics also are good exercise.

 Other exercises, if done in moderation, are safe for women who have done them for a while before pregnancy:

• Running. If you were a runner before you became pregnant, you often can keep running during pregnancy although you may have to modify your routine. Talk to your doctor about whether running during pregnancy is safe for you.
• Racquet sports. In some racquet sports, such as badminton, tennis, and racquetball, your changing balance may affect rapid movements. This can increase your risk of falling. You may want to avoid some racquet sports.
• Strength training will make your muscles stronger and may help prevent some of the aches and pains common in pregnancy.

The following activities should be avoided during pregnancy:

• Downhill snow skiing. As with racquet sports, your changing center of gravity can cause balance problems. This puts you at risk for severe injuries and falls. Even if you are skilled and careful, some hazards are beyond your control. For instance, exercising at altitudes higher than 6,000 feet can increase your risk of altitude sickness. This makes it harder for you to breathe and may cut down on your baby’s supply of oxygen.
• Contact sports, such as ice hockey, soccer, and basketball, could result in harm to both you and your baby.
• Scuba diving should be avoided during pregnancy. The large amounts of pressure from the water put your baby at risk for decompression sickness.

With some activities, such as gymnastics, water skiing, and horseback riding, there is an increased risk of falling, which in some cases can cause injury. These activities also should be avoided during pregnancy. With any type of exercise you’d like to try, be sure to discuss it with your doctor ahead of time. If you are an athlete, let your doctor know so you can get any special care you may need.

Your Routine

Exercise during pregnancy is most practical during the first 24 weeks. During the last 3 months, it can be difficult to do many exercises that once seemed easy. This is normal.

If it has been some time since you’ve exercised, it is a good idea to start slowly. Begin with as little as 5 minutes of exercise a day and add 5 minutes each week until you can stay active for 30 minutes a day.

Always begin each exercise session with a warm-up period for 5–10 minutes. This is light activity, such as slow walking, that prepares your muscles. During the warm up, stretch your muscles to avoid stiffness and soreness. Hold each stretch for at least 10–20 seconds.

After exercising, cool down by slowly reducing your activity. This allows your heart rate to return to normal levels. Cooling down for 5–10 minutes and stretching again also helps you to avoid sore muscles.

Things to Watch

The changes your body is going through can make certain positions and activities risky for you and your baby. While exercising, try to avoid activities that call for jumping, jarring motions or quick changes in direction that may strain your joints and cause injury.

There are some risks from becoming overheated during pregnancy. This may cause loss of fluids and lead to dehydration and problems during pregnancy.

When you exercise, follow these general guidelines for a safe and healthy exercise program:

• After the first trimester of pregnancy, avoid doing any exercises on your back.
• Avoid brisk exercise in hot, humid weather or when you have a fever.
• Wear comfortable clothing that will help you to remain cool.
• Wear a bra that fits well and gives lots of support to help protect your breasts.
• Drink plenty of water to help keep you from overheating and dehydrating.
• Make sure you consume the daily extra calories you need during pregnancy.

While you exercise, pay attention to your body. Do not exercise to the point that you are exhausted. Be aware of the warning signs that you may be overdoing it (see box). If you notice any of these symptoms, stop exercising and call your doctor.

After the Baby’s Born

Having a baby and taking care of a newborn is hard work. It will take a while to regain your strength after the strain of pregnancy and childbirth. Taking care of yourself physically and allowing your body time to recover is important. If you had a cesarean delivery, difficult childbirth, or complications, your recovery time may be longer. Check with your doctor before starting or resuming an exercise program. Some women may resume their routine within days of giving birth; others may need more time before resuming their prepregnancy routine.

Walking is a good way to get back into exercising. Brisk walks several times a week will prepare you for more strenuous exercise when you feel up to it. Walking has the added advantage of getting both you and the baby out of the house for exercise and fresh air. As you feel stronger, consider more vigorous exercise.

You will want to pick an exercise program that meets your own needs. Your doctor, nurse, or community center can help. There are also special postpartum exercise classes that you can join.

Finally…

Exercise during pregnancy can help prepare you for labor and childbirth. Exercising afterward can help get you back in shape. Before you begin an exercise program, talk to your doctor. Follow this guide to help maintain a safe and healthy exercise program during pregnancy.

Glossary

Cesarean Delivery: Delivery of a baby through an incision made in the mother’s abdomen and uterus.

Gestational Diabetes: Diabetes that arises during pregnancy; it results from the effects of hormones and usually subsides after delivery.

Premature Rupture of Membranes: A condition in which the membranes that hold the amniotic fluid rupture before labor.