Exercise during pregnancy

There are many benefits to being active during pregnancy. You may not feel great every day of your pregnancy, but exercise should make you feel better overall and may help prepare you for labor and childbirth.

There are some conditions or symptoms that may make exercising during pregnancy inadvisable. Recommendations NOT to exercise during pregnancy may be made in cases of:

• Pregnancy-induced hypertension
• Preterm premature rupture of membranes
• Preterm labor
• Vaginal bleeding
• Other ongoing medical conditions such as high blood pressure, heart disease, lung disease, and thyroid abnormalities

If you continue to exercise or start an exercise program while pregnant, it is important to discuss it with your health care provider who can advise you about what type of exercise routine is best.

According to the American College of Obstetricians and Gynecologists (ACOG), exercise may:

• Reduce backaches, constipation, bloating, and swelling
• Increase energy level
• Help with adjustment of posture
• Assist with muscle tone, strength, and endurance
• Improve sleep pattern
• Improve your ability to cope with the pain of labor

Choosing A Safe Exercise Program

It may be easier to exercise earlier in your pregnancy than during the last three months (third trimester) of pregnancy. Choosing safe exercises for you and your baby is important because some positions, as your weight and balance change, may become uncomfortable or have potentially harmful effects. After 20 weeks of pregnancy, you should not do exercises that require lying flat on your back, because this position may make blood circulation more difficult.

For a total body workout that is low stress on joints and muscles, you may consider walking, swimming, or riding a stationary bike. It is wise to start slowly and gradually increase the length of time you exercise. Always warm-up and cool down afterwards. With the extra weight from pregnancy, your body has to work harder than it did before. Exercise increases the flow of oxygen and blood to the muscles and diverts it away from other parts of the body. This makes it important to not overdo the workout, or do any exercise that is too strenuous.

The intensity, duration, and frequency of the workout should not cause pain, shortness of breath, or excessive tiredness. Remember, the goal of exercise is for you to gain general benefits during the pregnancy, but not to do anything that would have detrimental effects on you or your baby.

Hydration During Exercise

Hydration is always important with exercise but it is even MORE important when you are pregnant. You should drink up to 1 pint of liquid before exercising and 1 cup of liquid every 20 minutes during exercise to maintain enough hydration for you and your baby. Even if you don't feel thirsty after exercising, it is important to refresh the fluids that you lost during the exercise. You can lose up to 1-2 quarts of fluid per hour in perspiration.

General Recommendations

The following recommendations are based on the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians:

• Avoid doing exercises that require being on your back, after 20 weeks
• Wear comfortable clothing that is supportive but not constricting and will help keep you cool
• Consume an extra 300 calories a day that you need while pregnant
• Avoid getting overheated when exercising, especially in hot, humid weather
• Drink plenty of water to keep well hydrated

Recommended exercises include:

• Walking
• Stationary bike
• Low-impact aerobics
• Swimming

Sports that are high risk for fall or trauma include:

• Gymnastics
• Horseback riding
• Skating
• Skiing (water/snow)
• Hang gliding
• Vigorous racquet sports
• Weight lifting
• Scuba diving

Stop exercising and call your doctor if you have pain, vaginal bleeding, rapid heartbeat, uterine contractions, chest pain, fluid leaking from the vagina, dizziness, fainting, shortness of breath, or difficulty walking.

If you are an accomplished athlete, you may continue your workout routine. However, exercises that require using a lot of oxygen should be avoided to ensure enough oxygen is reaching the fetus. Active women should avoid contact sports during all stages of their pregnancy.

If you are not an experienced athlete or exerciser, pregnancy is not a time to begin a rigorous routine. Exercises that maintain muscle tone, such as walking and swimming, are good choices throughout pregnancy. For activities that require balance, such as water and snow skiing, it's best to be cautious throughout pregnancy, especially toward the end of the first trimester when the uterus "expands" out of the pelvis and begins to alter your center of gravity. With an altered center of gravity, you can be at an increased risk for accidents that could have a negative effect on yourself and your pregnancy. All activities that involve profound changes in pressure or profound physical stress, such as scuba diving and triathlons, should be avoided at ALL times during pregnancy.

Review Date: 2/19/2007
Reviewed By: Douglas A. Levine, MD, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

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