Exercise for a Healthy Pregnancy

Congratulations on your pregnancy! It may seem like the perfect time to sit back, relax and enjoy your good news. But, this good news is a great incentive to examine your exercise program. In fact, regular exercise throughout pregnancy is beneficial for most women.

Exercise improves physical fitness, helps with weight management, reduces the risk of gestational diabetes, reduces low back pain, and enhances psychological wellness and sleep—all important benefits. The American College of Obstetrics and Gynecology recommends at least 30 minutes of moderate exercise daily for five to seven days per week, unless there’s a medical or pregnancy complication. Even pregnant women who haven’t been active previously can begin with as little as 10 minutes of exercise a day.

What are the Benefits and Risks of Exercising?

As your healthcare provider will tell you, there are many significant benefits of exercise during pregnancy. Regular physical activity can prevent excessive weight gain, which is known to complicate pregnancy and contribute to obesity. Exercise also maintains and improves muscle tone, strength and endurance. It reduces back pain, pelvic girdle pain and other orthopedic symptoms associated with pregnancy. And, Kegel exercises have been shown to reduce symptoms of urinary incontinence.

Studies have also shown that exercise has potential benefits of reducing the risk of gestational diabetes, preeclampsia (high blood pressure with or without protein in urine), macrosomia (large baby) and caesarean delivery. More reasons to work exercise into your schedule.

Although exercise during pregnancy is generally good for both mother and baby, medical problems such as asthma, heart disease or diabetes may prevent you from exercising. Certain medical conditions can make exercise during pregnancy more dangerous. These include pregnancy-induced hypertension, incompetent cervix (weak cervical tissue), preterm labor during your current or previous pregnancies, threatened or recurrent miscarriage, persistent vaginal bleeding or spotting, placenta previa (placenta partially or completely covers cervix), and preeclampsia.

If you have any of these conditions, you should seek guidance from your healthcare provider before you start exercising.

What are Safe Exercises?

In general, women without major medical or obstetric complications should engage in moderate-intensity exercise 30 minutes a day, five to seven days per week. For moderate intensity, you are active while still being able to carry on a conversation during exercise.

You should choose activities you enjoy that include both aerobic and strength conditioning exercises. For example, swimming and water aerobics are great for pregnant women. They’re both aerobic exercises, and the water supports the weight of your growing body and minimizes the stress on your joints. And they reduce the risk of overheating and falling while you’re active.

Other good choices include brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics. Activities such as tennis, racquetball and jogging are generally safe. Women who are already runners before pregnancy and who have uncomplicated, healthy pregnancies should be able to run with no adverse consequences.

But for all exercises, you should do them in moderation, especially in later stages of the pregnancy, where balance and coordination are reduced due to your changing body.

Strength training can also be performed during pregnancy, but stick to low-intensity resistance training with low weights.

And for all exercise, make sure you warm up, cool down, stay hydrated and pay attention to your body.

What are Exercises to Avoid?

Because of changes in balance, coordination, looseness of joints and other changes during pregnancy, there are some activities that should be avoided. They include:

• Activities that carry a higher risk of falling or abdominal injury such as gymnastics, downhill skiing, horseback riding and rollerblading.
• Activities that require jumping movements and quick changes in direction.
• Exercise that may result in excessive stress to your joints.
• Contact sports such as ice hockey, soccer, basketball, volleyball and football.
• Exercises that require you to lie on your back after the first trimester because this position can limit the blood flow to your baby. And, of course, avoid exercises where you lie on your stomach.
• Hot yoga or exercise in hot, humid weather can raise your temperature too much and reduce blood flow to the baby.
• Heavy-resistance weight lifting, with the Valsalva maneuver, can cause a rapid increase in blood pressure and intra-abdominal pressure and temporarily decrease blood flow to the baby.
• Scuba diving because it can lead to dangerous gas bubbles in your baby’s blood vessels.
• Exercising at high altitudes, especially if you haven’t done these activities before pregnancy.

Any Special Considerations?

As important as it is to exercise, it’s also critical to listen to your body. Physical changes during pregnancy create demands on your body.

If you experience any of the following warning signs of a potential problem, you should stop exercising and call your doctor immediately:

• Vaginal bleeding
• Regular painful contractions
• Leakage of amniotic fluid
• Difficult or labored breathing before working out
• Dizziness
• Headache
• Chest pain
• Muscle weakness affecting balance
• Calf pain or swelling

Remember, your breathing, heart rate, body temperature, balance and joints respond differently when you are pregnant, so be aware that you may feel different when you exercise. But if something hurts or you experience any of the symptoms above, STOP and consult your doctor!

Finally, physically active women should strive to maintain a good fitness level throughout pregnancy without trying to reach their peak performance level.

And even if you haven’t been exercising regularly, you can use pregnancy as your motivation to begin. The psychological wellness alone is worth it!

Baohuong Tran, D.O., practices at Penn Ob/Gyn Chester County and is a member of Chester County Hospital’s Medical Staff. She sees patients in Exton, West Chester and Southern Chester County. Dr. Tran received her medical degree from the New York College of Osteopathic Medicine and completed her residency at the Newark Beth Israel Medical Center in New Jersey.