Safe and Effective Exercise Guidelines for a Healthy Pregnancy

There has been a lot of research into the area of exercise and pregnancy. There is overwhelming evidence that the right type of exercise causes no harm, in fact both you and the baby have improved health benefits.

Benefits of Exercise for You:

Improves or maintains fitness, flexibility, strength, and endurance
Maintains a healthy weight gain
Decreases risk of gestational diabetes and pre-eclampsia
Reduces incidence or intensity of back pain
Reduces risk of c-section
Reduces bloating, swelling, and constipation
Improves sleep quality
Reduces stress and anxiety
Increases feeling of wellbeing
Faster post-delivery recovery
Improved pelvic floor strength and coordination (which can lead to less incidence of incontinence or pelvic pain)

Benefits of Exercise for Baby:

Decreases risk of preterm labor
Healthier and stronger hearts
Can aid in brain development
Better blood flow
Healthy immune system
Improved Apgar scores
Babies sleep through the night earlier
Decreases risk of cord entanglement

So where do you begin? What guidelines exist for exercising while pregnant?

You want to make sure that you obtain consent from your healthcare provider before beginning exercise, especially if you did not regularly exercise before pregnancy. Generally, you can continue with your regular exercise if it is comfortable for you and you can start an exercise program if you are a beginner, just make sure to ease into it.

The goal is to exercise at a moderate intensity for 150 minutes per week.
Make sure that you begin with a warm up and end with a cool down including stretching surrounding your exercise.
Adapt your workout at you progress through your pregnancy.
Exhale while you lift or change positions.
Drink plenty of fluids before, during, and after exercise.
Wear loose, comfortable clothing and a good support bra. Later in pregnancy, a belly support belt may reduce discomfort.
Avoid exercise in hot, humid, or poor environmental conditions.

Exercises to Avoid in the First Trimester:

Exercises that have an increased risk of falling (skiing, horseback riding, gymnastics)
Exercises that risk trauma to your belly (martial arts, boxing)
Exercises that risk dehydration (hot yoga, hot Pilates)
Deep sea diving
Altitude training

Exercises to Avoid in the Second Trimester:

Lying directly on your stomach
Direct abdominal work (crunches, leg lifts, hanging lifts)
Avoid lying flat on your back to exercise after 20 weeks

Exercises to Avoid in the Third Trimester:

Exercises that cause coning (a small triangle shape at the top of your stomach, typically visible while reclining)
Reduce intensity if you find you tire quickly
Exercises that put you at an increased risk of falling (make sure you have support available as your posture may be changed)

Some Reasons to Discontinue Exercise:

If any of these symptoms occur during exercise, the American College of Obstetrics and Gynecology recommends that you stop the activity and call your doctor or provider right away.

Vaginal pain or bleeding
Dizziness or faintness
Pubic or back pain
Heart palpitations or chest pain
Shortness of breath prior to exercise
Sudden calf pain or swelling
Difficulty walking/muscle weakness
Headache
Leaking of amniotic fluid
Uterine contractions
Decreased fetal movement

Please note, if you have any of the following conditions, exercise is not recommended and exercise may be restricted: preterm labor or premature rupture of membranes, persistent second or third trimester bleeding, multiple gestation (3 or more fetuses) with risk factors for preterm labor, weakness or incompetent cervix or cerclage, low placenta/placenta previa after week 26, gestational diabetes with vascular disease, or other medical conditions such as restrictive lung diseases or pre-eclampsia, or other restrictions given to you by your practitioner.

So what are the best exercises to do while pregnant? The main goal is always to complete exercises that make you feel well, move comfortably, and stay strong. We want to train specifically so that exercises are targeted towards the goal of the job to come. The best exercises are ones that help prepare for labor and delivery as well as the job of being a mother postpartum. That means strength, stamina, pelvic floor prep, birthing movements, and relaxation techniques. Our physical therapists at Healthy Core specialize in women’s health and the pelvic floor and can help create a customized exercise program during and after pregnancy. We can also help expectant and postpartum moms by treating pain and dysfunction that may be interfering with the ability to exercise. You deserve to be the best version of yourself during and after childbirth.

References:

Exercise During Pregnancy. American College of Obstetricians and Gynecologists. Last updated March 2022. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy

Gregg V. and Ferguson J.E., Exercise in pregnancy. Clinics in Sports Medicine, Vol 36, Issue 4, P 741-752, October 2017. Doi: https://doi.org/10.1016/j.csm.2017.05.005.

Olson O., Sikka R.S., et al. Exercise in pregnancy. Current Sports Medicine Reports, Vol 8, No 3 pp 147-153, 2009.

written by Joanna Pavlak, DPT - July 2023