Exercise During Pregnancy

Why Should I Exercise?

Exercise offers a psychological "lift" to an expectant mother.  At a time of relatively profound changes in her body, a pregnant woman can exert some degree of control over her body through exercise.  Furthermore, exercise is relaxing and can help a woman maintain a positive self-image.

When Should I Start Exercising?

Childbirth is among the most physically stressful challenges a woman ever faces. Regular exercise during pregnancy:

• Strengthens muscles needed for labor and delivery
• Helps reduce backaches, constipation, bloating and swelling
• Improves posture
• Gives you energy and improves your mood
• Lessens some of the discomforts of pregnancy
• Helps you feel less tried and sleep better

Exercise in preparation for pregnancy and childbirth should begin when you are planning to get pregnant.  The sooner you begin exercising, the better you will feel.

A mistake many women make is not starting an exercise program until the last 3 months of pregnancy, when they start childbirth classes.  Some exercises can be more difficult during the last 3 months because your enlarged uterus and breasts cause a shift of the physical center of gravity, affecting your balance.  Also, due to hormonal changes, your joints become looser, which makes it easier to develop spasms and injure yourself.  Also, if you have not been exercising regularly until this point in pregnancy, even moderate exercise may decrease the oxygen supply to your baby.  Simple walking may be the best exercise at this time of pregnancy.

Before you begin an exercise program, discuss it with your health care provider. Make sure you follow his or her advice on an exercise program that is appropriate for you.  If you are experiencing problems with your pregnancy, you should not exercise.  Exercise can affect the amount of oxygen available to your baby.  A baby that already had problems with getting enough oxygen may not tolerate even light exercise.

Which Muscle Groups Are Most Important To Exercise?

In addition to your heart, the three muscle groups you should concentrate on during pregnancy are the muscles of your back, pelvis, and abdomen.

• Strengthening your abdominal muscles will make it easier to support the increasing weight of your baby  You will also be able to push more effectively during the last phase of delivering your baby.
• Strengthening pelvic muscles will help prevent urinary problems (leaking urine when you cough or sneeze) after delivery.
• Strengthening back muscles and doing exercises to improve your posture will minimize the strain of pregnancy on your lower back. It will help prevent discomfort caused by poor posture.

What kinds of exercise can I do?

Many old ideas about strenuous exercise during pregnancy have been disproved in recent years.  The type and intensity of sports and exercise you participate in during pregnancy depend on your health and on how active you were before you became pregnant.  This is not a good time to take up a new strenuous sport.  If you were active before you became pregnant there is no reason you cannot continue, within reason.

• Walking:  If you did not exercise before becoming pregnant, walking is a good way to begin an exercise program.
• Tennis:  If you are an active tennis player, you can probably continue to play unless you have special problems or feel unusually tired.  Just be aware of your change in balance and how it affects rapid movement.
• Jogging:  If you jog, you probably can continue as long as you feel comfortable doing it.  Avoid becoming overheated and stop if you feel uncomfortable or unusually tired.  Remember to drink plenty of water.
• Swimming:  If you are a swimmer, you can continue to swim.  Swimming is an excellent form of exercise.  The water supports your weight while you tone and strengthen many different muscles.  Scuba diving is not advised.
• Golf & Bowling:  Both of these sports are good forms of recreation.  You will have to adjust to your large abdomen.  Be careful not to loose your balance.
• Snow Skiing:  This sport can be dangerous because you can hit the ground with great force.
• Water skiing and surfing:  Falling at such fast speeds could harm your baby. Talk with your health care provider before participating in these activities.
• Climbing, Hiking, & Skiing above 10.000 feet:  Elevations above 10,000 feet can deprive you and the baby of oxygen.  This can cause premature labor. Avoid strenuous exercise at this altitude, especially if you normally live close to sea level.

What Are The Guidelines For Exercising During Pregnancy?

• Warming up and cooling down are very important.  Start slowly and build up to more demanding exercises.  Toward the end of an exercise session, gradually slow down your activity.
• Regular exercise (at least three times a week) is better for you than spurts of exercise followed by long periods of no activity
• Check your pulse during peak activity.  Slow down your activity if your heart starts beating faster than the target range recommended by your health care provider.  Don't exceed a heart rate of 140 beats per minute.  Exercise that is strenuous may speed up the baby's heartbeat to a dangerous level.  In general, if you are able to carry on a conversation comfortably while exercising, your  heart rate is probably within the recommended limits.  Check to make sure.
• Don't try to do too much.  Remember that the extra weight you are carrying will make you work harder as you exercise.  Stop immediately if you feel tired, short of breath or dizzy.
• Drink water often before, during, and after exercise to prevent dehydration.  Take a break in your workout to drink more water if needed.
• Don't participate in sports and exercise in which you might fall or be bumped.
• Be very careful with your back.  Avoid positions and exercises that increase the bend in your back.  They put extra stress on the stretched abdominal muscles and compress your spinal joints.  Deep knee bends, full sit-ups, double leg raises, and strait-leg toe touches also may injure the tissues that connect your back joints and legs.   A pregnant woman should avoid prolonged exercise in a supine (lying face-up) position. Exercising for a period of longer than five minutes in a supine position may cause a problem for some women because of the excess weight of her fetus.  It may obstruct the flow of blood back to your heart.  In fact, the American college of Obstetrics and Gynecologists (ACOG) recommends that exercise not be performed in a supine position at all after the fourth month of pregnancy.
• Do not get overheated.  Avoid outdoor exercise in hot, humid weather.  Also avoid hot tubs, whirlpools, or saunas.  Becoming overheated during pregnancy increases the risk to the baby's nervous system and brain.
• Do not exercise if you have an illness with temperature of 100 degrees F (37.8 degress C) or higher.
• Avoid jerky, bouncy, or high-impact motions that require jarring or rapid changes in direction.  Examples of such movements are pelvic, and leg pain. 
•  They could also cause you to loose your balance.
• Wear a good fitting support bra to protect your enlarged breasts.
• Make exercise a part of your daily life.  Daily tasks can double as exercise sessions if you do the following:
  -- Tighten your abdominal muscles when you are standing or sitting.
  -- Squat when you lift anything, whether it is light or heavy.
  -- Rotate your feet and ankles anytime your feet are elevated.
  -- Check your posture each time you pass a mirror.

When Should I Stop Exercising?

You should stop exercising and call your health care provider if you have any unusual symptoms, such as:

• pain, including pelvic pain, uterine contractions or chest pain
• trouble walking
• bleeding or fluid leaking from the vagina
• faintness or dizziness
• an increase in shortness of breath
• irregular heartbeat (skipped beats or very rapid beats)

Remember that it is very important to discuss your plans for exercise with your healthcare provider.  If you are experiencing problems with your pregnancy, exercise is not advised.  Talk to your health care provider if you have any questions.