The concept of exercise during pregnancy has come a long way since it was recommended that pregnant women avoid physical activity. Today, exercise is recommended throughout pregnancy as a way to keep in shape both physically and emotionally.
Women of childbearing age represent a sizeable share of the exercising population, so a concern for safe exercise for this special population is well founded.
Exercise plays an important role in the maintenance of a healthy lifestyle for anyone, and most expecting women are encouraged by their physicians to perform some level of physical activity during the full course of their pregnancy.
With that in mind, the American College of Obstetricians and Gynecologists has promulgated guidelines aimed at ensuring a safe and healthy pregnancy to the majority of women.1
As with any set of guidelines, there are many variations in the way women respond, or for that matter, any number of ways in which “guidelines” can be interpreted. One critical piece of advice is that pregnancy is not the time to begin a strenuous exercise program, especially for women who have not regularly exercised before becoming pregnant. However, some level of physical activity is recommended for most expecting and postpartum mothers.
Several recent studies suggest that women who exercised regularly before becoming pregnant and had uncomplicated pregnancies furnished a robust physiologic foundation to support the birthing process. Not only did the woman herself benefit from the exercise, but so did the health of her baby.
In addition to changes in outward appearance, the hormones produced during pregnancy also cause the ligaments that support the joints to relax. This can cause injuries such as ankle sprains to occur more easily than before pregnancy. Also, the added weight in the front of the body moves the center of gravity and puts more stress on the joints and muscles. This applies especially to the lower back and pelvis. And the extra weight will cause the body to work harder than before the pregnancy.
According to the ACOG, some activities are considered safe for pregnancy, even for women who are beginners to a sport or activity. Some examples include:
Avoid rocky terrain or unstable ground when walking or cycling.
Activities that carry a higher risk of falling are best avoided during pregnancy. Some examples include:
- Downhill skiing
- Water skiing
- Contact sports such as basketball or soccer
- Horseback riding
- Scuba diving. Although there isn’t as much risk of falling per se, scuba diving can cause decompression sickness, an illness that stems from rapid changes in pressure around the body.
The physiological effects of exercise on pregnancy as well as the effects of pregnancy on exercise can help to define the parameters of safe and appropriate exercise levels for both the woman who has not exercised regularly before pregnancy and the woman who has.
A woman experienced with exercise may have more confidence in her ability to choose appropriate levels of tolerable exercise and, as a consequence, may be more likely to continue her previous exercise practices even if they conflict with the suggestions supplied by her healthcare providers.
Some additional guidelines for exercising during pregnancy include:
- Never exercise to the point of exhaustion or breathlessness. This is a sign that the baby and body are not getting the oxygen supply they need.
- Wear comfortable exercise footwear that gives strong ankle and arch support.
- Take frequent breaks and drink plenty of fluids during exercise.
- Avoid exercise in extremely hot weather.
The following baseline information is important in determining the level at which a pregnancy fitness program should be established:
- Level of pre-pregnant exercise and fitness
- Type of exercise routinely engaged prior to pregnancy
- Routine duration of exercise
- Routine intensity of exercise before pregnancy.
Staying fit throughout pregnancy should be healthy, safe, fun and rewarding, but contraindications and warning signs of over-exercise need to be emphasized. Perceived exertion may be the best guiding factor in individualizing an exercise program for each woman during pregnancy.
One educational resource for both pregnant women and personal trainers to consider is an orientation to pregnancy fitness class taught by an obstetrics nurse certified in pregnancy exercise.
2. Exercise and Pregnancy. CAPT Marlene DeMaio and CAPT Everett F. Magann J Am Acad Orthop Surg August 2009 ; 17:504-514.