How to safely exercise during pregnancy

As you work towards a healthy lifestyle for yourself and your little one, you may be thinking about nutritious foods, a balanced diet, and safe physical activities to keep your body, mind, and soul strong and resilient. When done correctly, exercise and other physical activity are good for both you and your baby, and unless you have certain medical problems or pregnancy complications, can be done safely throughout your pregnancy and even after you give birth!

IN THIS ARTICLE:

Is it okay to exercise while pregnant? 

Perhaps you are thinking about starting up an exercise program, but you’ve heard some things that are stopping you. For example, you may have heard that exercise can somehow harm you or the baby, that you should avoid abdominal exercises or weight lifting, or that you should limit your activities to prevent a miscarriage.

• These things aren’t true. The World Health Organization (WHO) [] recommends the following for pregnant and postpartum caregivers, unless they have certain medical conditions: At least 150 minutes (2 ½ hours) of moderate-intensity aerobic physical activity spread out through the week.

• Perform a variety of aerobic and muscle-strengthening activities.

• Limit time being sedentary because even light-intensity activities have benefits.

In addition to these three points, the U.S. Centers for Disease Control and Prevention (CDC) [] adds these recommendations:

• Those who habitually engage in vigorous-intensity physical activity can continue these activities during pregnancy and postpartum.

• Those who are pregnant should consult their healthcare provider about whether or how to adjust their activity during pregnancy and after their baby is born.

Both the CDC and WHO recommend healthy physical activity, because it can reduce all sorts of potential issues, such as:

• Gestational diabetes

• Excessive gestational weight gain

• Delivery complications

• Postpartum depression

Exercise can also benefit your newborn baby through: 

• Healthy birth weight

• Improved fetal brain development

• Optimized placental delivery of oxygen and nutrients

• Reduced risk of low blood sugar after birth

Consult your healthcare provider about working out

OK, we’ve talked about many of the benefits of exercise, but it’s important to know that some people actually shouldn’t exercise in pregnancy, or should try to limit their physical activities to prevent harm or injury. Although we recommend that everybody seek advice from their healthcare providers before starting or increasing an exercise program during pregnancy, those with certain conditions should be especially careful. These include but are not limited to:

• Significant heart disease

• Asthma

• Balance disorders

• Severe obesity

• Severe anemia

• Prelabor rupture of membranes

• Placental disorders, such as placenta previa

• Multiple gestations, such as twins or triplets

• Cervical insufficiency

Remember – even if you don’t have any of those conditions, you should still get medical clearance before you start an exercise regimen during pregnancy – just to be safe. Some of the things you and your healthcare provider should discuss include the following.

Stage of pregnancy. 

Exercise routines in the first trimester will have to change once your tummy starts to show. For example: It's OK to do sit-ups early in the pregnancy, but after about 20 weeks, you should avoid lying on your back for too long. Abdominal exercises should be done either on your side or all fours.

After your second trimester, your center of gravity changes, and your joints begin to loosen. This means that some exercises can make you more likely to fall.

Altitude.

If you live at sea level, you can safely exercise in higher altitudes up to 6,000 feet. If you already live at that elevation, you might be able to go higher, but check with your healthcare provider first.

Weight.

If you are overweight, a nutritious diet and physical activities are a great way to get healthy. However, in pregnancy, you should start with low-intensity and short periods of exercise and gradually increase the duration and intensity. Your healthcare provider can help you develop a good plan.

Athletes.

Competitive or elite athletes should discuss exercise routines with a healthcare provider as well, because you may have to decrease your training regimen, find ways to limit overheating, increase hydration, and consume more calories.

Listen to your body

Once you’ve spoken with your healthcare provider and have come up with a great exercise plan, let’s talk about safety, how to listen to your body’s signals, and how to respect your limits.

• Avoid pushing yourself to exhaustion. One way to set a limit is with something called a “talk test”. This means that you should still be able to carry on a conversation with someone while you are exercising. If you can’t talk, then you’re probably pushing yourself too far.

• Remain well hydrated. Among the many body changes you experience in pregnancy, one important one is how you maintain fluids. Keep yourself hydrated at all times.

• Avoid long periods of doing exercises while lying flat on your back – especially after the first trimester. This may cause an injury and may reduce blood flow to your placenta.

Additionally, you may notice that your exercise tolerance just isn’t the same as before pregnancy. You’ll find it's much easier to become short of breath, and your body simply won’t respond the way that you’re used to. Some things to watch out for include:

• Vaginal bleeding

• Leaking amniotic fluid

• Regular painful contractions

• Abdominal pain

• Difficulty breathing, especially before exertion

• Dizziness

• Headache

• Chest pain

• Muscle weakness that affects your balance

• Calf pain or swelling

If you do experience these problems, stop exercising immediately, and seek medical attention.

Choose the right exercises for you

There are many exercises and activities that you can do, and it's important to choose something that you feel comfortable with, that’s safe, and that you’ll enjoy. For example, if you were an active runner before pregnancy, you can continue running during pregnancy – just be careful to run in safe areas without tripping hazards. 

If you didn’t run much before pregnancy, now is not the time to start. Instead, consider some low-impact activities, such as:

• Walking

• Swimming

• Aquatic exercise

• Prenatal yoga

Activities you should definitely avoid during pregnancy because they may cause an injury include:

• Contact or collision sports, such as soccer, basketball, downhill skiing

• Horseback riding

• SCUBA diving

• Hot Yoga

Stay hydrated and nourished

Pregnancy changes all sorts of your body’s functions, including how it handles fluids. It's especially important to keep hydrated and ensure you are consuming enough calories to support your increased activities. One way to know that you are drinking enough water is to check your urine – it should be clear. If it’s starting to get dark, then you aren’t drinking enough.

Also, make sure that you’re eating enough. Check with your healthcare provider on how much weight you should be gaining, because it’s different for everybody. Also, be careful of the quality of your food – ensure you are eating balanced meals (protein, carbs, and fats) every day.

Modify exercises as pregnancy progresses

Your exercise routine will typically have to adapt as your body changes over the nine months due to your changing hormones and growing baby. Some things to consider are the following.

Exercise tolerance. 

As your pregnancy progresses and your body fluids shift, your heart won’t respond to exertion the way that you’re used to. In fact, if you’ve monitored your heart rate as a measure of exercise intensity, you may notice the difference. When this happens, it’s best to adjust your exercise based on your breathing efforts.

Changing body shape. 

As your baby grows, you’ll experience a change in your center of gravity. This leads to shifting forces across your joints – and especially your spine – so that many will experience back pain. A good way to help this out is through strengthening your core abdominal and back muscles, especially early on in your pregnancy. While it's OK to lie on your back in the first trimester, you should modify abdominal and lower back exercises after 20 weeks so that you are on all-fours or sitting in a chair. Some of these modifications can include []:

• 4-point kneeling – this will strengthen and tone abdominal muscles while maintaining a strong back.

• Seated leg raises – this will strengthen abdominal muscles and help with balance and stability.

• Kneeling heel touch – this will tone the muscles of your upper back, lower back, and abdomen.

• Standing backbend – this will counteract the forward bending caused by a growing uterus.

Temperature regulation. 

While most exercise won’t raise your body temperature high enough to cause problems, it's best to maintain a cool environment, and it’s advised to stay away from hot yoga. This is probably most important during your first trimester because high body temperature could potentially cause problems with neural tube defects. This is also why you should avoid hot tubs and hot baths in your first trimester. 

Takeaway

Exercising during pregnancy offers many benefits to you and your baby, such as:

• Reduced risk for gestational diabetes

• Maintaining a healthy weight

• Reducing delivery complications

• Preventing postpartum depression

While exercise is safe and recommended during pregnancy, everyone should check in with their healthcare providers before starting – just to be sure you won’t be harming yourself or your baby.

A balanced approach is key. If you are new to exercise, start slow and gradually work your way up.  If you’re a high-intensity exercise enthusiast, it’s best to slow down. Remember to exercise in moderation, enough to sweat a little, but not too much where you can’t carry on a conversation. This will help ensure you won’t cause harm or injury to yourself or your baby.