From The Cleveland Clinic: Your Guide to Pregnancy: Exercise During Pregnancy

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Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that it may prevent gestational diabetes (diabetes that develops during pregnancy), relieve stress and build more stamina needed for labor and delivery.

If you were physically active before your pregnancy, you should be able to continue your activity in moderation. Don't try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact. Do not let your heart rate exceed 140 beats per minute.

The pregnant competitive athlete should be closely followed by an obstetrical provider.

If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or obstetric complication.

Who Should Not Exercise?

If you have a medical problem, such as asthma, heart disease or diabetes, exercise may not be advisable. Exercise may also be harmful if you have an obstetric condition such as:

• Bleeding or spotting
• Low placenta
• Threatened or recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your health care provider before beginning an exercise program. Your health care provider can give you personal exercise guidelines, based on your medical history.

What Exercises Are Safe During Pregnancy?

Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

Tennis and racquetball are generally safe activities, but your change in balance during pregnancy may affect rapid movements. Other activities such as jogging can be done in moderation. You may want to choose exercises or activities that do not require great balance or coordination, especially later in pregnancy.

To learn strength and toning exercises that are safe to do during pregnancy, see Sample Exercises.

What Exercises Should Be Avoided During Pregnancy?

There are certain exercises and activities that can be harmful if performed during pregnancy. Avoid:

• Holding your breath during any activity.
• Activities where falling is likely (such as skiing and horseback riding).
• Contact sports such as softball, football, basketball and volleyball.
• Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
• Activities that require extensive jumping, hopping, skipping, bouncing or running.
• Deep knee bends, full sit-ups, double leg raises and straight-leg toe touches.
• Bouncing while stretching.
• Exercises that require lying on your back or right side for more than three minutes. (especially after your third month of pregnancy).
• Waist twisting movements while standing.
• Heavy exercise spurts followed by long periods of no activity.
• Exercise in hot, humid weather.

What Should an Exercise Program Consist of?

For total fitness, an exercise program should strengthen and condition your muscles.

Always begin by warming up for five minutes and stretching for five minutes. Include at least fifteen minutes of cardiovascular activity. Measure your heart rate at times of peak activity (your heart rate may range from 140-160 beats per minute during activity). Follow aerobic activity with five to ten minutes of gradually slower exercise that ends with gentle stretching.

Here are some basic exercise guidelines:

• Wear loose fitting, comfortable clothes as well as a good support bra.
• Choose shoes that are designed for the type of exercise you do. Proper shoes are your best protection against injury.
• Exercise on a flat, level surface to prevent injury.
• Consume enough calories to meet the needs of your pregnancy (300 more calories per day than before you were pregnant) as well as your exercise program.
• Finish eating at least one hour before exercising.
• Drink water before, during and after your workout.
• After doing floor exercises, get up slowly and gradually to prevent dizziness.
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over-exerting yourself and should slow down your activity.

What Physical Changes May Affect My Ability to Exercise?

Physical changes during pregnancy create extra demands on your body. Keeping in mind the changes listed below, remember that you need to listen to your body and adjust your activities or exercise routine as necessary.

• Your developing baby and other internal changes require more oxygen and energy.
• Hormones produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight shift your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area and makes it easier for you to lose your balance.

Warning

Stop exercising and consult your health care provider if you:

• Feel chest pain.
• Have abdominal pain, pelvic pain or persistent contractions.
• Have a headache.
• Notice an absence or decrease in fetal movement.
• Feel faint, dizzy, nauseous or light-headed.
• Feel cold or clammy.
• Have vaginal bleeding.
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily.
• Notice an irregular or rapid heartbeat.
• Have sudden swelling in your ankles, hands or face or calf pain.
• Are short of breath.
• Have difficulty walking.
• Have muscle weakness.

How Soon Can I Exercise After Delivery?

It is best to ask your health care provider how soon you can begin your exercise routine after delivering your baby.

Although you may be eager to get in shape quickly, return to your pre-pregnancy fitness routines gradually. Follow your health care provider's exercise recommendations.

Most women can safely perform a low-impact activity one to two weeks after a vaginal birth (or three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it. Wait until about six weeks after birth before running or participating in other high impact activities.

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View the full table of contents for the Pregnancy Guide.

Reviewed by The Cleveland Clinic Birthing Services and the Department of Obstetrics and Gynecology.

Edited by Tracy Shuman, MD, November 2005, WebMD.

SOURCE: The March of Dimes.