Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. It can also improve your posture and decrease some common discomforts like 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 with modifications as necessary. You can exercise at your former level as long as you are comfortable and have your doctor's approval. 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. Do not try a new, strenuous activity. Walking and swimming are 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 uncontrolled Type 1 diabetes, exercise may not be advisable. Exercise may also be harmful if you have an obstetric condition such as:
- Bleeding or spotting
- Weak cervix
Avoid aerobic exercise during pregnancy if you have:
- Hemodynamically significant heart disease
- Restrictive lung disease
- Incompetent cervix/cerclage
- Multiple gestation at risk for premature labor
- Persistent second- or third-trimester bleeding
- Placenta previa after 26 weeks of gestation
- Premature labor during the current pregnancy
- Ruptured membranes
- Preeclampsia/pregnancy-induced hypertension
Take precautions with aerobic exercise during pregnancy if you have:
- Severe anemia
- Unevaluated maternal cardiac arrhythmia
- Chronic bronchitis
- Poorly controlled type 1 diabetes
- Extreme morbid obesity
- Extreme underweight (BMI <12)
- History of extremely sedentary lifestyle
- Intrauterine growth restriction in current pregnancy
- Poorly controlled hypertension
- Orthopedic limitations
- Poorly controlled seizure disorder
- Poorly controlled hyperthyroidism
- Heavy smoker
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 bicycling 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 or running 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, including activities that include jarring motions or rapid changes in direction
- Activities that require extensive jumping, hopping, skipping, or bouncing
- Deep knee bends, full sit-ups, double leg raises and straight-leg toe touches
- Bouncing while stretching
- Exercises that require lying on your back for more than three minutes. (especially after your third month of pregnancy)
- Heavy exercise spurts followed by long periods of no activity
- Exercise in hot, humid weather
- Scuba diving
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 added weight also puts stress on joints and muscles in the lower back and pelvic area, plus makes it easier for you to lose your balance.
What Are the Warning Signs to Quit Exercising?
Stop exercising if you:
- Experience chest pain
- Have abdominal pain, pelvic pain or persistent contractions
- Have a headache unrelieved by rest and Tylenol
- Feel faint, dizzy, nauseated 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
Call you doctor if any of these conditions persist after you stop exercising.
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 (typically three to four weeks after a cesarean birth). Do about half of your normal floor exercises and don't overdo it. Wait until about six weeks after birth before running or participating in other high impact activities.