Why Should You Exercise During Pregnancy?
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 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 with modifications as needed. But some exercises are not a good idea when you're pregnant. Knowing the difference can help keep you and your growing baby safe.
You can exercise at your former level as long as you are comfortable and have your doctor's approval. Low-impact aerobics are encouraged over high-impact ones. Do not let your heart rate exceed 140 beats per minute. If you're a competitive athlete, follow your obstetrician's advice.
If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your doctor. Do not try a new, strenuous activity. Walking and swimming are considered safe to begin when pregnant. The CDC recommends at least 30 minutes of moderate exercise per day for 5 days a week unless you have a medical or obstetric complication.
If you are at high risk for complications, your doctor may recommend that you put your exercise plans on hold until after you give birth. Or they may suggest that you cut back on exercising at around 20 to 24 weeks.
Before considering any exercise program, talk with your doctor about your specific risks and concerns, especially what types of exercises are best to avoid.
Who Should Not Exercise?
If you have a medical problem, such as asthma, heart disease, or type 1 diabetes that is uncontrolled, exercise may not be advisable. Exercise may also be harmful if you have an obstetric condition such as:
- Bleeding or spotting
- A 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 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 an extremely sedentary lifestyle
- Intrauterine growth restriction in current pregnancy
- Poorly controlled hypertension
- Orthopedic limitations
- Poorly controlled seizure disorder
- Poorly controlled hyperthyroidism
- A habit of heavy smoking
Consult your doctor before beginning an exercise program. They can offer personalized exercise guidelines based on your medical history.
Safe Exercises 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, low-impact aerobics (taught by a certified aerobics instructor), yoga or Pilates, and strength training with light weights. These activities carry little risk of injury, benefit your entire body, and can be continued until birth.
Contact sports that could cause injury to your stomach should be avoided, according to the American College of Obstetricians and Gynecologists. 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.
Stretching exercises for pregnancy
Stretching exercises make the muscles limber and warm, which can be especially helpful when you're pregnant. Here are some simple stretches you can do before or after exercise:
Neck rotation. Relax your neck and shoulders. Drop your head forward. Slowly rotate your head to your right shoulder, back to the middle, and over the left shoulder. Complete four slow rotations in each direction.
Shoulder rotation. Bring your shoulders forward and then rotate them up toward your ears and back down. Do four rotations in each direction.
Thigh shift. Stand with one foot about 2 feet in front of the other, toes pointed in the same direction. Lean forward, supporting your weight on the forward thigh. Change sides and repeat. Do four on each side.
Leg shake. Sit with your legs and feet extended. Move the legs up and down in a gentle shaking motion.
Ankle rotation. Sit with your legs extended and keep your toes relaxed. Rotate your feet, making large circles. Use your whole foot and ankle. Rotate four times on the right and four times on the left.
Kegel exercises during pregnancy
Kegel exercises help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles during your pregnancy, you can develop the ability to relax and control the muscles in preparation for labor and birth. Kegel exercises are also highly recommended during the postpartum period to promote the healing of perineal tissues, increase the strength of the pelvic floor muscles, help these muscles return to a healthy state, and increase urinary control.
To do Kegels, imagine you are trying to stop the flow of urine or trying not to pass gas. When you do this, you are contracting the muscles of the pelvic floor and are doing Kegel exercises. Try not to move your leg, buttock, or abdominal muscles. In fact, no one should be able to tell that you are doing Kegel exercises. You can do them anywhere!
Try to do five sets of Kegel exercises a day. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax. Repeat this 10 times for one set of Kegels.
Tailor exercises for pregnancy
Tailor exercises strengthen the pelvic, hip, and thigh muscles and can help relieve low back pain.
Tailor sit. Sit on the floor with your knees bent and ankles crossed. Lean slightly forward, and keep your back straight but relaxed. Use this position whenever possible throughout the day.
Tailor press. Sit on the floor with your knees bent and the bottoms of your feet together. Grasp your ankles and pull your feet gently toward your body. Place your hands under your knees. Inhale. While pressing your knees down against your hands, press your hands up against your knees (counterpressure). Hold for a count of five.
Pregnancy ball exercises
A birthing ball, which can be used during pregnancy, labor, and postnatal, has many functions. Birthing balls are larger than exercise balls and are made of a stronger material that can hold your weight when you are expecting.
Using this ball can improve your posture and your core, which prepares your body for labor and can help your baby get into a proper fetal position.
You can complete some basic exercises, such as rocking back and forth, simple bouncing, or some pelvic floor exercises. Some exercises are similar to those you may have done before you were pregnant, with the ball adding some additional comfort and stability. These exercises include:
Moving hips side to side. Sit on the birthing ball, almost in a sumo squat position, with knees above your ankles. Move from left to right, feeling the motion in your glutes. Release the tension. Repeat as needed, stopping before signs of tiredness.
Child's pose with the ball. Kneel in front of the ball with your knees hip-distance apart. With your hands on the ball, roll the ball away from you, lowering your head and placing it between your arms. Push your glutes out. Relax and inhale and exhale deeply, releasing your back, neck, and shoulders.
Hugging/rocking the ball. Kneel in front of the ball. Hug the ball, placing your hands around the back and resting your upper and lower arms on the ball. Place your chest on the front of the ball, then gently rock back and forth and left to right in short motions, avoiding your belly area and keeping your face looking forward. Rotate between shifting your weight through your glutes and then relaxing them. Repeat as desired and stop before feeling tired.
Exercises To Avoid During Pregnancy
There are certain exercises and activities that can be harmful if performed during pregnancy. If you were exercising before you became pregnant, ask your doctor or midwife if it’s safe to keep the same routine. Here are some activities to stay away from:
Exercise to lose weight. Depending on your prepregnancy weight, you can expect to gain about 25-35 pounds. This can be hard to take, emotionally and physically, but save the calorie burning for after you give birth. As long as you eat a healthy diet, weight gain during pregnancy is a sign of your baby’s healthy development. However, if you have obesity, you should talk to your doctor about acceptable weight gain.
Contact sports. Sports such as soccer, basketball, and ice hockey come with a high risk of getting knocked in the stomach. It's best to avoid these sports during your pregnancy, especially in the later stages when your belly starts to get bigger.
Fall-prone activities. The risks outweigh the benefits when it comes to activities that require a lot of balance, such as skiing and horseback riding. Even riding a bike outdoors can be unstable when you're not used to balancing a pregnant belly. After week 12 or 14, do your pedaling on a stationary bike. If you ride a bike for transportation, talk with your doctor about how to keep yourself and your baby safe.
Overdoing it. Pushing to the point of exhaustion may boost athletic performance, but when you're pregnant, it can reduce blood flow to your uterus. During exercise, you should be able to sing one round of “Happy Birthday” without running out of breath. If you can’t, you're pushing too hard.
Bouncing or jarring activities. Joints get looser during pregnancy, which can raise your risk of injury. Take a temporary vacation from high-impact aerobics and kickboxing.
Too much heat. On hot summer days, plan ahead so you can exercise in the cool of the morning or evening, or find a gym that has air conditioning. Steer clear of Bikram and other forms of hot yoga while you're pregnant. Make sure you drink plenty of water.
Lying on your back. It’s fine to lie on your back for a few minutes. But as your uterus gets heavier, it can cut off circulation to your legs and feet, as well as to your baby. Avoid yoga poses, crunches, and any other activities that call for lying on your back longer than just a couple of minutes.
High-altitude exercise. If you visit the mountains while you’re pregnant, stay below 6,000 feet when you exercise. Talk with your doctor or midwife if you have questions so you don’t unnecessarily avoid healthy exercise. Here are some signs of altitude sickness you should watch out for:
- Shortness of breath
If you have any of these symptoms, call it quits for the day and call your doctor or midwife.
Deep-sea exploration. Put any plans to go scuba diving on hold. The change in pressure could put your baby at risk of decompression illness.
Other types of exercises to avoid:
- Holding your breath during any activity
- 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
- Heavy exercise spurts followed by long periods of no activity
- Waist-twisting movements while standing
What Should an Exercise Program Consist Of?
For total fitness during pregnancy, an exercise program should include moderate-intensity aerobic activity. The intensity of your workout should be less than 60%-80% of your age-predicted maximum maternal heart rate, which is usually no more than 140 beats per minute, according to the American College of Obstetrics and Gynecology.
Begin by warming up and stretching for about 5 minutes. If you are new to working out, ease into exercise. You could begin with 5 minutes and gradually increase to 30 minutes of exercise a day.
Be aware of your level of intensity throughout your workout. Moderate intensity means you notice an increase in your heart rate, may begin sweating, and can talk but cannot do additional activities such as singing.
Follow aerobic activity with 5-10 minutes of 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.
- Get 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 1 hour before exercising.
- Drink water before, during, and after your workout.
- After doing floor exercises, get up slowly and gradually to prevent dizziness.
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, making it easier for you to lose your balance.
Making Exercise Modifications
If your favorite sport appears on the list of don’ts, you may be able to continue, within reason. Talk with your doctor or midwife about ways to modify your exercise so it's safe for your baby. Here are a few suggestions:
Less intensity. Instead of sprinting around the track, go for a light jog or a brisk walk. Instead of hot yoga, look for a prenatal yoga class.
Shorten your workout. As your pregnancy progresses, you may tire out more quickly. Save energy by breaking up your exercise into smaller sessions. If you can’t take a 30-minute walk, take 10-minute walks throughout the day.
Shift your weight. Roll up a towel and put it under one side of your back so you can keep the blood flowing to your legs and uterus while you stretch.
Use lighter weights. More repetitions with lighter weights can keep your muscles strong without hurting your joints.
With these modifications, you have many ways to exercise during pregnancy that are good for you and your baby’s health. Before you head out to the gym or field, talk with your doctor or midwife. Then go ahead and get moving!
When to Stop Exercising
Take a break if you have any of the following:
Shortness of breath. A growing baby can push against your lungs and make it harder to take a full breath, especially in your last few months. Even earlier in pregnancy, the hormonal changes that affect your lungs can make you feel short of breath. But if you have increased shortness of breath or any other breathing changes that are unusual, call your doctor or midwife right away.
Overheating. If you feel yourself getting hot, slow down. Getting overheated can cause some serious problems for your growing baby, including birth defects. Make sure you drink plenty of water while exercising. Stay safe and take it easy when you're exercising on hot days.
Dizziness. You're more likely to feel dizzy when you’re pregnant, especially early in your second trimester. Dizziness during exercise, though, could cause you to fall. Don't risk it. If you feel dizzy, take a break and lie down on your side. Call your doctor or midwife if the symptoms persist.
Pain in your back or hips. This is another sign your body's had enough for the time being. Stop what you're doing and take it easy.
You should also stop exercising if you:
- Have a headache unrelieved by rest and Tylenol
- Feel cold or clammy
- Have sudden swelling in your ankles, hands, or face or calf pain
- Have difficulty walking
Call your doctor if any of these conditions persist after you stop exercising.
When to Call Your Doctor
Stop exercising right away and call your doctor or midwife if you have any of the symptoms below:
Warning signs of preterm labor. It may be possible to avoid preterm labor if you and your doctor or midwife act quickly. Be on the lookout for:
- Contractions, especially if they continue after you rest and drink water
- Vaginal bleeding
- Unusual pain in your belly
- Fluid leaking or gushing from your vagina
Trouble breathing. Breathing conditions, such as asthma, can be more serious when you’re pregnant. If you have asthma, always carry your inhaler. Phone your doctor or midwife if you have:
- Lightheadedness or feeling like you might faint
- Chest pain
- Pounding heart
- Rapid heartbeat
Exercise is a great way to stay fit and emotionally grounded while pregnant. But pay attention and be ready to back off or call your doctor or midwife if your body sends you any of these warning signals.
How Soon Can I Exercise After Having a Baby?
Although you may be eager to get in shape quickly, return to your prepregnancy fitness routines gradually. Follow your health care provider's exercise recommendations.
Most women can safely perform a low-impact activity within a few days after a routine vaginal delivery. It can typically take up to 6 weeks, however, to begin exercise after a cesarean delivery.
It is best to ask your health care provider how soon you can begin your exercise routine after delivering your baby and what exercises are safe for you.