Exercise During Pregnancy

One of the first questions active moms-to-be ask after seeing a positive pregnancy test is, “How safe is it to exercise during pregnancy?” The good news? Not only is it safe, but your doctor will likely encourage it!

“Exercising in pregnancy should be a part of every pregnant woman’s daily routine,” says Sherry A. Ross, MD, OB-GYN, and women’s health expert at Providence Saint John’s Health Center. Pregnancy affects joint stability, balance, and coordination, and physical activity causes heart rate fluctuations, which Ross says, requires choosing a safe exercise program.

Erica Ziel, a certified Pilates instructor, personal trainer, and creator of Knocked-Up Fitness, says many forms of exercise during pregnancy require modifications, such as less range of motion, decreased weight, or slightly modified positions, so that the exercises are effective.

“I always teach my prenatal clients that any exercise program they follow while pregnant should not cause pain, incontinence, or a ‘coning of the belly,’ which is a ridge that pops out down the midline of the belly,” she explains.

The American College of Obstetricians and Gynecologists (ACOG) recommends participating in a regular exercise routine during pregnancy as long as you are healthy and your pregnancy is normal. That said, here are some precautions to keep in mind while working out:

• discuss any concerns or risks with your doctor during an early prenatal visit
• exercise at least 30 minutes a day, 5 days a week, for a total of 150 minutes per week
• stay hydrated throughout the day and always have water with you when working out
• avoid activities that may cause you to overheat, like hot yoga, especially during the first trimester
• wear supportive clothing
• avoid lying flat on your back for too long, especially during the third trimester
• avoid high intensity or contact sports

The best workouts for pregnancy include:

• brisk walking
• light jogging
• swimming/water aerobics
• recumbent cycling
• prenatal yoga or Pilates
• resistance training with weights and exercise bands
• elliptical trainers and other stationary cardio machines
• Kegel exercises

Breaking a sweat is not only good for your physical health but also a top pick for managing stress, which can run high while pregnant. Additionally, regular exercise during all three trimesters can:

• reduce blood pressure levels
• reduce blood sugar levels
• lower cholesterol levels
• help manage body weight and body fat
• improve your quality of life
• reduce low back pain (hello, growing tummy!)
• help manage symptoms of anxiety and depression
• improve postpartum recovery time
• set you up for postpartum fitness

The ACOG also points to a lower incidence of preterm birth, cesarean birth, gestational diabetes, hypertensive disorders like preeclampsia, and lower infant birth weight, in women who exercise during pregnancy.

Your body changes in many ways during pregnancy. And as your pregnancy progresses, Ross says you’ll need to adjust your workouts based on increased body weight and temperature, faster heart rate, fatigue, reduced stamina, back pain, joint instability, and feeling winded more easily.

“Taking more frequent rest periods, hydrating throughout the workout, and taking more bathroom breaks are necessary when working out while pregnant,” she explains.

You’ll also need to account for an increase in injuries or instability. Anika Arevalo, PT, DPT, physical therapist, and pelvic health specialist at Back 2 Normal, says an increase in the hormone relaxin, which increases joint and ligament laxity, can lead to these areas being more prone to injuries during exercise.

There’s also more demand on your heart, which Arevalo says can cause frequent light-headedness and dizziness. Plus, your growing tummy alters your body’s center of gravity, making you less stable with movements. Being aware of these changes can help you choose activities that are safe and provide you with a way to take a break if needed.

Pelvic floor health is another issue to address during pregnancy. “Because of your growing baby, your pelvic floor, which is part of your ‘deep core system’ has more demand on it to be supportive,” says Arevalo.

Your pelvic floor is part of the core system, which also comprises your diaphragm, transverse abdominis, and multifidus muscles in your back. Arevalo says it’s really important that these muscles work in coordination with proper breathing, especially with a growing baby and less room for the diaphragm to move.

Dysfunction in this system can lead to an increased risk of diastasis recti, a separation of the two rectus muscles that meet in the midline of your stomach that prolongs the healing of this core system after birth. To help minimize diastasis and promote healing after birth, you may want to consider working with a pelvic floor physical therapist.

If you enjoy the adrenaline rush of contact sports or other high intensity activities, you’ll need to find a new way to satisfy that urge, at least for the next 9 months. Contact sports and other high risk activities that are on the naughty list while pregnant include:

• boxing
• soccer
• basketball
• snow skiing
• racquet sports
• scuba diving
• horseback riding
• rock climbing

If this isn’t your first go-around with pregnancy, there’s a good chance you’ve experienced the spinning and swaying that often hits you at the worst times. Since pregnancy affects a woman’s balance and coordination, it’s not uncommon to feel faint or dizzy.

Ross says carrying extra weight, especially in the belly area, makes the center of gravity for a pregnant woman very unstable. “Because of this, any exercise that can affect your balance, including jumping jacks and other jump-heavy exercises, would not be recommended beyond 20 weeks for fit and experienced exercise enthusiasts,” she explains.

Even if you’re experienced in these forms of exercise, Ross says you can be surprisingly affected by the physical changes associated with pregnancy that make you unsteady on your feet.

Exercise, especially low impact activity, is generally safe and recommended throughout pregnancy. However, there are instances in which raising your heart rate or pushing your body too hard may pose problems.

If you are experiencing any of the following symptoms while exercising, the ACOG says to stop and call your doctor right away:

• feeling faint or dizzy
• chest pain or shortness of breath prior to working out
• headache
• swelling or pain, particularly in the calf muscles
• bleeding or fluid gushing or leaking from the vagina
• contractions that are painful and regular

Additionally, your doctor may advise against exercise if you have a condition like placenta previa after 26 weeks, severe anemia, cervical insufficiency, preterm labor, or preeclampsia, as well as if you’re pregnant with multiples and experiencing a high risk pregnancy.

Unless a doctor has told you otherwise, it’s safe to exercise all 9 months of pregnancy. That said, you may find that certain activities like running may become a bit awkward (hello pregnancy breasts!) or uncomfortable the closer you get to your due date.

The key to sticking to a consistent exercise routine is to choose workouts that are fun, safe, and comfortable. Talk to your doctor if you have any questions or concerns about prenatal exercise. Remember to give yourself permission to take it easy, and focus on moving to feel good!