A Review of Current Recommendations
Although it is considered safe for pregnant women to continue vigorous exercise throughout pregnancy, and women who have not been active are encouraged to begin an exercise regimen during pregnancy, there are some recommendations that will ensure you are exercising safely.
A pregnant woman should be conscious of things that will cause her body temperature to increase. During the first trimester, increased body temperature is associated with neural tube defects. Anytime during pregnancy, becoming overheated uncomfortable and should be avoided. To prevent overheating, be sure to drink plenty of water, wear appropriate clothing and in a properly heated environment (such as an air-conditioned room or outside on a non-humid day).
The demands on the pregnant body can cause a pregnant woman to fatigue faster while exercising. Pay attention to your body and stop exercising when you get tired, dizzy or short of breath. Remember, you want to maintain your fitness level not make major increases.
Be sure to eat a protein and complex carbohydrate (cheese and wheat crackers, peanut butter on a whole wheat bread) 2 hours before exercising to prevent extreme drops in blood sugar levels.
Avoid breath holding during exertion. Keep your breathing as normal as possible, and exhale during moves that take extra effort.
Avoid positions and exercises that put stress on the stretched abdominal muscles. Also, avoid moves that put extra pressure on your connective tissues of your joints. Your joints will be looser during pregnancy because of the hormone relaxin, and extra care should be taken to ensure you do not damage. Take extra care when adding weights to your routine.
Work out at an intensity that lets you talk during exercise, but not sing. That will let you know that you are exercising at a moderate level.
Although exercise can help prevent excessive weight gain during pregnancy, it should not prevent you from gaining a normal amount of weight. The average weight gain for a healthy pregnancy is 35 pounds.
If you are experiencing problems with your pregnancy, talk to your health care provider about how to modify exercises.
Contraindications for Exercise in Pregnancy
The American College of Obstetricians and Gynecologists (ACOG) has stated that for most women, exercise during pregnancy is healthy. However, they do advise that each pregnancy be evaluated individually to determine the safety to mother and baby.
According to ACOG, there are cases in which it is not safe for the mother to participate in aerobic exercise. The mother is recommended not to exercise if she has:
- Haemodynamically significant heart disease
- Restrictive lung disease
- Incompetent cervix/cerclage
- Multiple gestation at risk for premature labor
- Persistent second or third trimester bleeding
- Placenta praevia after 26 weeks gestation
- Premature labor during the current pregnancy
- Ruptured membranes
- Pregnancy induced hypertension
ACOG also feels that in some instances, aerobic exercise may not be safe. Pregnancies should be reviewed carefully if the mother has:
- Severe anemia
- Unevaluated maternal cardiac arrhythmia
- Chronic bronchitis
- Poorly controlled type I diabetes
- Extreme morbid obesity
- Extreme underweight (body mass index < 12)
- History of extremely sedentary lifestyle
- Intrauterine growth restriction in current pregnancy
- Poorly controlled hypertension/pre-eclampsia
- Orthopaedic limitations
- Poorly controlled seizure disorder
- Poorly controlled thyroid disease
- Heavy smoker
According to ACOG, a pregnant woman should cease exercising and contact her health care provider if she experiences:
- Vaginal bleeding
- Dyspnoea before exertion
- Chest pain
- Muscle weakness
- Calf pain or swelling (need to rule out thrombophlebitis)
- Preterm labor
- Decreased fetal movement
- Amniotic fluid leakage
ACOG Committee 2002 Opinion no. 267: exercise during pregnancy and the postpartum period. Obstet Gynecol 99:171-3
The American College of Sports Medicine. Current Comments: August 2000
Kropp, Tori 2000 Prenatal Training. American Fitness 19:5 p45(1)
Rote, Bonnie 1995 The Pregnant Exerciser. American Fitness 13:1 p24(6)
Exercise During Pregnancy. Clinical Reference Systems, Annual 2001 p751