Pregnancy is supposed to be a time for joy, anticipation and new experiences.
But for a lot of moms it also comes with a lot of anxiety and questions. With all the blogs, articles and social media confusion, moms are forever wondering if they are doing the right thing. For women that like to exercise, they often wonder how much is too much, what’s safe and how they should modify their activity?
The good news is exercise is both safe and encouraged for most pregnant women!
Exercise Recommendations And Cautions
Unless a woman has certain high risk conditions (bleeding, cardiac issues, fetal growth restrictions) both The American Congress of Obstetricians and Gynecologists (ACOG) and Society of Obstetricians and Gynecology of Canada (SOGC) recommend daily exercise.
In 2015 ACOG published guidelines recommending pregnant women get 20-30 minutes of exercise daily. Exercise should be at a moderate intensity level, which means you should be slightly out of breath but still able to hold a conversation. Regular exercise maintains physical fitness, helps with weight management, reduces the risk for gestational diabetes in obese women, and enhances psychologic well-being. Furthermore, exercise in the year prior to conception decreases the risk for pre-eclampsia.
For a mom with an exercise program in place, she can continue to exercise with appropriate modifications. Women can continue walking, lifting weights, swimming and even running to a certain extent.
It is recommended to stop activities where mom may fall on the abdomen or something may hit the abdomen after the first trimester (such as racquetball). Other activities may just need modifications.
For example, if mom is a biker, she may want to consider no longer using pedal clips after the first trimester. Then if she loses her balance it is easy to place a foot down to avoid a fall. The safest option is to move indoors and ride on a trainer or stationary bike. Many women can continue to run as long as they listen to their body. Women may have to change the “goal” of their activity and focus on exercising to be active in pregnancy, not run/bike/walk for certain mileage or speed. It’s extremely important she listen to her body for signs of fatigue, pain, or changes in fetal movement.
Yoga and Pilates is often encouraged during pregnancy. Both have been found to decrease stress levels in moms, improve common pregnancy pain complaints, and improve effectiveness of breathing.
If a mom has been performing yoga or Pilates, little modification is needed. She may want to avoid inversion (head below hips) positions and large asymmetric movements (movements where legs are going in opposite directions). As the baby grows, having the hips above the head for prolonged time can put pressure down and potentially disrupt normal blood flow and breathing patterns. Most moms that have been practicing Pilates and Yoga can tolerate these positions for short time periods without issues. If a mom experiences dizziness, shortness of breath or a headache, it’s recommended she stop these positions. If new to Pilates or Yoga, she should take a class specific to pregnancy with a trained instructor and consider starting with an individualized session or two.
Setting Up New Habits
Many moms use pregnancy as the time to start new healthy habits. We love that!
For moms starting a new exercise routine, walking is generally the safest cardiovascular activity. Light free weights or machines are a great way to start strengthening. Strengthening should focus on the muscles of the arms, upper back and leg muscles. Balance may be affected by pregnancy but strengthening and exercise is a great way to decrease fall risk. So the take home message is don’t be afraid to have your patients keep moving during pregnancy! If a mom is unsure how to start a routine or modify her routine, this is where you can help. If exercise prescription isn’t in your scope of practice, refer her to someone qualified to set up a program. Exercise has many benefits to mom and baby, so keep moving!
ACOG Committee Opinion No. 267. Exercise during pregnancy and the postpartum period. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;99:171-173.
Artal R, O’Toole, M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med 2003; 37: 6-12.
Barakat R, Pelaez M, Montejo R, Luaces M, Zakynthinaki M. Exercise during pregnancy improves maternal health perception: a randomized controlled trial. American Journal Of Obstetrics & Gynecology May 2011;204(5):402.e1-7
Beddoe A, Yang C, Kennedy H, Weiss S, Lee K. The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing. May 2009;38(3):310-319.
Dempsey J, Butler C, Williams MA. No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exerc Sport Sci Rev. 2005 July;33(3):141-149
Moran-Perich S, Benson E. Power Pilates: Empowering Your Pregnancy. 2004 June.
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