Since the beginning of my pregnancy, I’ve received all sorts of comments regarding working out while pregnant. Most of the comments have been positive with people saying things like “You’re an inspiration, even to women who aren’t pregnant” or “Your baby is going to come out doing push-ups” and “Wow, you look great. Congrats on working out while pregnant”. These are the types of comments I welcome while I’m working out but every once in a while someone will approach me asking if it’s safe for me to work out or telling me that I should stop. While I haven’t received any derogatory statements from anyone during my pregnancy regarding my workout regimen, I have heard the disapproval in some people’s inquiries and I’ve seen some of the looks I get at the gym when I’m working out. I knew this was coming so it’s not too difficult to accept but I thought it was important to ease everyone’s minds on this topic of working out while being pregnant.
I would never do anything to jeopardize my life or the life of my unborn child. Before I conceived, I had previously taken a class in exercise physiology which reviewed a section on working out while pregnant not only saying that it is okay, but that it is preferred.
“Once I found out that I was pregnant, however, I asked my doctor if it was okay to continue my current exercise regimen, and I did my own research on the topic. My conclusion: working out while pregnant is welcomed and recommended.”
Recommendations on working out while pregnant have persisted for many many years. Earlier discussions on this topic indicated that exercise may cause organs to slip and impair fertility. As a result of this misconception, recommendations for working out while pregnant were limited to only 1 mile of walking per day. In 1985, further research was assessed determining that aerobic exercise of no more than 15 minutes per day, with a heart rate less than 140 bpm was the maximum amount of work a pregnant woman could safely sustain. Again the standard was changed in the early 90s suggesting that regular exercise 3 time per week was the maximum amount of exercise a woman carrying could safely sustain. Since then, much research has been done on this topic to determine how much exercise is truly safe. The current standard is based upon assessments done in 2002 by the ACOG (American Congress of Obstetricians and Gynecologists), stating that 30 minutes or more of exercise performed daily is recommended provided that the mother has no medical or obstetric complications. In a nutshell, this suggests to us that exercise is not only welcomed but it is recommended for pregnant women as long as they are not experiencing any complications.
“All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy.”
As a result of a mother’s growing uterus and expanding pelvis, she undergoes changes which cause increased strain on muscles and ligaments supporting the vertebral column and an increased laxity of ligaments causing a decrease in joint stability throughout the body. These problems may be minimized with the incorporation of regular exercise during pregnancy, however, they are also cause for concern whether exercise is performed or not. Laxity in ligaments coupled with an altered center of mass as a result of the growing uterus has an impact on balance, raising concern for some activities of daily living as well as certain exercises. Knowing the “Do’s and Don’ts” of exercise during pregnancy are necessary to maintain health throughout the pregnancy.
We already know that, based on past research by obstetricians, gynecologists, and exercise professionals, exercise during pregnancy is safe. But in case you need some reasons to get you into a regular fitness regimen, here are some reasons why pregnancy and exercise are beneficial: (1) maintenance and/or improvement of physical fitness, (2) decreased risk of problematic gestational development, (3) increased potential for a shorter and less painful delivery, (4) companionship and social interaction, (5) decrease in mental and emotional stress, depression, anxiety, and insomnia, (6) reduction in pregnancy symptoms (i.e. fatigue, nausea, constipation, body aches, and swelling), and (7) decreased risk for gestational diabetes.
These benefits may inspire many women to exercise during pregnancy who may have not previously been engaged in regular exercise. Pregnancy myths tell us that only women who were engaged in exercise prior to pregnancy may continue exercise throughout pregnancy, and those who did not participate in exercise need to stay away until the child’s birth, however, it is only a myth. Women who are pregnant may begin exercising during pregnancy as long as they begin with a low intensity/ low duration regimen. These women should start slow, exercising for only 15 minutes a day or less incorporating aerobic and/or anaerobic exercise, whilst increasing the duration of exercise by 5 minutes every week or two until 30 minutes has been reached. Aerobic exercising incorporating large muscle groups in a continuous manner (i.e. walking, cycling, and swimming) are suggested for women beginning an exercising regimen during pregnancy and for those continuing exercising. Anaerobic exercise suggestions during pregnancy (especially for those who are beginning a routine) include lighter weights, with more reps, and avoiding heavy resistance weight training.
There are many recommendations for women and exercise during pregnancy: many of which become obvious as the mother begins to know her symptoms and her pregnancy body on a more intimate level. Due to the laxity of ligaments and balance inconsistencies, water-based exercises are best. Swimming and water aerobics not only strengthen the muscles and ligaments, but they also provide for a low impact workout reducing the risk for muscular and/or ligament damage.
Pregnant women should also avoid 3 major tasks (1) exercises that increase lower back strain as is true with many strength training exercises (i.e. heavy deadlifts), (2) supine position exercises, especially in the 1st trimester (i.e. bench press), as lying supine decreases cardiac output and decreases venous blood return through the body and to the heart, and (3) motionless standing, as it also decreases cardiac output, decreases blood pressure and causes blood pooling in the legs as a result of decreased venous blood return. Women exercising during pregnancy should decrease their pre-pregnancy workload and intensity as oxygen requirements are greater. Pregnant women should exercise in a well-ventilated or air-conditioned environment due to an increase in body temperature. Increases in body temperature should be regulated by avoiding caffeine and staying hydrated (at rest: 64oz of water per day; exercise: sipped 8oz of water every 20 minutes). Keep in mind that running is okay during pregnancy and abdominal exercises are actually recommended to avoid diastasis recti ( a ridge between the left and right side of the abdomen as a result of the growing uterus). While there are many recommendations for exercises, there are also guidelines to stop exercising if certain symptoms persist.
While working out, if any of the following symptoms occur exercise should be stopped immediately: chest pain, vaginal bleeding or excessive fluid leakage, dizziness, faintness, or excessive shortness of breath, and persistently elevated blood pressure following exercising. Other symptoms which may occur on a daily basis (not in the gym) are causes for ceased activity of working out such as: swelling of ankles, hands, or face, pain, and/or redness in the calf, preterm labor, persistent contractions (6-8 per hour), decreased fetal movement, amniotic fluid leakage, and insufficient weight gain during the last two trimesters.
It is important for pregnant women to keep in mind that exercise during pregnancy is not a one-size-fits-all approach. Exercise should be personalized based on daily symptoms and symptoms that arise during exercise. For some women, water-based exercises may be the only appropriate form of exercise during pregnancy while others may be able to comfortably strength-train and jog. Intensity, duration, and frequency of exercise are subjective and should be monitored. No exercise regimen should be continued if abnormal symptoms persist during exercise. And the safest way to exercise is to perform workouts that were previously utilized prior to conception. Pre-pregnancy workouts have already acclimated your body to a particular type of stress that is safe for you. Attempting to change or begin a rigorous exercise training protocol may be detrimental to your health and that of your developing child.