Exercise During Pregnancy

By Madhavi Gupta, M.D.

The benefits of exercise during pregnancy

Everyone can benefit from exercise. Our bodies are meant to move. But there are special reasons to be active while trying to conceive and while pregnant. Exercise helps you maintain a healthy weight, which improves fertility and is associated with healthier pregnancies and birth outcomes.

According to the Mayo Clinic, women who exercise in pregnancy may have “a lower risk of gestational diabetes, shortened labor, [and] a reduced risk of having a C-section (1).” Exercise can also reduce some of the discomforts of pregnancy, such as backaches and constipation. And exercise helps you sleep better. 

    1. Start now: The best time to start exercising is before you conceive, to strengthen your body for the challenges of pregnancy. Aim for 150 minutes of moderate aerobic exercise a week. Or go for 75 minutes of intense aerobic exercise a week and add two days of strength training. If you’re not exercising that much right now, work up to it in ten-minute increments. But don’t overdo it. You should be able to hold a conversation while you work out.
    2. Keep it up: Once you become pregnant, keep up that same level of activity. Good exercises during pregnancy include walking, swimming, water aerobics, using a rowing machine or stationary bicycle, yoga, and stretching. If you lift weights, use light ones with more repetitions. Running is probably safe if you were already a runner before getting pregnant. If you have any questions about safe exercising, consult your healthcare provider.
    3. Be on the lookout: Be sure to drink water while you exercise, and listen to your body. The following are signs that you need to stop: abdominal pain, chest pain, dizziness, headaches, shortness of breath, uterine contractions, or vaginal bleeding. If these symptoms continue after you stop exercising, seek medical attention.
    4. Ease back in: After the baby comes, exercise can help you lose the baby weight, restore your abdominal muscles, reduce stress, and boost your mood. Talk to your health care provider about the best time to start, and when you do, build back up to your previous level of activity gradually. Walks around the neighborhood with the baby are a good, gentle first exercise.


Benefits of exercise for mom:

Exercise provides important benefits for expectant moms. Exercise can help:

  • Reduce delivery complications. Studies have shown women who exercised during pregnancy were less likely to develop gestational diabetes or have unplanned cesarean sections than those who didn’t follow a fitness plan (2). And women who exercised three times a week gained less weight during pregnancy and were less likely to have heavier babies (more than nine pounds at birth) which can lead to complications during delivery (3). 
  • Improve overall health and well-being. Exercise has a positive effect on cardiovascular function, and can suppress excessive pregnancy weight gain, decrease musculoskeletal discomfort, reduce muscle cramps and lower limb edema, decrease preterm birth, increase neonatal lean body mass, and expand placenta volume (4). 
  • Postpartum recovery: The better your fitness level before delivery, the faster you can recover after giving birth. 
  • Reduce depression: About half of all women report increased depression or anxiety during pregnancy. According to research, exercise during pregnancy reduces depression, releasing endorphins to help boost your mood while diminishing stress and anxiety (5).
  • Lower blood pressure: During pregnancy, it’s normal for blood pressure to occasionally go up, but too much elevation can be a warning sign of preeclampsia. Even moderate exercise has been found to keep blood pressure from rising (6).
  • Relieve discomfort: Your growing baby puts extra pressure on your lower body, often resulting in an achy back and pelvis. Exercise can help relieve lower-back and pelvic pain during late pregnancy (7).
  • Energy levels: Many women feel fatigued during the first trimester, and again in the third trimester approaching delivery. Simply taking a walk—even when you are feeling tired—can improve your energy level.
  • Sleep: Sleep is precious when you are pregnant. Pregnant women often have a harder time falling asleep. Regular exercise can improve the quality of your sleep and help you wake more rested.
  • Keep you regular:Staying active helps keep your digestive system functioning well and helps fight constipation, often a challenge during pregnancy.


Benefits of exercise for baby:

In addition to the benefits for mom, there are also proven benefits for your developing baby.

  • Better neuromotor skills: Exercise during pregnancy can positively influence developing systems allowing for improved neuromotor development, leading to infants who are more adept at movement, and presumably more likely to be active, which may also potentially reduce childhood risk of obesity (8).
  • Better heart health: In research, the babies of moms who exercised regularly during pregnancy had lower fetal heart rate and increased heart rate variability (associated with cardiovascular fitness) which persisted after birth, suggesting a positive impact on cardiovascular health promotion and disease prevention (9).
  • Less body fat: Studies show that a mom’s activity levels during pregnancy are associated with decreased neonatal fat levels without significantly reducing the baby’s neonatal fat-free mass (10).

         

        Is exercise safe during pregnancy?

        For most women, exercise is safe during pregnancy, and with so many potential benefits to you and your baby, it’s usually recommended. If you were already active before pregnancy, it’s likely safe for you to continue to be physically active during pregnancy. Exercise does not put you at risk for miscarriage in a normal pregnancy. Check with your healthcare provider and bring up any questions you have specific to your pregnancy.

        Exercise during pregnancy is not about weight loss but about supporting your overall fitness. Staying active throughout your pregnancy can make weight loss easier after delivery and continuing to stay active once you recover from labor, can make postpartum easier. 


        Is physical activity safe for all pregnant women?

        For some women, exercise is not safe during pregnancy. Your provider can help you determine whether exercise is safe for you. The following conditions may make it unsafe or require you to modify your exercise and use extra caution.

        • Preterm labor
        • Being pregnant with twins, triplets or multiples
        • Cervical insufficiency or a cerclage; cervical insufficiency means your cervix dilates too early during pregnancy
        • Gestational hypertension or preeclampsia 
        • Placenta previa after 26 weeks of pregnancy; this is when the placenta lies very low in the uterus and covers all or part of the cervix 
        • Severe anemia or certain heart or lung conditions—if you have a heart or lung condition, ask your provider if it’s safe to exercise during pregnancy


        Best types of exercise during pregnancy

        If you haven’t been exercising before becoming pregnant, discuss your plans with your healthcare provider and ease into things gently.

        • Walking: Walking is a great place to start if regular exercise is not already part of your routine.
        • Yoga and Pilates: Let your instructor recommend modified poses where necessary. Many places offer special classes created for expectant moms.
        • Swimming: Swimming is easier on your joints and muscles and the support of the water feels especially good as your baby grows.
        • Stationary Bike: A stationary bike can be safer than a traditional bike, especially as your belly grows and balance is affected.
        • Strength Training: Weight training can help you build muscle and strengthen bones. Go easy on the amount of weight and check in with your provider.
        • Squatting: Doing squats during pregnancy can be good practice for squatting during labor which can open your pelvic outlet to help your baby descend.
        • Pelvic Tilts: Pelvic tilts strengthen the muscles in your abdomen and help alleviate back pain during pregnancy and labor. 


        Activities to avoid during pregnancy

        Tune in to your body and don’t do any exercise to the point of exhaustion. 

        • Activities where falling is more likely
        • Exercise that may cause any abdominal trauma
        • Activities that require extensive jumping, hopping, skipping, or bouncing
        • Contact sports
        • Waist twisting movements while standing
        • Scuba Diving 
        • Skydiving
        • Intense bursts of exercise 
        • Exercise in hot, humid weather or high altitude
        • Don’t hold your breath for an extended period of time


          Body changes that can affect exercise

          During pregnancy, your body changes in many ways. Even if you are regularly very active, you may notice some differences when exercising while pregnant. You can lose your balance more easily. Your body temperature is slightly higher during pregnancy, so you start sweating sooner. The growing pressure on your diaphragm might make you short of breath and you may feel you have less overall energy than before. Your heart works harder and beats faster during pregnancy to get oxygen to your baby. Pregnancy hormone levels can relax the tissues that support your joints so be careful not to strain them.

           

          Exercise is important after giving birth

          Exercise continues to be important after you birth your baby. It may help improve your mood and decrease the risk of deep vein thrombosis (DVT). Exercise can also help you manage stress, keep up your energy, lose pregnancy pounds, and recover from delivery.

           

          Don’t forget nutrition needs

          Good nutrition goes hand-in-hand with your exercise plan and is important for your health and the health of your developing baby. It’s difficult to get everything you need from diet alone. Taking a high-quality prenatal multivitamin is the best way to fill in any nutrient gaps.

          Regular exercise is always important, but the more you can stay active in pregnancy, the better you will feel and the better prepared for your baby’s arrival.


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