Exercising While Pregnant

  • “I’m worried if I run, that I will hurt my baby.”
  • “If I continue to do Pilates, will I squish my little one?”
  • “Can I keep doing Cross Fit?”
  • “I’ve never really exercised before…can I start now that I’m pregnant?”

These are some common questions pregnant patients ask during visits and understandably so as there is so much conflicting information out there. Hopefully, this will shed some light on the subject.

What is exercise? Why should I make it a part of my routine?

Exercise, defined as a planned activity with the intention of improving one or more components of physical fitness, has been shown to have many positive benefits for a person in pregnancy. Pregnant patients who have maintained a regular exercise schedule have shown to gain a healthier amount of weight during pregnancy, lose excess weight more quickly after delivery, reduce the risk of medical conditions related to pregnancy such as gestational diabetes, preeclampsia, and cesarean sections, as well as, an overall improved feeling of well-being during pregnancy itself.

To Exercise or Not to Exercise

First, before starting an exercise program, it is important that you speak with your provider and understand if your pregnancy is high or low risk. There are certain conditions in which exercise in pregnancy may be unsafe, such as:

  • Significant heart or lung disease
  • Incompetent cervix or cerclage
  • Multiple pregnancies at risk for preterm labor
  • Bleeding in the second or third trimester
  • Placental concerns
  • Premature labor during the current pregnancy
  • Premature rupture of membranes
  • Pre-eclampsia or high blood pressure in pregnancy
  • Severe anemia

For those who are considered to have a low-risk pregnancy, there are very few limitations on what you can do. It is recommended that healthy pregnant people get 150 minutes of moderate-intensity aerobic activity divided over the course of a week, (i.e., brisk walking, water aerobics, bicycling slower than 10mph).

If one has regularly participated in more vigorous-intensity activity or who may be considered highly active prior to pregnancy, they may consider continuing these activities during pregnancy, safely, with modifications as needed. Some examples of vigorous-intensity include: running, swimming laps, hiking uphill, bicycling more than 10mph, or high-intensity interval training.

If one has not been very active prior to pregnancy, it is ok to start during pregnancy. It is just important to start slowly and build up. Consider setting a time goal for yourself for about 10-15 minutes for the first few weeks, adding about 10 minutes or so until you hit the goal of about 30 minutes. It may take a few weeks to achieve your goal, but that’s ok. Consistency is key.

Activities to consider avoiding when pregnant:

  • Skydiving
  • Scuba diving
  • Activities with a high risk of falling/abdominal trauma, ie. Water skiing, surfing, off-road cycling, horseback riding
  • Contact sports
  • Hot yoga or hot Pilates

How much is too much?

It used to be thought that a pregnant person should not increase their heart rate above a certain level with exercise. However, this has been proven to be inaccurate. It is more accurate by monitoring your level of exertion – if it feels hard, it likely is (see table 1 below). Another way is to do that is by the “talk test.” If you are able to carry on a conversation while exercising, it is likely that you are not overexerting yourself.

While performing physical activity, it is encouraged that you rate your perception of exertion. This feeling should reflect how heavy and strenuous the exercise feels to you, combining all sensations and feelings of physical stress, effort, and fatigue. Do not concern yourself with any one factor such as leg pain or shortness of breath but try to focus on your total feeling of exertion.

Try to appraise your feeling of exertion as honestly as possible, without thinking about what the actual physical load is. Your feeling of effort and exertion is important, not how it compares to others. Look at the rating scale below while you are engaging in an activity; it ranges from 6 to 20, where 6 means “no exertion at all” and 20 means “maximal exertion.” Choose the number from below that best describes your level of exertion. This will give you a good idea of the intensity level of your activity, and you can use this information to speed up or slow down your movements to reach your desired range.

Table 1: Borg Exertional Scale – from CDC

 

Borg RPE scale © Gunnar Borg, 1970, 1985, 1994, 1998

Important Considerations

With pregnancy, your center of gravity changes as the curve in the lower back increases. Therefore, modifications to your exercise practice may be needed. Additionally, laying on your back for prolonged periods of time should be avoided. Working with your instructor and listening to your body is very important. If it hurts, you feel unbalanced, dizzy, or any other concerns, then consider stopping that particular movement and moving to the next one. Or, you may want to stop completely. Persistent pain or discomfort warrants evaluation by a health care provider.

Remember that it is important to stay adequately hydrated while exercising and to ensure adequate caloric intake, especially before engaging in high-intensity or prolonged exercise. Again, listening to your body is very important!

Stop exercising if you experience…

  • Vaginal bleeding
  • Contractions that are regular and painful
  • Concern for the leaking of fluid
  • Shortness of breath or difficulty breathing before exercise
  • Headache
  • Chest pain
  • Concern for balance
  • Calf pain or swelling

Staying Motivated

Again, consistency is key! Sometimes having a partner to work-out with may be helpful. Group prenatal exercise classes may offer the social setting to accomplish the goal of achieving physical fitness while establishing relationships with other expectant parents. Prenatal exercise DVDs or streaming prenatal work-outs may also help, giving the option of convenience to working out.

Bottom Line

It is safe to start exercising or continue to exercise in low-risk pregnancies after discussing with your health-care provider. Exercise is an important part of maintaining good physical and mental health and has been shown to have positive benefits during pregnancy.

To schedule an appointment with an Emory Women’s Center Obstetrician,
call our appointment line at 404-778-3401.