Regular exercise is very important for promoting health and well-being in women in all phases of life, but especially during pregnancy.
- Joint changes—hormonal changes during pregnancy cause joints to be more mobile and lax, which puts you at greater risk of injury.
- Balance—center of gravity changes, even in early pregnancy, make pregnant women at risk of losing balance and falling.
- Heart rate—pregnancy increases the body’s cardiovascular demands, which can reduce stamina and endurance. Outdated heart rate restrictions during pregnancy suggested a 140-beat per minute limitation; however, there is no medical basis for this restriction. If you can talk while exercising, your heart rate is at an acceptable level. Do not continue to exercise if you are experiencing chest pain, shortness of breath, exhaustion or dizziness.
Most exercises are safe during pregnancy and require minimal modifications. Walking is good for a total body workout and is a great way to start an exercise program. Swimming minimizes stress on joints and helps with swelling in legs. Cycling is a great aerobic workout, but should be limited to stationary or recumbent bikes after the first trimester as pregnancy increases your risk of falling. Running is safe during pregnancy, especially if you were a runner before pregnancy. The bouncing of running may cause ligament discomfort later in pregnancy, which can be reduced by wearing a maternity belt while exercising. Racquet sports such as tennis and racquetball are safe although competitive, aggressive games put you at increased risk of falling. Aerobics in the form of step, high/low, spinning class, interval class, and boot camp are safe. Strength training and weight lifting are safe during pregnancy in moderation. Care should be given to proper form in order to minimize injury. Exercises that cause you to strain the pelvic floor can increase risk of hemorrhoids and pelvic floor injury. These include squats with heavy weight and leg presses with heavy weights. These exercises are safe as long as the weight amount is in moderation. Core abdominals are great to do in pregnancy as it improves posture and helps reduce back pain. Abdominal exercises should be avoided lying flat on the back after the first trimester. Sometimes abdominal exercises become uncomfortable late in pregnancy and need to be modified. Pilates and yoga are safe exercises during pregnancy. You should avoid “hot” yoga (any yoga in an excessively heated environment) just as you should avoid overheating with any exercise.
Water skiing and snow skiing should be avoided after the first trimester because of the risk of falling and abdominal trauma. Also, exercises at high altitudes over 6,000 ft. can increase your risk of altitude sickness. Scuba diving should be avoided in pregnancy due to pressure changes that may put the baby at risk for decompression sickness. Contact sports should be avoided after the first trimester in pregnancy due to the risk of trauma to your abdomen. This includes basketball, softball, soccer, ice hockey, volleyball and contact martial arts. Activities such as gymnastics, non-stationary cycling, and horseback riding also should be avoided after your first trimester due to the risk of abdominal trauma.
Discuss exercise with your doctor if you are high risk, or if you have pre-term labor, ruptured membranes, vaginal bleeding, placental problems like previa, recurrent miscarriage, high blood pressure or pre-eclampsia, fetal growth restriction, or incompetent or shortened cervix.
Exercise is important pre-conceptually to help normalize weight and improve overall health. It is especially important postpartum to help with weight loss and body image changes, as well as stress reduction. There are really no exercise limitations after a vaginal delivery. After a Cesarean Section, exercise and heavy lifting should be avoided for the first six weeks. The best approach is to use common sense and, if something hurts or is uncomfortable, don’t do it.
Consult your doctor about specific situations or questions.
