Exercise During Pregnancy

Exercise and Pregnancy

by Stephen M. Pribut, D.P.M. and Amelia Perri-Pribut, M.B.A., R.N.

The proper amount and intensity of exercise during pregnancy has been debated for many years. The concept of exercise during pregancy being as being helpful to the mother and baby's well being has evolved over the years. The amount and intensity that is safe is truly not known. For many of today's women, aerobic exercise and other fitness activities are a vital part of their lives. Most women, in the absence of medical disorders, do not have to lead a sedentary life during their pregnancy.

An exercise regimen during pregnancy must be geared toward the individual. Her current fitness level, medical history and emotional needs must all be taken into consideration. The type and amount of exercise should be safe for both her and her baby. Your physican would be best able to review the position statement of the American College of Obstetricians and Gynecologists on Exercise during Pregancy and discuss with you recommendations specifically applicable to you. Warning signs that would necessate stopping exercise should also be discussed.

There are risks to the fetus if maternal temperature becomes too high or if the intensity of exercise has been so great that the baby does not get adequate blood flow throught the placenta. There are no studies that indicate that birth weight, preterm delivery, incidence of C-sections or other complications of labor and delivery at the time of birth are related to maternal exercise during pregnancy.

Supplementary & Preparatory Exercises

Prior to delivery many health care practitioners recommend doing pelvic floor exercises (Kegel Exercises) to strengthen the muscles needed to push during the delivery.

Other recommedations include pelvic tilt exercises to help avoid the low back pain that frequently accompanies pregancy in the latter stages.

Recommendations of the American College of Obstetricians and Gynecologists

selected recommendations:

Regular, mild to moderate exercise, three times per week is preferable to an irregular schedule
After the 1st trimester (the fourth month of pregnancy), avoid exercise in which the mother is lying on her back or right side. This position could allow the woman's expanding uterus to compress the vein that carries blood to the heart, which could interfere with blood flow to the uterus.
Exercise capabilities decline in pregnancy, so it is important to listen to your body.
Moderate to intense aerobic activities should be limited to periods of 15 to 20 minutes. Lower intensity activities may be conducted continuously over a longer period but should not exceed 45 minutes in total.
Heart rate should be measured at times of peak activity and should not exceed 140 beats per minute. One way to determine whether exercise is too intense is the "talk test": if the pregnant woman is unable to converse normally while exercising, she is overexerting herself.
Strenuous exercise should not be performed in hot, humid weather or during illness accompanied by fever.
Care should be taken to rise from the floor gradually to avoid an abrupt drop in blood pressure, and to continue some form of activity involving the legs for a brief period.
Exercise sessions should be followed by a brief cool-down period of gradually declining activity that includes gentle stationary stretching. Stretches should not be taken to the maximum resistance.
Choose exercises which do not require great balance because coordination and center of gravity are changed. Exercises that require jumping, jarring motions or rapid changes in direction should be avoided. These can cause damage to connective tissue.
Avoid exercise with risk of even mild abdominal trauma.
Maintain adequate diet. Pregnancy requires an additional 300 calories per day. Do not try to lose weight during pregnancy.
Dress appropriately and drink lots of water; do not exercise in the heat of the day or night or if it is very humid.
A pregnant woman's temperature should not exceed 100.4 F while exercising. She should drink plenty of water before and after exercise to prevent dehydration and hyperthermia and take a break during exercise if more water is needed or she is tired.
Return to pre-pregnancy routines gradually. It takes 4-6 weeks to recover and up to 10-12 after a C-birth.
If weight gain is not sufficient, it is a good idea to reduce the time or strenuousness of the regimen.
Avoid exercises where falling is likely (horseback riding, skiing, sky jumping...)
Stop any exercise if any bleeding, vaginal water loss, sudden swelling in ankles, hands, face, redness in calf, dizziness, faintness, heart palpitations or rise in blood pressure, abdominal pain, perineal pain or persistent contractions are noted.
Check with your physician about fitness during pregnancy classes.

Other information sources:

Ask the Midwife Exercise and Preganancy
Parent's Place Pregnancy and Birth Reading Room
NOAHNOAH on Exercise and Preganancy

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