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Guidelines for Exercise During Pregnancy

Exercise programs should take into consideration your individual medical and exercise history. Consult with your physcian before beginning or continuing an exercise program to see if you have any conditions which might restrict your physical activity during pregnancy.

 

STOP exercising and consult your physician if you experience any of the following symptoms during exercise:

*bleeding

* cramping

*faintness

*elevated blood pressure

*dizziness

*severe joint pain

Pregnant women should NOT exercise to exhaustion--stop when you are fatigued.

Listen to your body. Exercise should not be painful. Be alert to medical conditions which may indicate the need to change activities or stop exercising. Some examples are:

* early effacement or dilation

* premature labor

*multiple fetuses.

Expect some discomfort, particularly in the third trimester. Learn all you can about exercise during pregnancy so you know how much discomfort is ordinary and what might be cause for concern..

 

Exercise regularly and consistently. You should exercise at least three times per week. If you exercise more frequently, alternate hard and easy workouts.

Do not exercise vigorously in hot, humid weather. Do not exercise at all during an illness with fever. A core body temperature that remains elevated for prolonged periods can impair development of the fetus, particularly during the first six weeks of pregnancy.

 

During pregnancy, all the connective tissue in the body becomes more lax than normal. To help prevent injury, avoid deep flexion and extension of the joints and avoid activities that require jumping or jarring motions or rapid changes in direction. If an activity becomes uncomfortable due to joint instability, modify or discontinue the activity.

 

 

 

Drink plenty of fluids, especially water, before and after exercise to avoid becoming dehydrated. If your exercise session is longer than 15 minutes, interrupt your workout to drink additional liquids. Drink even if you are not thirsty, as thirst lags behind the body's need for fluids.

 

 

 

Rise gradually from the floor to avoid a sudden, rapid decrease in blood pressure which may result in a momentary blackout. Continue walking after rising to assist return blood flow to the heart.

 

 

Exercise at a comfortable intensity, and be prepared to modify exercise intensity as your pregnancy progresses. You can gauge exercise intensity by using the talk test--you should be able to talk while exercising. Consult your physician or a qualified exercise instructor to determine your specific target heart rate.

 

 

Measure your heart rate 2-3 times during peak activity to make sure your are exercising at the proper intensity. Avoid an anaerobic or breathless pace during exercise and avoid competitive events.

Your core temperature should not exceed 100.4 degrees--do not become overheated. If you feel you are becoming too hot, decrease your exercise intensity. Avoid exercising outdoors during the hottest part of the day.

 

 

Limit strenuous activities to a duration that does not cause exhaustion If you wish to exercise for longer time periods, alternate light and vigorous exercise.

Avoid exercises that use the Valsalva maneuver (forced exhalation against closed mouth and nostrils; for example, lifting weights while holding your breath). This can lead to an increase in blood pressure and can interfere with return blood flow to the heart.

 

After your fourth month is completed, discontinue prolonged exercise done lying on your back since the enlarging uterus can interfere with return of blood to the heart. If dizziness, shortness of breath, nausea, or tingling of the lower limbs occurs while exercising on your back, role onto your left side and remain in that position until the discomfort passes. Subsequent exercise should be modified to avoid the back-lying position or to remain on the back for brief periods of time interspersed with exercise done in other positions. Experiment with exercise done for 1 minute in the back-lying position interspersed with 2-3 minutes of exercise done in other positions (i.e. side-lying or sitting).

Exercises to strengthen the muscles most stressed by pregnancy--abdominal, low back and pelvic floor--can be performed daily.

Check abdominal muscles weekly after 20 weeks gestation to determine if the rectus abdominus muscle has separated. This condition, known as diastasis recti, can occur during pregnancy, though it often occurs during delivery.

To check for diastasis recti, lie on your back with knees bent and feet flat on the floor. Place your fingertips in the center of the abdomen just above the navel. Exhale and lift your head off the floor as you press your low back into the floor. Gently press the fingertips into the gap between the two sides of the muscle.

 

 

A 1-2 finger-width gap is considered normal. A gap of more than 2 finger widths requires corrective exercise to prevent further muscle trauma (see "Exercise Examples" section).

Increased Braxton-Hicks contractions are normal late in pregnancy. However, if these contractions increase markedly during or after exercise you should:

* decrease exercise intensity

* change posture

* try a different activity

If Braxton-Hicks contactions continue regularly for more than 24 hours after exercise, notify your physician.

 

Follow your exercise session with a 5-15 minute cool-down consisting of slow biking or walking. Cool down until your heart rate is less than 100 beats per minute (16 beats in 10 seconds).

Your ability to exercise may decrease during the first three months of pregnancy as well as the last few weeks before delivery. You can continue to exercise until delivery barring medical problems.

A general guideline for exercise during pregnancy--consider your pre-pregnancy fitness and activity level. Most physically fit women can continue most activities at or slightly below levels prior to pregnancy. Do not try to exceed pre-pregnancy levels.

Activities that can be started during pregnancy, even by those not currently participating in an exercise program are:

* low impact aerobics

* cycling/stationary biking

* golf

* rowing machine

* stairmaster/stair climbing

* swimming

* walking

* water aerobics

* tennis/racquetball (only if you are in good physical condition)

* weight training

Activities that can be continued during pregnancy by those currently participating are:

* backpacking (only if in good physical condition)

* ballet (not professionally)

* basketball (non-competitive)

* body building (non-competitive; only for experienced)

* cross country skiing (only if in good physical condition)

* running (only if in good physical condition; non-competitive)

* softball (non-competitive)

* volleyball (non-competitive)

The following activities should be avoided during pregnancy due to increased risk to the mother and/or baby.

*competitive sports

*hang gliding

*horseback riding

*inversion

*scuba diving

*sky diving

*snow skiing

*springboard diving

*water skiing