Exercise During Pregnancy - What Is Safe?

I'm Pregnant - Should I Exercise?

When new participants showed up in my fitness classes and saw me, the instructor, bearing a round, pregnant figure, their faces took on a look of either admiration, condemnation, or worry. All expressions I easily understood, for when I discovered I was pregnant, I too felt a range of feelings toward my part-time career in the fitness industry. Could I still workout? Could exercise harm me or the baby? What types of exercises could I continue, and which should I quit?

Despite what many well-meaning grandmothers will advise, and despite the old wives tales, (such as if a woman raises her arm over her head, the cord can strangle the baby), most exercises can be continued safely during pregnancy if certain precautions are taken.

The American College of Obstetricians and Gynecologists has summarized their stand on the issue by stating that unless there are certain medical or obstetrical conditions, (such as hypertension, preterm labor or rupture of membranes, incompetent cervix, persistent bleeding, or IUGR), "women who have achieved cardiovascular fitness prior to pregnancy should be able to safely maintain that level of fitness throughout pregnancy and the postpartum period." The following guidelines are geared to women who are experienced exercisers and have been working out for at least six months prior to pregnancy.

The First Trimester

The most important rule of thumb: listen to your body! A woman's body is keenly intelligent. Just as hunger tells you when to eat, fatigue tells you when to rest. During the first trimester, when fatigue is often at its worst for pregnant women, you may want to shorten the duration of your workouts or lessen the number of times a week you workout, but at this stage, your usual routine is still very safe.

At this time, you can still safely do abdominal toning in a supine position (lying on your back). As a matter of fact, you should focus on this area, as it helps so much with pushing during labor. Having strong abdominal muscles also helps alleviate backache and improves posture. Women whose abs are strong before and during pregnancy usually return to their pre-pregnant figures faster after delivery.

For women who suffer from morning sickness, you'll want to workout at the time of day you feel your best. If you just don't feel up to it, it's OK to take a break from your usual workouts and store up on much needed rest. On the other hand, your workout may give you the energy-boost you need to get through the day.

The Second & Third Trimesters

During the second and third trimesters, important changes occur in your body that require some alterations to your workout. First, your blood volume, cardiac output, and resting pulse increases. Lung capacity decreases as internal organs shift upward. This means that cardio workouts will become more challenging. It is advised that a pregnant woman not exceed a heart rate of 144 beats per minute, or 24 beats in 10 seconds. This general guideline has been given by AFAA (Aerobics and Fitness Association of America) simply to be on the safe side, since not much research has been done concerning the maximum heart rate a pregnant woman can safely achieve.

Physically, your center of gravity shifts and balance becomes more difficult. Most pregnant women aren't attempting to perfect their balance beam routines at this time, but you should recognize which exercises require some element of balance and adapt your movements appropriately.

Also at this time in your pregnancy, the hormone relaxin helps to loosen your joints. Some women don't notice any changes at all while others may be very aware of loose joints. During my first pregnancy, I didn't notice any change in my joint mobility, but during my second pregnancy, my knee was very loose, sometimes even popping out of place. Take care when exercising, especially if you notice loose knee joints. AFAA advises that you avoid propulsion movements, rapid twisting, and abrupt directional changes because of the instability of the joints.

Now is also the time when you should begin to avoid the supine position because it puts pressure on the interior vena cava, obstructing blood flow to the uterus. This is the same reason why you shouldn't sleep on your back after the first trimester. To keep your abdominal muscles toned without lying on your back can be challenging, but you can substitute standing crunches and pelvic tilts.

Because your back is working hard to support your growing uterus, you want to avoid exercises that strain the back muscles, such as double leg lifts, planks, and regular push-ups (from a plank position). You can do push-ups lady-style (using your knees rather than feet for support) or against a wall rather than on the floor.

Important Reminders

If you are an experienced exerciser, you're aware of the importance of an adequate warm-up and cool-down. These elements of your workout increase in importance when you are pregnant but also require some changes. Obviously, it will become harder to perform stretches that require you to bend over your tummy. Alter these stretches to make yourself more comfortable.

Again, you want to avoid stretching while lying on your back. My favorite stretches during pregnancy include the cat stretch (rounding your back while on your hands and knees) and the child's pose or prayer position (arms extended overhead flat on the floor, body in a kneeling position. Let the knees fall apart to allow your tummy room to rest.) These stretches help alleviate backache, a major complaint of pregnancy. Another good stretch to perform is a calf stretch, especially is you are prone to leg cramps.

Stay hydrated. I noticed that leg cramps haunted my sleep when I didn't drink enough water during the day. It's recommended that you drink 8 oz. of water before, during, and after working out, a total of 24 oz. to compensate for lost fluids. That seems like a lot, especially if you already have to empty your bladder every ten minutes, but it really helps prevent leg cramps, overheating, and swelling.

Use Common Sense

As your pregnancy comes to an end, modify your workouts to get progressively easier on your body. If your routine was jogging, you should slow down to walking. If you worked out using a step bench, take away the risers. If you're accustomed to aerobics, slow down the music tempo and eliminate jumpy moves. If you were kickboxing, lower your kick height. If you make appropriate changes, you need not eliminate your workout altogether.

Women who have not exercised prior to pregnancy should discuss an exercise program with their physician. Pregnancy is not the time to begin something extremely new to your body or to set world records in your area of fitness.

Dangerous sports, of course, should be completely avoided. A labor and delivery nurse reported a young woman coming to the hospital with a fetal demise at eight months gestation. The girl wondered if the cliff diving she had done that weekend had any effect. Clearly, there are physical activities that cannot be safely continued during pregnancy.

You should use common sense when deciding which activities are safe. Above all, listen to your own body, and if you're still worried, discuss your concerns with your doctor. Die-hard exercisers may disagree, but it's not the end of the world if you have to cut out your workout routine for a short period of time. The most important outcome of your pregnancy, after all, is a healthy baby and mother.