Exercise in Pregnancy
Lem and June Collections
The benefits of physical activity in normal, uncomplicated pregnancies outweigh the risks for most women. Inactivity can put women at risk for health problems and pregnancy-related complications. Even so, a care provider should be consulted when beginning, continuing, or modifying an exercise routine. This is because a small percentage of women with certain medical conditions or pregnancy complications may be advised to avoid exercise. Also, there are special considerations that need to be made in pregnancy because of the changes that happen to the body. This means some exercises may need to be modified or avoided.
💡 Tip: It's possible you already have a favorite type of exercise that can still be done. If you were a frequent runner or jogger prior to pregnancy, there may not be any reason to stop. Those that played racket sports before becoming pregnant may be able to continue doing so. It is important, however, to avoid quick, jarring motions that can harm your joints or lead to a fall. Strength training is another option that can still work. Just make sure to consult a care provider for specific guidance when it comes to continuing these activities during pregnancy.
Benefits of Exercise in Pregnancy
Staying active in pregnancy is beneficial for overall health, and childbirth is hard work that requires strength and stamina. According to this resource from the Journal of Midwifery and Women’s Health, there are other benefits, as well:
Exercise can reduce certain discomforts in pregnancy, like back pain, constipation, and fatigue.
Staying fit may reduce the risk of certain pregnancy-related complications or conditions, like preeclampsia, gestational diabetes, and postpartum depression.
The risk of needing a cesarean section may be reduced.
Those that are expecting that exercise are more likely to experience healthy weight gain, and their babies are more likely to be born at a healthy weight. These same people often have an easier time returning to their pre-pregnancy weight.
Safe Forms of Exercise
Staying fit during pregnancy doesn't need to be complicated. Take brisk walks around your neighborhood/ on a treadmill or hike at a local park. Swimming and other water workouts are great during pregnancy if you have access to a pool or other body of water. Low-impact aerobics, light weight training, and rowing are safe to do in pregnancy. Walk up and down the stairs, ride a stationary bike, or put on some music and have a dance party at home! Consider taking a yoga or Pilates class that includes modifications for pregnancy. Even doing chores around the house, like vacuuming and raking leaves can help you to stay active. There are other fitness programs specifically geared toward pregnancy, as well. I’ll talk about two of my favorites later in this post.
It's possible you already have a favorite type of exercise that can still be done. If you were a frequent runner or jogger prior to pregnancy, there may not be any reason to stop. Those that played racket sports before becoming pregnant may be able to continue doing so. It is important, however, to avoid quick, jarring motions that can harm your joints or lead to a fall. Strength training is another option that can still work. Just make sure to consult a care provider for specific guidance when it comes to continuing these activities during pregnancy.
Gentle stretching is ok during pregnancy. Just make sure to avoid overstretching and bouncing into a stretch, in order to protect your muscles and joints. Stretch to the point of feeling good, not to the point of pain. Exercises that focus on mobility are even better, though. While flexibility can help you passively achieve a greater range of motion, mobility helps you achieve strength within that greater range of motion.
Recommendations for Aerobic Exercise and Muscle Strengthening
Based on current recommendations, pregnant people should aim for 150 minutes each week of aerobic activity at a moderate intensity. Spread this time out through the period of a week. Workouts lasting thirty minutes, done five days a week, is one option. Someone exercising at the appropriate intensity would experience sweating and an elevated heart rate, while still having the ability to talk through the activity. Also, make sure to stay hydrated and avoid exercise in hot and/ or humid conditions.
Those who exercised regularly prior to pregnancy may be able to continue with their normal fitness routine until it becomes uncomfortable. Consult a care provider for specific guidance, especially when workouts are of a high intensity or last longer than 45 minutes. Calories may need to be increased if weight loss occurs.
Even those who were sedentary prior to pregnancy can safely begin a fitness routine. Five minutes a day is a good starting point, increasing the length of the workout gradually by adding five more minutes each week.
Muscle strengthening activities should also be done two days per week. Here are some examples:
Walking up and down stairs or hills
Using weights or resistance bands
Using your body weight to do exercises like squats, lunges, wall push-ups, etc.
When to Stop Exercising
According to ACOG and ACNM, physical activity should immediately be discontinued and a care provider contacted if any of the following occur:
Vaginal bleeding
Fluid leaking from the vagina
Feeling dizzy or lightheaded
Shortness of breath before beginning an exercise
Chest pain
Headache
Muscle weakness
Calf pain or swelling
Regular, painful contractions before reaching 37 weeks of pregnancy
Feeling your baby move less than normal
Exercises to Avoid
According to ACOG and ACNM, here’s a list of exercises that should be avoided in pregnancy:
Contact sports that increase the risk of taking a blow to the abdomen (no basketball, football, hockey, soccer, boxing, etc.)
Activities that have an increased risk of falling (no downhill skiing, gymnastics, water skiing, horseback riding, surfing, off-road cycling, etc.)
Scuba diving
Sky diving
"Hot yoga" or "hot Pilates" or anything that can cause you to become overheated
High-intensity racket sports
Lifting weights over 50 lbs.
Avoid physical activity at elevations above 6,000 feet, unless accustomed to living at higher altitudes
Pregnancy Complications Rendering Exercise Unsafe
While staying active in pregnancy is normally recommended and encouraged, it's possible to develop a condition or complication making it necessary to stop or restrict exercising. This would be in response to specific situations. A care provider should communicate any necessary limitations if this applies to you.
It is important to note that bed rest, which is far more restrictive than just limiting certain activities, has been routinely recommended in pregnancy to reduce the risk of preterm labor and certain other complications. Current evidence does not support this practice, and it is no longer recommended. In fact, unnecessary bed rest can be harmful, both physically and mentally. It can also lead to unnecessary economic hardship. It is always your right to ask questions and get a second opinion if you have any concerns.
Adjusting to Your Changing Body
During pregnancy, our bodies go through some really big changes. I’m going to talk about just a few here. It can help in understanding why modifications are sometimes necessary and why some exercises aren’t recommended in pregnancy.
Increased Levels of Relaxin
Levels of a hormone, called relaxin, increase during pregnancy. This hormone has several functions, but one to note in regards to this topic is to relax the ligaments supporting the pelvis. This will make it easier for the baby to pass through when the time comes. While this is beneficial for birth, relaxin may have the same effect on other connective tissue in the body. Therefore, it's best to avoid quick, jarring motions in your workouts.
Shift in Center of Gravity and Weight Gain
As pregnancy progresses, our center of gravity shifts forward. This has an effect on stability and balance, leading to an increased risk of falling. Weight gain adds stress on our joints. Also, our bodies function best when they’re properly aligned or stacked. The way we use our bodies everyday can already have an effect on this but pregnancy can pull us further out of alignment. Our body parts are all part of one interconnected system, so this can lead to pain and dysfunction.
Stress on the Core System
Your growing uterus also adds stress to the core system, which is made up of the abdominal muscles in the front and on the sides, back muscles, respiratory diaphragm on the top, and pelvic floor muscles on the bottom. Think of the core like a canister. In pregnancy, the body can adjust to this additional load. However, misalignment in the body and even how we breathe while activating our core muscles can add even more stress to the system, causing pain and dysfunction.
Shortness of Breath
The diaphragm (part of the core system mentioned above) is the primary muscle used in respiration, moving downward to allow the lungs to expand and fill with air. In later pregnancy, the uterus gets in the way of the diaphragm's downward movement. At the same time, the amount of oxygen a pregnant body requires increases over what it needs in a non-pregnant state. Because of these changes, it's common to feel out of breath more easily. This may limit the intensity of workouts during pregnancy.
But our bodies are amazing and adapt to help us out with this. Our rib cages actually change shape in pregnancy to help us breathe a little easier! We can help ourselves out by focusing on optimal breathing, allowing our ribs to expand front to back and side to side when breathing.
Some also experience this shortness of breath sensation in early pregnancy, which is due to increases in the hormone levels of progesterone.
Increased Weight of the Uterus and Lying on Your Back
The increased weight of your uterus can make it uncomfortable to lie on your back. After the first trimester, the increasing weight of the uterus presses on a large vein, called the inferior vena cava. This can cause low blood pressure and make you feel dizzy and nauseous, which is called supine hypotension. When exercising in the second and third trimesters, you can exercise on your back for short periods of time, as long as you are paying attention to how you feel. You can also modify your workouts and avoid lying on your back altogether, if this makes you feel uncomfortable.
Increased Size of Breasts/ Chest
We’ve talked about baby bumps increasing in size during pregnancy, but it’s important to note that the breasts/ chest area often do, too. Extra support can make exercising more comfortable. I recommend finding a supportive (but not too tight!) bra. A really tight bra can actually prevent that expansion in the ribs we want when breathing optimally.
Pregnancy-Specific Exercise Programs
These changes can add challenges, but they aren’t a reason to avoid exercise in pregnancy. Instead, they are a reason to focus on the quality of our movements. They are a reason to focus on making sure we are strong and resilient to counteract the additional load and stress on our bodies. And exercise can help us avoid dysfunction in our bodies.
You can absolutely opt for any pregnancy-safe type of exercise. There are also pregnancy-specific exercise programs. I’m going to talk about two that I have personal experience with and highly recommend. The creators of these programs are very knowledgeable on optimal exercises for managing the specific challenges that come with pregnancy. These programs also help to prepare your body for the challenges of birth and can help you avoid dysfunction postpartum. Here are my two favorites:
Strong Body Strong Mama
This is the program I used during my third pregnancy, and I’m still working with Julie now at three years postpartum.
Body Ready Method®
I am a Certified BRM® Pro and highly recommend their programs.
The link above is an affiliate link, so I do receive a portion of any sales at no additional cost to you. I also have a discount code available. Send me an email, if you need it!
Final Thoughts
You can prepare your body to manage the challenges of pregnancy. However, nothing can guarantee that you won’t experience pain and dysfunction. And if you are, please get a referral from your care provider to see a physical therapist. Insist on it, if necessary. Pain and dysfunction aren’t normal parts of pregnancy, despite what you might hear.
Additional Resources to Explore
Exercise is one of the health and safety topics listed in my To-Do Lists by Trimester spreadsheet. You can find it in my Toolkit, called Proactive Pregnancy: Early Essentials for Expectant Parents toolkit. Click the button below to learn more!