In a recent article published in the American Chiropractor Association News by Nataliya Schetchikova, PhD, recent research indicates that
“Exercising during a healthy pregnancy can help prevent excessive weight gain, significantly reduce the risk of gestational diabetes mellitus and preeclampsia, prepare the body for childbirth, and reduce the intensity of pregnancy-induced low back pain.”
A survey of pregnant women found that even though most women received advice about physical activity during pregnancy, they considered relaxation and rest more important than physical activity. Often doctors don’t do their job to help their pregnant patients find suitable exercise regimens. Typically, physicians discuss exercise with their patients, but they only help select an exercise program in only 10 percent of cases. Nearly 70 percent of expecting women have been advised by health care providers to restrict their exercise routines according to the more conservative guidelines (circa 1985) set forth by the American Council of Obstetricians and Gynecologists (ACOG) instead of current guidelines which encourage women to take an individualized approach to fitness and exercise.
According to Marianne Gengenbach, DC, DACBSP, and co-author of several sports chiropractic textbooks,
Doctors are worried that if they encourage a pregnant woman to exercise and something happens, they’ll be liable, so they tend to be cautious. But, it’s accepted nowadays that if you are healthy and have a healthy pregnancy, exercise helps to maintain flexibility
Other benefits of exercise during pregnancy include avoiding excess weight gain and maintaining good fitness habits. Some studies indicate that delivery is easier for women who exercised during pregnancy.
However, pregnancy is not the time to take up a new and rigorous fitness routine. Women who are fit prior to conception can monitor heart rate (HR) levels and not let HR go above 140 bpm throughout pregnancy. These women can typically maintain their previous workout regimen as long as they avoid contact and high impact sports. According to Maida Taylor, MD (a San Francisco-based OB-GYN), “Women who have not been fit can condition themselves [during pregnancy], but they must take things more slowly.” They should definitely seek the advice of a health care provider before beginning a fitness routine during pregnancy.
Goal setting helps women stick with a program. In healthy pregnancies where women don’t have any obstetric complications, the ACOG recommends women participate in 30 minutes or more of daily moderate exercise. Setting a goal which includes frequency and time of day can really help women stick to the program (assuming they’re past the point of utter and complete fatigue and exhaustion due to supporting new life formation in the first trimester).
How a women feels during the different days of pregnancy definitely dictates what she should do. If she needs to rest, then by all means, she should rest. But, if she’s feeling “blah” but isn’t fatigued beyond measure, than a little exercise can be a great endorphin-releasing way to add a little pep in her step.
New to Exercise
If a woman is new to exercise, the best way to begin is through a walking program which is something that can be maintained all throughout pregnancy and even long after baby’s born. Begin with 15 to 20 minutes a day. Then, do the same amount of time, but twice a day. Gradually increase to 45 minutes up to 1 hour. Don’t walk at a pace beyond which you’re able to carry on a conversation so that you don’t overexert yourself. For added precaution, wear a heart rate monitor so that you’re able to slow down if your heart rate approaches 140 bpm. Suddenly stopping completely will only cause an increase in your heart rate, so slow down for a few minutes to cach your breath before you stop completely.
Pregnant Elite Athletes
Dr. Taylor is a former long-distance swimmer who treated elite swimmers, runners, triathletes, and ultra-marathoners. She says,
Active women with healthy pregnancies don’t necessarily need to limit their exercise routines in pregnancy. Elite athletes don’t want ot get injured, and they know how to maintain a balance between pregnancy and their sport. If you maintain any previous exercise at the same level, your level of fitness will increase because of hte level of energy expenditure and oxygen consumption in pregnancy — it’s like running with weights on. If you cut back on exercise, you can still maintain your level of fitness.
Tailor Exercise Uniquely to You
Exercise needs to be tailored to the individual. The recommended HR of 140 beats per minute for a pregnant woman in her 20s to 30s should still be gauged to individual tolerance. Flexibility training through pre-natal yoga and stretches help with balance when the woman’s center of balance is constantly changing. Walking on an elliptical trainer or treadmill decrease the amount of impact on the body in comparison to the pavement. In extremely hot or cold climates, walking on an indoor track or inside a shopping mall can prevent overheating of core temperature which may lead to birth defects.
Recommendations by Trimester
Tri 1: Almost anything is acceptible except contact sports. Avoid surpassing 140 bpm on your heart rate for any activity. It’s best to avoid any sit-ups or crunches or any similar exercise.
Tri 2: Reduce the amount of activities that have impact. Jogging may need to transform into walking. Golf may need to remain and chipping and putting. Tennis may need to shift from volleying with a partner to hitting balls against the wall while remaining fairly stationary. Martial artists should avoid kicks higher than the knee, jumping, and any strikes in the region of the belly.
Tri 3: Stick with walking, yoga, pilates, stretching, and swimming. Martial artists should stick to walking through kata, hyungs, or forms and no high speed or sharp movements.
Light weight lifting throughout pregnancy is helpful to keep muscles tone and strong for delivery and eventually holding and carrying a baby. Upper body weight lifting as well as deep knee squats (no weight or very light weight) and lunges are excellent, low-impact exercises which can be maintained throughout pregnancy.
The best advice for staying healthy during pregnancy is to use common sense and to listen to your body. If you’re tired, rest. If a more significant warning arises, stop exercise and contact your health care provider immediately.
Warning signs include: unusual bleeding, spotting, heavy breathing, dizziness, headache, chest pain, feeling decreased fetal movement.
Contraindications to exercise include:
multiple gestation, significant history of miscarriages or premature births, and autoimmune diseases, pregnancy-induced hypertension, premature rupture of membranes, pre-term labor in previous pregnancies, placenta previa, and fetal growth retardation.
General Sport Guidelines
- Cycling – great in early pregnancy, however, balance problems could result in later pregnancy
- Swimming - it’s been shown to increase the mother’s fitness without any risk to the woman or fetus
- Water aerobics – may reduce pregnancy-induced low back pain even more than a land-based physical exercise program
- Weight lifting – it helps to strengthen the postural muscles and maintain muscle tone. As ligaments and tendons loosen during pregnancy, there is an increased risk for sprains. So, proceed with caution and stick with light weights and high reps.
- Scuba diving - increased risk to fetus due to inability to filter bubble formation
- Contact sports –
- Ice hockey
- Martial arts sparring
- High-impact sports
- jumping rope
- long-distance running
- Sports with high risk for falling
- horseback riding
- mountain climbing
- raquet sports
Resource: Schetchikova, N. Like running with weights. ACAnews. June 2008. p. 26-8.