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Exercise and Pregnancy: A Healthy Combination
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Exercise and Pregnancy: A Healthy Combination

Image for pregnant fitness In recent years, we have learned that not only is exercising during pregnancy likely safe, it’s increasingly recommended. The Centers for Disease Control and Prevention (CDC) and the American College of Sports Medicine recommend that all individuals get 30 minutes of moderate intensity exercise on most, if not all, days of the week. According to the American College of Obstetricians and Gynecologists (ACOG), these same recommendations apply to pregnant women who have no medical or obstetric complications. These recommendations apply even though some authorities feel there is still not enough evidence to definitively judge the benefits or risks of exercise during pregnancy.

The Benefits of Exercising During Pregnancy

Some of the likely benefits of exercising regularly during pregnancy include:

  • Less discomfort due to swelling and decreased severity of varicose veins
  • Stronger abdominal and back muscles, which improves posture and may lessen back pain
  • Increased energy levels
  • Improved mood
  • Relieved stress
  • Increased body image perception
  • Enhanced quality of sleep

Weight Gain

Research shows that exercising during pregnancy also decreases the likelihood of excessive weight gain during pregnancy. This is important because a study published in the August 2002 issue of Obstetrics and Gynecology, found that excess weight gain during pregnancy and failure to lose weight during the first six months after pregnancy increase the likelihood of long-term obesity.

Birth Weight

Research also shows that exercising during pregnancy does not adversely affect a baby’s birth weight as long as the mother is eating enough. But there is some evidence to suggest being physically inactive increases the likelihood of having a very low birth-weight baby. A study in the March 2003 Maternal and Child Health Journal looked at data from 9,089 women and found that women who didn’t exercise regularly during pregnancy were 1.75 times more likely to give birth to a very low birth-weight baby.

Gestational Diabetes

Research also suggests that exercise may prevent gestational diabetes, especially in women with a body mass index (BMI) greater than 33. A study in the January 2004 issue of the American Journal of Obstetrics and Gynecology found that resistance training may help overweight women who develop gestational diabetes avoid insulin therapy. For women who already have gestational diabetes, exercise may help lower blood sugar levels when not possible through diet alone.

Recommended Exercises

The best exercises for pregnancy are those that put minimal stress on the joints, involve smooth movements, and have a low risk of falling or body contact. Great exercises include swimming, walking, stationary biking, and elliptical machines.

Activities to Limit or Avoid

Some activities pose increased risks in pregnancy and should be limited or avoided. These include:

  • Scuba diving
  • Activities done on the back (eg, certain yoga poses, the backstroke)
  • Activities that present an increased risk of falling (eg, skiing, skating)
  • Sports with a high potential for contact (eg, ice hockey, soccer)
  • Exercising at high altitudes (over 6,000 feet)
  • Weight-bearing activities such as jogging
  • Resistance training with heavy weights

Exercise Intensity

The ACOG and most other guidelines advise exercising at a moderate intensity. However, because “moderate intensity” varies widely among individuals, the ACOG guidelines suggest using ratings of perceived exertion to monitor intensity. On a scale of 6-20, moderate intensity falls between 12-14. Women who exercised at a high intensity before pregnancy and have uncomplicated pregnancies may be able to continue high intensity activities, but should check-in frequently with their doctors.

Exercise Duration and Frequency

Exercising for 30 minutes a day on most days of the week is all that’s needed to maintain fitness and achieve related benefits. Women who wish to exercise for longer than 45 minutes should speak to their doctors before doing so.

Other Factors to Consider

  • Balance: As your body shape changes, so does your balance, which could put you at a greater risk of falling.
  • Temperature regulation: Exercising in a controlled, air-conditioned environment will help keep temperature levels in check. And in general it’s a good idea to wear layers of clothes and exercise during the cooler hours of the day. Also, drink plenty of fluids to stay hydrated.
  • Nutrition: Women who are pregnant need an extra 300 calories per day during the last six months of pregnancy. Exercising may further increase your calorie need.

If you were sedentary before pregnancy, don’t despair. You can still reap the benefits of exercise by gradually working up to 30 minutes per day. But realize that pregnancy is not the time for making significant gains in your fitness level—or for athletic competition. Competitive athletes who wish to maintain a more strenuous exercise schedule throughout pregnancy should do so only under the close supervision of their doctors.

Before You Begin

Talk to your doctor before beginning an exercise program during pregnancy and be sure to follow up with regular check-ups. Additionally, if you notice any of the following symptoms, stop exercising immediately and contact your doctor:

  • Vaginal bleeding
  • Shortness of breath
  • Dizziness
  • Headache
  • Chest pain
  • Muscle weakness
  • Calf pain or swelling
  • Preterm labor
  • Unusual change in your baby’s movement
  • Amniotic fluid leakage

Although it may be wise to proceed with a little more care then usual, pregnant women who are medically cleared should feel free to partake in a wide array of activities. Exercising during pregnancy has many benefits, including an improved sense of well-being. It’s probably the best way to prepare for the physical demands of motherhood.

RESOURCES:

The American College of Obstetricians and Gynecologists
http://www.acog.org

Fit For Two: Tips for Pregnancy.
National Institute of Diabetes & Digestive & Kidney Diseases
http://win.niddk.nih.gov/publications/two.htm

CANADIAN RESOURCES:

Canadian Society of Exercise Physiology
www.csep.ca

The Society of Obstetricians and Gynaecologists of Canada
http://sogc.medical.org/

References:

Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003; 37:6-12.

Brankston GN, Mitchell BF, Ryan EA, Okun NB. Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Am J Obstet Gynecol. 2004;190:188-193.

Exercise during pregnancy and the postpartum period. American College of Obstetricians and Gynecologists website. Clin Obstet Gynecol. 2003;46:2.

Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev. 2006 Jul 19;3:CD000180.

Leiferman JA, Evenson KR. The effect of regular leisure physical activity on birth outcomes. Maternal and Child Health Journal. 2003;7(1):59-64.

Pregnancy and exercise. Better Health Channel: Victorian Government’s Department of Human Services, Australia website. Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_and_exercise?OpenDocument. Accessed April 5, 2004.

Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol. 2002;100(2):245-252.

Snyder S, Pendergraph B. Exercise during pregnancy: what do we really know? Am Fam Physician. 2004 Mar 1.



Last reviewed June 2008 by Ganson Purcell Jr., MD, FACOG, FACPE

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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