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Exercise in Pregnancy

In the past, women were advised to increase calories and decrease or stop exercise when they became pregnant.  However, the current recommendation by the CDC (Center for Disease Control) is for 150 minutes of exercise per week in normal healthy pregnancies.  Studies have shown that exercise in pregnancy helps minimize excess weight gain and decreases the risk for both pre-eclampsia and gestational diabetes.  The fetal heart rate responds to maternal exercise by increasing 10-30 beats per minute (regardless of the intensity of the exercise), which is not considered harmful to the fetus.  Therefore, most women can safely start or continue some form of exercise; however, it is advisable to be evaluated by your doctor and discuss your specific and personalized program prior to starting, especially if you have diabetes, hypertension, or severe obesity.

When designing an exercise program, you and your doctor should take into account:

  • Age
  • General physical condition
  • Past and current exercise history
  • Medical conditions: pulmonary, musculoskeletal, cardiovascular, ect.
  •  Medications
  • Preferences and enjoyment of various exercise forms

Both aerobic exercise and musculoskeltetal fitness should be incorporated into the pregnancy program.  Aerobic exercise refers to a steady state of oxygen use by the lungs and muscles and includes activities like walking, jogging, swimming, rowing, dancing, and cycling (stationary bikes are recommended in mid-late pregnancy).  It is normal for aerobic exercise to increase the heart rate, and it is generally recommended for pregnant women who are new to exercise to maintain their heart-rates at 60-70% of their maximal heart-rate.  However, this can be difficult to judge unless you own a heart-rate monitor.  A more practical gauge is the “talk test.”  If you are able to have a conservation during your work-out, you are probably at or below the recommended heart-rate.  Studies have shown that women who were regular exercisers prior to becoming pregnant may continue at their previous level of intensity without adverse effects, though most women naturally decrease their intensity as the pregnancy progresses.

Musculoskeltal fitness refers to both strength and flexibility.  Typically lighter weights and higher reps are recommended for resistance training in pregnancy, though studies have not shown that higher weight increases the risk for adverse events.  Gentle stretching activities are sufficient for flexibility, but pre-natal yoga classes are also increasing in popularity and are offered at many gyms and community centers.

The major concerns of exercise during pregnancy:

  • Heat Stress: extreme temperatures can be dangerous for the developing fetus, so it is important to be aware of over-heating and proper hydration.  A controlled air-conditioned environment minimizes this risk.  If you prefer to exercise outside, it is a good idea to utilize the coolest parts of the day.
  • Caloric Intake: the caloric cost of exercise needs to be balanced by caloric intake to ensure that both the mother and baby are receiving adequate nutrition.
  • If you experience chest pain, dizziness, vaginal bleeding, or any other symptom that worries you, stop exercise immediately and consult your doctor.

While exercise is both safe and recommended in pregnancy, there are certain activities that should be avoided:

  • Scuba Diving: fetal pulmonary circulation is insufficient to filter air bubbles, so decompression sickness can develop
  • Athletics: basketball, soccer, gymnastics, horseback riding, skiing, and other activities that have a high risk for falls and/or trauma to the abdomen
  • Post work-out sauna or hot tub: can increase your core temperature causing heat stress.

Randomized controlled trials have indicated that exercise during pregnancy is not only safe, but also effective in improving pregnancy outcomes.  If you haven’t already discussed exercise with your doctor, schedule an appointment today!

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