Exercise in Pregnancy
Exercise is focused sustained physical activity that increases heart and respiratory rate while working the major body muscles.
The benefits of exercise are far reaching and include heart health, bone health, weight loss, improved sleep quality and are a good way to relieve stress and maintain overall wellbeing.
Regular exercise is recommended in pregnancy as it benefits both the pregnant patient, fetus and helps make for a healthy pregnancy.
Women who exercised prior to pregnancy are encouraged to continue exercising during the course of the pregnancy and in the postpartum period. For those women who did not, starting an exercise regimen as little as ten minutes a day of walking has been shown to be beneficial. The key for these women is to start with simple exercises and add to their routine on a monthly basis.
How long should you exercise? It is recommended that pregnant women exercise at least 30mins a day , five days a week.
Benefits of exercise. Engaging in regular exercise has been shown to decrease the risk of diabetes and pregnancy related high blood pressure as well as the risk of cesarean delivery. Additionally, because pregnancy is associated with a higher risk of developing blood clots, regular exercise will help decrease this risk. Exercise in the postpartum period is associated with decreased depression, and loss of weight associated with pregnancy.
Pregnant women diagnosed with diabetes in pregnancy as well as those who have diabetes prior to pregnancy are encouraged to engage in regular exercise regimen at least 5days a week or at least 150minutes per week as part of the diabetes treatment plan. This along with healthy eating habits has been shown to improve glucose levels as well as decrease the risk of large newborns which in turn decreases risk of shoulder dystocia, fetal and maternal injury during the birthing process.
Obese women who are also pregnant are also encouraged to exercise during the course of the pregnancy. This helps decrease the risk of developing pregnancy related disorders like hypertension, diabetes, blood clots and excessive weight gain.
How much weight should I gain during pregnancy?
The Institute of medicine recommends the following weight gain in pregnant women. These recommendations are based on a patient's pre-pregnancy body mass index (BMI).
| BMI less than 18.5 | 28-40lbs |
| 18.5- 24.9 | 25-35lbs |
| 25-29.9 | 15-25lbs |
| 30-and above | 11-20lbs |
Your OBGYN physician or clinician will monitor your weight through the course of the pregnancy.
What is the best exercise routine ?
While there is no set or recommended exercise regimen in pregnancy:
- Taking a 15minute brisk walk after meals is a good option.
- Swimming or water aerobics is an excellent option especially for pregnant women who experience back or joint pain.
- Running.
- Aerobics.
- Yoga.
- Weight lifting - for those who engaged in weight training prior to pregnancy.
- Dancing.
Patients should avoid contact sports, deep sea diving, or any exercise/sport that increases risk of abdominal trauma.
Who or when should you not exercise?
Pregnant women who experience.
- Chest pain or have a serious heart or lung condition.
- Have an abnormal placenta or placental insufficiency.
- Vaginal bleeding.
- Loss of amniotic fluid.
- Pain.
- Shortness of breath.
- Malnutrition.
- Current blood clot.
- Increased risk of preterm labor.
- Pregnant with twins or triplets.
- Who have been advised by their doctors not to exercise.
All pregnant women should discuss their current or planned exercise regimens with their clinician to ensure appropriateness of the exercise regimen given the health of the patient and the pregnancy.
Pelvic floor exercises have proved to be valuable before and during the course of the pregnancy and in the postpartum period. . In addition to strengthening the pelvic floor muscles, they help decrease the risk of vaginal tears and the uncontrolled loss of urine during and after delivery.
Exercise in the Postpartum Period
Women who have an uncomplicated vaginal delivery or cesarean section may resume low impact exercises like walking, within about a week of delivery.
Women who have a complicated vaginal delivery or cesarean delivery should consult with their obstetrician on when they are clear to resume exercise. Deliveries may be complicated by heavy bleeding during or after delivery, vaginal tears, anemia, severe range blood pressures, seizures, heart disease or failure, etc.
Breastfeeding mothers should nurse prior to engaging in exercise. Wearing a well-fitting comfortable bra is advisable.
With all forms of exercise ensure you stay very well hydrated and take breaks as you need to. Listening to your body is key, both during and outside of pregnancy.
References:
- Gestational Diabetes in Pregnancy Practice Bulletin # 190, 2018. ACOG.
- Obesity in Pregnancy, Practice Bulletin # 230, 2021. ACOG.
- Exercise During Pregnancy. Frequently Asked Questions. ACOG.
- Physical Activity & Exercise During Pregnancy and the Postaprtum Period. Committee Opinion, # 804. ACOG.
- Mottola MF, Davenport MH, Ruchat S, et al. 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine 2018;52:1339-1346.
- Institute Of Medicine; Weight Gain during Pregnancy.
- Move your way. US dept. of Health and Human Services.
