Pregnancy Exercise Guidelines – the Do’s & Don’ts
This is the transcript from our Pregnancy Exercise Guidelines 2013. Download the Pregnancy DO’s & Don’ts Video in our Free App.
Pregnancy Exercise Guidelines – the Do’s and Don’ts
So you have your doctor’s permission to exercise…now what do you do? We will use the following sources to bring you the latest in research, and safest for you and your baby: ACOG, ACSM, ACE, SOGC, CSEP Pregnancy Guidelines.
Below is the video transcript of our Pregnancy Exercise Guidelines You can also download this FREE Pregnancy video in our Free App. We follow these guidelines in our Free Prenatal Workouts located here.
These guidelines are for singleton pregnancies.
ACOG, the American College of Obstetricians and Gynecologists, ACSM, the American College of Sports Medicine, CSEP, the Canadian Society for Exercise Physiology, and SOGC Society of Obstetricians and Gynaecologists provide this general guideline for exercise during pregnancy: in uncomplicated pregnancies, women with or without a previously sedentary lifestyle should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle. On the flip side, pregnancies with complications should be discouraged from exercise.
Beginners: According to SOGC/CSEP if you are a beginner you should start with 15 min 3x/week and work up to 30 min 4x/week. You can this by walking, swimming or yoga.
Intermediate: If you exercise moderately you should continue.
Advanced: If you are an avid exerciser you need to listen to the next section. But overall you pre-pregnancy intensity should not increase.
TYPES OF EXERCISE AND INTENSE TRAINING GUIDELINES
We are going to cover Safety, Mode, Intensity & Duration
SAFETY: Exercise should adapt to the changes in weight distribution, balance and coordination. (ACSM 2010) This seems like the logical thing to do, but some of us do not realize we have put ourselves in an unstable position until we have already fallen! This is why Trimester-Specific exercise is important. Not only for exercise adaptation as your belly grows and your body changes. But keep in mind something that barely got your heart rate up in your first trimester will have your heart rate too high in your 3rd trimester. So keep you and that baby safe with trimester specific.
MODE: Weight bearing exercise and non-weight bearing exercise is important. Non-weight bearing like swimming or cycling improves maternal fitness. While weight bearing exercise like low-impact aerobics or strength training will do the same. *A note to all of my avid exercisers.,,heavy weight lifting, or any activity that requires straining, should not be performed! (ACSM 2010). So my advice is to put down those intense training DVD programs and keep you and baby safe with prenatal exercise. We will get into some reasons why in a bit.
INTENSITY: Exercise should not exceed pre-pregnancy levels. Intensity should be regulated by how hard a woman believes she is working. Moderate to hard is quite safe for a woman who is accustomed to this level of exercise. (ACSM 2010)
You should workout most days of the week. Research suggest around 30 minutes is best. Some research says no longer than 45 minutes and some suggest no longer than 60 minutes.
Sole use of a heart rate monitor is not recommended due to all the changes in your cardiovascular system.
ACSM, ACOG , SOGC, CSEP and ACE all recommend using R.P.E. or Rate of Perceived Exertion. Both of the scales below can be found in research. I have listed both R.P.E. scales below. You should always be able to talk while exercising.
Pregnancy Exercise Intensity Guidelines 10-Point Scale
Rate of Perceived Exertion:
ACOG published guidelines in 1985, 1994, 2002 reaffirmed in 2009. Most recently ACOG & ACSM recommend staying in between 12 & 14 on this 15-Point Borg Scale. This is very similar to the 5-7 Range on the 10-Point Scale.
WEIGHT GAIN GUIDELINES & WHAT TO DO IF STARTING OFF PREGNANCY OVERWEIGHT
A woman’s body is made to bear a child. In order to do that, you will have to gain some weight. For most women that weight will ideally be somewhere between fifteen and thirty-five pounds.( see below for the IOM guidelines). You’ll put that amount of weight on in nine months time. No matter how you look at it, that’s a significant amount of weight to gain in that timeframe. Losing that amount of weight would be hard for anyone to lose. The good news, is that the pregnancy weight you will have to lose will go when the baby is born and 6 weeks post-baby. The rest is up to you and how you take care of yourself. You’re left with loose skin, loose muscles and probably a few more lbs. than going into the pregnancy. You may be asking yourself where all of this weight comes from and the answer is that a majority of it comes from the baby itself (7 to 8 pounds) and your increasing muscle tissue and fluid (4 to 7 pounds). Other sources of weight gain are from the placenta and amniotic fluid that protect the baby (3 to 4 pounds); increased size of breasts (approximately one pound); increased size of uterus (2 pounds); increased blood volume (3 pounds); and finally increased body fat (5 or more pounds).
Institute of Medicine 2009 Weight Gain Guidelines
You can easily find your BMI on any online BMI calculator. Use your pre-pregnancy weight in the calculation.
A quote directly from ACSM “Extra caloric demands of pregnancy are extremely variable: no fixed equation accurately estimates the amount of increased caloric need.”
So the best weight to monitor to keep you and your baby on the right track is to monitor yourself. Later we will cover the ABC’s of prenatal Nutrition, but if you want more info on this we have provided a guide in our Pregnancy 3-Pack DVDs and Downloads.
According to statistics 50-70% of women of childbearing age are overweight. Now please know I am not saying that to offend anybody – I started my first pregnancy off overweight after 4 IVF’s and tons of fertility weight gain! But if you are starting your pregnancy off overweight the Moms Into Fitness registered dietitian recommends you slow the weight gain down. This can be done through exercise and nutrition. Which the ABC’s of nutrition are on their way shortly.
CONCERNS – there are plenty, but I am going to the most common concerns.
1. Gestational Diabetes. If you have gestational diabetes it is recommended you speak with your OB about exercise, as exercise can help and sometimes prevent gestational diabetes up to 50% if activity is done before 20 weeks.
2. Blood flow to the baby. When you exercise your blood goes to your muscles. But as long as you follow the intensity guidelines, the blood flow will not go away from your baby.
3. Back Pain, Pubic Pain, Carpal Tunnel, varicose veins, cellulite and more. We cover all of these topics in a different video. Just search Moms Into Fitness and youtube and you will come across it!
4. Babies heart rate increase. Studies done my doctors such as James Clapp only show a moderate increase. So the baby should be just fine!
I am going to give you 6 reasons you should exercise to benefit your baby. But know the benefits for you are also there – like less swelling, less back pain, more energy, easier post-baby body, easier labor and much much more! So how does your baby benefit?
All of this comes from Dr James Clapp, a leader in pregnancy research :
1) Babies are born healthier & handle labor better.
2) It increases babies nutrients and removes baby’s toxins – your placenta grows faster and functions better. The placenta is your babys lifeline!
3) Exercising moms show babies with an increase in prenatal function.
4) Babies have better oral language skill by age 5.
5) Babies weigh less and have less body fat at birth – on that we note we are shooting for babies over 5.5 lbs.
6) They tend to be more calm – although I may have to have a chat with the Doc on that one – my 3 are anything but calm!
CORE EXERCISE & DIASTASIS RECTI
1) Your doctor says no
2) You have diastasis recti. What is Diastasis Recti – CLICK HERE.
3) Your core exercise is going to be differenty than when you were not pregnant! The American College of Obstetricians and Gynecologists does not recommend lying on your back after your 4th month. So we won’t be doing any of that! And as you get bigger, some core exercises just are plain ole not comfortable. You will see all of these guidelines in our Pregnancy Abs workouts.
What you should do now for an easier recovery
I am going to keep it simple, BUT BLUNT!
1) Stay within your recommended weight gain, which we went over earlier.
2) Train your Inner Core. This means using your pelvic floor and transverse abdominis. This can be done as simple as saying the work “hut”. Notice how your muscles activate? They key is incorporating this into exercise now and in the postpartum recovery period.
3) Gradually work yourself back into exercise at the 4-6 weeks postpartum mark. Your body will experience so much, so expect it to take 5-6 months if not more to get back to normal. We also have some Core Recovery movements you can do right after pregnancy. Again search for MIF on youtube (www.youtube.com/momsintofitness) and you will find it!
4) So you need to do what is convenient and safe for you and your baby.
So much info – and how the heck do you stay within the recommended weight gain? Some of us throw up too much and some of us crave way too much. So I have 3 words I want you to live by when it comes to nutrition and pregnancy:
Balance – so all you want is chips, well balance it out with a grilled cheese so you are still getting some nutrients and not filling up on junk.
Variety – you hate chicken right now? Well balance your day out with different proteins like yogurt, cheese, eggs, nuts, beef, seafood (of course no big fish – we get into the nitty gritty in our 40 page ebook on prenatal nutrition – otherwise this dos and donts video would be an hour long!) If you want more you can find it for free on your Kindle or with our Pregnancy DVD/Download packs.
Moderation – do you want a whole bag of candy corn like me? Its so much easier said than done but limit yourself to 1 serving of “junk”. And my general rule is eat well 80% of the time during pregnancy and 90% of the time when you are not pregnant.
And last, but most important!
When you should not exercise & when you should stop exercise
If you experience regular contractions 30 minutes after exercise it could indicate preterm labor. Contact your doctor.
If you are not fully recovered within 15-20 minutes of exercise, you overdid it!
If you are not gaining the proper amount of weight – either too much or too little – check your schedule and your nutrition!
Try to be consistent, sporadic intensity can be harmful especially in that 1st trimester!
These are my Big 5 rules to keep in mind. After these 5 rules we are going to go over some very important stuff so stay tuned!
THE BIG 5:
1) 8 oz of water every 15 min of exercise and food within the hour. Also a snack consisting of protein and carbs within the hour.
2) Avoid hot and humid, especially in the 1st trimester.
3) Use the RPE scale, remember its between 5 & 7 on the 10 point scale and 12 & 14 on the 20 point scale.
4) Wear supportive shoes and a supportive bra.
5) Know when to stop! And do the correct exercises: toning, water, cardio, yoga – no contact sports.
YOU MUST KNOW WHEN TO STOP EXERCISE. If any of the following occur you need to call your doctor immediately. Please refer to ACOG Committee Opinion 267 for signals to stop exercise as well as reasons exercise would not be recommended for you.
Video Transcript Sources:
Artal, Dr. Raul, and M. O’Toole. “Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.” Exercise in Pregnancy. 37.1 (2003): n. page. Web. 21 Mar. 2013. <http://bjsportmed.com/content/37/1/6.full?sid=9ef578d1-10f2-4939-92a9-b6c70a63b617>.
Artal, M.D., Raul, James F Clapp III, M.D., and Daniel Vigil, M.D., FACSM. “Exercise during pregnancy and the postpartum period..” American College of Sports Medicine Current Comment. ACSM, n.d. Web. 21 Mar 2013.
ACE. ACE Advanced Health and Fitness Specialist Manual. 1st ed. 2008. 575-599. Print.
May, Linda. “ACSM Curent Comment.” ACSM Exercise During Pregnancy. ACSM, n.d. Web. 2 Apr 2013. <http://www.acsm.org/docs/current-comments/exerciseduringpregnancy.pdf>.
Davies, Gregory, MD, FRCSC, Wolfe, Larry, PhD, FACSM Mottola, Michelle, PhD, and MacKinnon, Catherine, MD, FRCSC. “Exercise in Pregnancy and the Postpartum Period.” Joint SOGC/CSEP. 129 (2003): 1-5. Web. 21 Mar. 2013. <http://www.sogc.org/guidelines/public/129E-JCPG-June2003.pdf>.
ACOG. “Exercise during pregnancy and the postpartum period..” ACOG Committee Opinion. 276.99 (2002): 171-173. Print.
Sara Kooperman. Moms In Motion: Pre/Post Natal Exercise Certification. SCW-EDU
Gwen Hyatt, MS and Catherine Cram, MS. Prenatal & Postpartum Exercise Design. DSW Fitness, 2003.
James F. Clapp III, M.D. Exercising Through Your Pregnancy: Your guide to an active, healthy pregnancy written by the physician whose research makes the compelling case for exercise before, during and after pregnancy. Nebraska: Addicus Books, 2002.
Lenita Anthony. Pre- and Post-Natal Fitness: A guide for Fitness Professionals from the American Council on Exercise. California: Healthy Learning, 2002.
Elizabeth M. Ward, M.S., R.D. Expect the Best: Your guide to Healthy Eating Before, During and After Pregnancy. New Jersey: John Wiley and Sons, Inc., 2009