You’re pregnant, you’re used to working out, you’re nervous about combining the two. I completely understand your hesitation and I am here to tell you there is a safe and effective way to be both pregnant and remain fit.

Your body is smart — it bears a child — it adapts the second you are pregnant by increasing blood volume, preparing your body and heart for your baby. So listen to it. Do only what you are comfortable doing. There is no one-size-fits-all exercise for pregnant women. Some days you will be more tired than others. And that means your Rate of Perceived Exertion (RPE) will be different on different days, especially in the first and third trimester. RPE is the intensity of a workout – more on that below.

In uncomplicated pregnancies –

If a moderate exercise regimen was followed prior to pregnancy, keep it up!

If you were previously inactive, don’t suddenly start an aggressive exercise routine, but adapt slowly – starting with 10-15 minutes.

If you were a regular exerciser and engaged in high intensity exercise programs such as jogging and aerobics, you should be able to sustain the same amount of exercise with some modifications as your belly grows. Fit women who want to engage in prolonged exercise sessions over 45 minutes need to monitor body temperature, hydration and “overtraining syndrome”. Read more about fit pregnancy: the pregnant athlete.

A combination of strength training and aerobic exercise is highly recommended 3-4x/ week [1].

Overall you have the same exercise guidelines as a non-pregnant woman. But there are anatomical changes and fetal requirements that require modifications as you move into your second and third trimester.

Your exercise routine should include: an accumulation of 120-150+ minutes a week of strength training, aerobic training, stretching. Research shows core exercise should be a part of your strength training routine – this helps minimize the force on your spine and joints as your belly grows.[2]  Core exercises should be modified and include specific pelvic floor and transverse abdominis training. All of these components are available in our pregnancy programs.

Before we get into the pregnancy do’s and don’ts, I want you to understand that all of this information comes from key sources like ACOG CO 804 (American Congress of Obstetricians and Gynecologists) & ACSM (American College of Sports Medicine).

ACOG and ACSM 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.

Remember, exercise can improve mood during pregnancy and help maintain and even increase strength and fitness levels. Download our Prenatal & Postnatal Starter Pack for a comprehensive prenatal and postnatal guide!

Pregnancy Exercise Do’s:

• Get your doctor’s permission before beginning any exercise program.
• Stick to what you have been doing. Exercise should not exceed pre-pregnancy levels. ACSM suggests that moderate to hard is quite safe for a woman who is accustomed to this level of exercise.
• Use core exercises designed for your pregnant body.
• Overall pregnant women have the same exercise guidelines as non-pregnant women – aim for 20-30 minutes of moderate activity most days of the week. After 20 weeks there are several anatomical changes and fetal requirements that require prenatal exercise workouts.
• Exercise in a cool environment, avoiding prolonged exposure to heat.
• Be aware of hypermobility or “overstretching”. Relaxin, the hormone that allows your pelvis and rib cage to expand to fit your growing baby, also creates loose joints, as well as instability. The loose joints allow for more flexibility, but they also may harbor an environment for injury if you are not careful.
• Be aware of a blood pressure drop with positional change (lying to standing), which may cause lightheadedness and dizziness. This can happen in interval training-type workouts.
• It is important to fuel your workout especially when you’re pregnant. An hour before exercise, a snack with complex carbohydrates, protein and a little fat is recommended. Drink about a cup (eight ounces) of water for every 15 minutes of exercise.
• Heart rate monitors are not necessarily recommended to gage intensity, unless you are an athlete or elite athlete. Instead you should be able to carry on a conversation while exercising. You can also use the RPE (rate of perceived exertion) or talk test, see below.
• Make sure you warm up before a workout and cool down after a workout. A warm up for each exercise session gives the body a chance to adapt gradually to movement and exertion, therefore making exercise easier. And it gives your body a chance to deliver oxygen to your muscles and your baby. And a cool down returns the body back to normal.
• If you enjoy running and other fit pregnancy activities, there are a few extra guidelines you should follow.
• Check in with your doctor about conditions such as diastasis recti (an abdominal separation), back pain and pelvic pain. Some exercises are not safe or effective if you have these conditions. Our pregnancy workouts are modified for diastasis recti.
• If you are not gaining the proper amount of weight – either too much or too little – check with your doctor!
• Types of exercise that have been studied and found to be safe and beneficial include: walking, stationary cycling, aerobic exercise, Yoga-modified, Pilates-modified, dancing, resistance exercises (including weights or resistance bands), stretching, running, racquet sports and water aerobics.[2, 3] Both running and racquet sports are safe only if done prior to pregnancy.
• The “intensity” of a prenatal fitness plan is going to depend on a number of factors, including your prior experience with exercise, your health history, the status of the pregnancy, and her own personal tolerance for exertion. All women who have become pregnant should consult their doctor regarding the exercise regimen best suited.
• Overall, the intensity of your exercise sessions should be somewhat hard or moderate. On a 15 point scale you will want to stay between a 12 and 14. You can also use the Talk Test – where you can speak a full sentence while working out.

Pregnancy Exercise Don’ts:

• Competitive events, contact sports, activities with a high risk of falling, risk of abdominal trauma, scuba diving and Hot Yoga/Pilates should all be avoided. [2, 3]
• Avoid lying on your back or standing still for long periods of time. Also avoid repetitive, strenuous movements. After 20 weeks be cautious when participating in a yoga or Pilates class where you are on your back for extended periods of time – this decreases venous blood return back to the heart.
• Overall don’t get overtired, don’t continue if you feel lack of coordination or discomfort, don’t forget adequate fluid, and don’t forget a thorough cool down.
• Discontinue exercise if any of the following happen; vaginal bleeding, amniotic fluid leakage, regular painful contractions, difficult or labored breathing before exertion, dizziness, headache, chest pain, muscle weakness affecting balance, calf pain or swelling or anything that doesn’t feel “right”.
• If you experience regular contractions 30 minutes after exercise it could indicate preterm labor. Contact your doctor.
• Don’t overdo it! If you are not fully recovered within 15-20 minutes of exercise, you overdid it!

Sources:

[1] https://jamanetwork.com/journals/jama/article-abstract/2612623, accessed 2020.

[2] ACOG Committee Opinion 804. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period

[3] ACSM Pregnancy Physical Activity. https://www.acsm.org/docs/default-source/files-for-resource-library/pregnancy-physical-activity.pdf

[4] 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. <https://bjsportmed.com/content/37/1/6.full?sid=9ef578d1-10f2-4939-92a9-b6c70a63b617>.

[5] 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.

[6] 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. <https://www.sogc.org/guidelines/public/129E-JCPG-June2003.pdf>.