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. As it grows a tiny human being, it adjusts your blood pressure, expands your rib cage, and increases your blood volume, among many other amazing things … all without you telling it to do so. So, listen to your body! It will tell you what’s too much and when you should take it easy. But, keep in mind, adaptations are unique for every pregnant woman and not every woman will respond to exercise during pregnancy in the same way.

You need to stop exercising and seek medical attention if any of the following occur: vaginal bleeding, regular painful contractions, amniotic fluid leakage, difficulty breathing before starting exercise, dizziness, headache, chest pain, muscle weakness and calf pain or swelling.

Prenatal Exercise for Uncomplicated Pregnancies

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) and 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 and Postnatal Guide for comprehensive prenatal and postnatal fitness guidance and an exercise routine!

Pregnancy Exercise Dos

• Get your doctor or midwife’s permission before beginning any exercise routine.
• If a moderate exercise regimen was followed prior to pregnancy, 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.
• If you were previously inactive, start slowly 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 and the pregnant athlete.
• Heart rate monitors are not necessarily recommended to gauge 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.
• A combination of strength training and aerobic exercise is highly recommended 3 – 4 times/week [1].
• Overall you have the same exercise guidelines as a non-pregnant woman — 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.
• Your exercise routine should include: an accumulation of 120 – 150+ minutes/week of strength training, aerobic training, and 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.
• After ~20 – 24 weeks gestation, there are certain anatomical and fetal changes that warrant following prenatal-specific 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.
• 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.
• Check in with your doctor or midwife 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 or midwife!
• 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.
• Overall, the intensity of your exercise sessions should be somewhat hard or moderate. On the Borg Scale below, you will want to stay between a 12 and 14. You can also use the talk test — you should be able to speak a full sentence while working out.

Pregnancy Exercise Don’ts

• Competitive events, contact sports, activities with a high risk of falling or risk of abdominal trauma, and scuba diving should all be avoided. [2, 3]
• Avoid activity in the heat and humidity to protect against heat stress. Exercise doesn’t usually increase core temperature to a point of concern. Your pregnant body is intelligent. To date, the effects of hot yoga/hot Pilates have not been published in studies; there are a few observational studies. ACOG emphasizes regulating core temperature during activity, while the ACSM explicitly recommends avoiding hot yoga and hot Pilates. Stated simply, this decision should be made between you and your healthcare provider.
• 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 still on your back for extended periods of time — this decreases venous blood return back to the heart in a small percent of pregnant women.
• Don’t continue if you feel lack of coordination or discomfort.
• Don’t forget adequate hydration.
• 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 or midwife.
• 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