When I was researching for The Pregnancy Companion, I realized how little science backs up some of our most common recommendations, especially exercise. A recent study by Syzmanski et al1 provides additional support for the most recent guidelines for physical activity in pregnancy. They observed fetal heart rate tracing during exercise and ultrasounded the babies immediately after. The study revealed normal oxygen status in the baby, even in the vigorously exercising moms.
As obesity rates skyrocket, never has exercise in pregnancy been a more important issue. Ideally, women should enter pregnancy with a BMI of <30, but in my state of Tennessee which has a 30% obesity rate and where 50% of pregnancies are unplanned, that often doesn’t happen. Once pregnant, weight loss is not recommended, however exercise during pregnancy has shown to help reduce excess weight gain, preeclampsia, c-section and the risk for gestational diabetes.
Current recommendations for healthy women by the US Department of Health and Human Services:
- Healthy women who are not already highly active or doing vigorous-intensity activity should get at least 150 minutes of moderate-intensity aerobic activity a week during pregnancy and the postpartum period. Preferably, this activity should be spread throughout the week {i.e. 30 minutes, 5 days a week as a goal}.
- Pregnant women who are highly active can continue physical activity during pregnancy and the postpartum period. Assuming that they remain healthy and discuss with their healthcare provider how and when activity should be adjusted over time.
So how does this translate into real life?
6 Tips for Safe Exercise During Pregnancy
1. Even if you haven’t been previously active, get movin’! Walking, pilates and swimming are great activities that you can safely start during pregnancy. Remember to start slow. Begin with 10-15 minutes a day and add 5 minutes a week until you reach 30 minutes a day.
2. Don’t fall down. Activities such as horseback riding, skiing and hockey which have a high risk of falling or trauma should be avoided after the first trimester.
3. Don’t push it. If during exercise you begin experiencing chest pain, contractions or vaginal bleeding, then stop and consult your doctor. Lifting in pregnancy is recommended to be limited to less than 50 pounds, however that also can depend on your pre-pregnancy conditioning. {An example being a crossfitter who can normally squat 250# could probably lift 150# without straining, whereas a non-athlete may feel strained when lifting 40#}
4. On a scale of 1 to 10, you want to workout with an exertion level of 6 to 7. You want to have your heart rate up, but still be able to talk during the activity. Ideally exercise 30-60 minutes a day.
5. Check with your doctor if you are a professional/competitive athlete {if you work out more than an hour a day} so she can help to determine the safety of your specific situation.
6. Don’t lay flat after 20 weeks. The cardiovascular changes in the body and the position of the uterus reduce the blood flow to the uterus if you lay flat after 20 weeks.
Pregnancy complications that make exercise contraindicated:
- Heart disease
- Severe lung disease
- Cerclage
- Preterm labor {in current pregnancy}
- Placenta previa {> 26 weeks}
- Unexplained vaginal bleeding
- Preeclampsia
If you are active when you start pregnancy, that is great. Continue your routine throughout pregnancy, if you have no contraindications. If you are not active, look for ways to get moving and incorporate exercise into your daily activities.
I did stay active by walking during my pregnancy, until 32 weeks. After that I couldn’t find the energy {in my defense, I was working 90 hours a week}.
What exercise did you do during pregnancy and how long did you make it?
1. Syzmanski L, Satin A, Exercise during Pregnancy Fetal Responses to the Current Public Health Recommendations. Obstetrics & Gynecology. 2012, 119: 603-610.
So glad to see you mention CrossFit with a realistic scaling option! I am a coach and owner of one and pregnant with our first. My midwives said lift nothing over 35# and I explained to them I’ve been doing this for 6 years and that’s not even a warm up weight for me. Working at 70% of my lifts has been going pretty well for me so far.
ps. “Her thoughts” refer to my Family Practice doc. My mom is of the traditional “left side only” opinion (along with not lifting one’s arms above the head or you’ll wrap the cord around baby’s neck.) heh 🙂
I think the key is not lay flat on your back. Perhaps you could sleep partly on a pillow or wedge so the you were atleast angled and not flat.
If you see my reply to Helene above I think the ACOG reference mentioned would also apply to your situation.
I get mixed reviews on the “do not lay flat” issue. My mom says one thing while my MD says it’s ok. Her thoughts were that as long as I’m not feeling reduced blood flow to my legs, that I’m probably ok. I’ve always been a back sleeper and have back pain during pregnancy (laying on my back is the most comfortable sleep position). Doc thinks that adequate restful sleep is a good reason to keep up the ceiling view. Any good resources on this issue that I could check out?
Thanks!
It’s so encouraging to see mums taking initiative to exercise to keep themselves healthy. But are there any exercises for the baby’s mental growth? After all, 70% of the baby’s Brain growth occurs during pregnancy! Watch this video to know more.
My friend was doing these exercises when she got pregnant and it really helper her during labor.
Interesting read, so even people who have not really been into excercise in the past before getting pregnant should consider something light when they are with child. I guess swimming would be the #1 choice.
Studies by Dr. Clapp (the foremost expert in the field of maternal exercise physiology) and others show that exercising on the back does NOT significantly reduce arterial blood flow to the uterus, as compared to side-lying exercise.
Women are advised not to exercise on their backs due to a rare condition called Supine Hypotensive Disorder, which occurs in less than 9% of all pregnancies. In this condition, when lying supine, the weight of the uterus compresses the Vena Cava, the largest vein in our bodies, which carries oxygen depleted blood back to the heart. Venous return is reduced, not cut off. Supine Hypotensive Disorder results in a rapid onset of maternal dizziness. That’s it. Invariably, women move into another position.
BeFit-Mom
Helene,
I just checked out the your website. It is excellent! What a great resource. Thank you for your comments.
Yes, complications are rare from laying on your back with exercise. I have seen women pass out in this position from the hypotension, though so I continue to endorse the ACOG recommendation not to exercise in this position. Hate to see a woman dizzy holding a dumbbell over her head!
“The cardiovascular changes associated with pregnancy are an important consideration for pregnant women both at rest and during exercise. After the first trimester, the supine position results in relative obstruction of venous return and, therefore, decreased cardiac output and orthostatic hypotension. For this reason, pregnant women should avoid supine positions during exercise as much as possible.” ACOG Committee Opinion 267
The activities you are describing appear appropriately within the new guidelines. I agree with you that staying active is key.
Thank you! I just don’t want to hurt things doing something that’s supposed to help.
I’ve really been wondering about this myself! I’m not a super-athlete or anything, but I was doing resistance machine weight-training 3-4 times/week, Zumba once a week, and then another hour-long class that varies (step aerobics, kickboxing, yoga, interval training…something different each week), plus hiking on the weekends.
Then my mom told me it was important to only work out at fifty percent intensity and not get my heart rate or body temperature up too high–but the heart rate the chart told me to aim for is barely above resting for me!
But this sounds like I can probably keep doing most things (at least until I get big), just being extra careful not to fall (I’ll let the DH walk the Lab on the rockslides, lol), but maybe lower my intensity a little? I really want to stay strong during the pregnancy and for afterward and not gain a ridiculous amount of weight.
What do you think?