Recently, I read an article citing a 2002 report by the American College of Obstetricians and Gynecologists (ACOG). It stated that pregnancy is no longer a condition for confinement.
Confinement? Really? As recently as 2002, pregnancy was considered a condition for confinement? It sounds like a statement from the times when menstruating women were sent away from the village.
Yes, pregnancy is no longer considered a time when women should stay in bed, resting and hiding away from the rest of the world. It is now recommended that healthy, pregnant women get out and aboutthat moving around and doing moderate exercise is a great thing for a pregnant woman and her baby. The benefits of moderate exercise while pregnant are increased stamina, fewer aches and pains, faster recovery after delivery, a better overall mood, and prevention of excess weight gain. Most women who were regularly active before they got pregnant and are experiencing a healthy pregnancy can continue to exercise throughout their nine months.
Before beginning an exercise program, get clearance from your doctor. It never hurts to get the official okay. Topics to discuss with your doctor can be the ACOG contraindications to exercise:
- Hemodynamically significant heart disease
- Restrictive lung disease
- Incompetent cervix/cerclage
- Multiple gestation at risk for premature labor
- Persistent second or third trimester bleeding
- Placenta previa after 26 weeks gestation
- Premature labor during the current pregnancy
- Ruptured membranes
- Pregnancy-induced hypertension
- Severe anemia
- Unevaluated maternal cardiac arrhythmia
- Chronic bronchitis
- Poorly controlled type 1 diabetes
- Extreme morbid obesitiy
- Extreme underweight
- History of extremely sedentary lifestyle
- Intrauterine growth restriction in your current pregnancy
- Poorly controlled hypertension/preeclampsia
- Orthopedic limitations
- Poorly controlled seizure disorder
- Poorly controlled thyroid disease
- Heavy smoker
ACOG recommends that healthy pregnant women with no contraindications use the same Centers for Disease Control guidelines as everyone else30 minutes or more per day of moderate exercise, most days of the week.
So what does “moderate exercise” mean? There is no longer a specific heart rate pregnant women should stick to. The intensity of the exercise is specific to the woman. Pregnant women can use the “talk test” to assess how hard they are exercising. If you can talk while you are exercising, but it is becoming difficult to speak without effort, that is considered “moderate exercise.” You can still do many types of aerobic exercise while pregnant.
There are some things to think about when you exercise. Pregnant women should consume adequate water before and during a workout, exercise in moderate temperatures, never exercise on an empty stomach, not hold their breath while exercising, and avoid heated pools, saunas, and steam rooms. Be aware of changes in your blood sugar levels. If it is 95 degrees outside, perform your exercises in the air conditioned gym.
When you are pregnant and exercising, be careful to use common sense and not get too crazy. Now is not the time to take up extreme sports. Jogging, light resistance training, or dancing is fine. Rugby, rough contact sports, and downhill skiing on treacherous mountains are not fine. I recently met a pregnant woman who did a lot of yoga prior to her pregnancy. She said she had asked her doctor if she could continue to do headstands while she was pregnant. Her doctor said this was okay as long as she did not fall. The lesson here is that if you are unsure of your ability to safely perform an exercise, it is probably best not to do it.
Pay attention to what your body is telling you. According to ACOG, if you experience any of the below symptoms when exercising, you should stop:
- Vaginal bleeding
- Dyspnea (shortness of breath) before exertion
- Chest pain
- Muscle weakness
- Calf pain or swelling
- Preterm labor
- Decreased fetal movement
- Amniotic fluid leakage
After the second trimester, pregnant women should avoid exercises performed on their backs. Being motionless on her back can cause hypotensive supine syndrome. This occurs when the growing baby and uterus become heavy enough to compress the vena cava, the large vein that carries deoxygenated blood from the lower half of the body into the right atrium of the heart. Adding an incline bench or performing exercises on the left side instead of the back can help prevent problems.
Pregnant women often feel more flexible than they did before they were pregnant. This is due to the hormone relaxin, which makes your joints more pliable. When exercising, be careful to maintain a safe range of motion. If you could not do certain stretches before you were pregnant, be careful not to get overly zealous about performing them now. Also be aware of this when you are strength training.
Progesterone levels increase during pregnancy, in part to help trigger milk production. It also helps your uterus stay thick as your cervix thickens. Progesterone plays a role in exercise because your body experiences a bit less vigor when it pumps blood out of your lower extremities. If a pregnant woman stays still too long, this may decrease cardiac output, leading to fainting, varicose veins, and swollen ankles.
To avoid this, pregnant women should move around a lot. Be careful not to stand around between sets. It is a good idea to move foot to foot, or stand up and down on your tiptoes as you are resting between exercises.
You will likely have a lot of questions about exercising while you are pregnant. In addition to talking with your doctor, it is a good idea to see if your gym has any personal trainers who are certified to work with pregnant women. When choosing a personal trainer, ask a lot of questions about the trainer’s experience with pregnant women and what certifications they have completed. Always remember to use your common sense when working out. Just because someone tells you an exercise is okay, only you know what your body is feeling. If something seems off, stop the exercise and ask your doctor.
All suggested guidelines follow recommendations put forth by the American College of Obstetricians and Gynecologists. This information is not meant to replace the advice of a doctor. Every woman is different; consult your doctor before beginning an exercise program.
Stacey Rosenberg is a personal trainer in Somerville, Massachusetts.