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Pregnancy & Exercise

Tuesday, April 10, 2007


Additional Resources

Pregnancy & Exercise - Tuesday, April 10, 2007

Exercise during pregnancy can have positive effects on both the mother and baby. Some of the benefits include: a reduction in pregnancy-related symptoms, such as back pain, leg cramps, and fatigue; a reduction in the risk of pregnancy-induced hypertension, and a reduced likelihood of developing diabetes during pregnancy (gestational diabetes). Exercise diminishes the risk of gestational diabetes for all pregnant women but especially for those with a body mass index of greater than 33. In addition, exercise may diminish bone density loss during the time that the mother is breast-feeding. Women who have exercised during their pregnancy often have a shortening of the active stage of labor -- the time during which the cervix measures between 4 to 10 cm in diameter. A program of regular physical activity can also increase the sense of maternal well-being and can improve endurance for the mother during the labor process. Mild or moderate intensity exercise does not affect the ability to produce breast milk.

In 2002, the American College of Obstetricians and Gynecologists (ACOG) published updated recommendations and guidelines for exercise during pregnancy and the post-partum period. ACOG currently recommends 30 minutes or more of moderate intensity exercise per day on most days of the week during pregnancy, in the absence of serious medical conditions or obstetrical complications. In the past, it was not recommended that sedentary women began an exercise program during pregnancy, but this recommendation has changed: previously sedentary pregnant women who are otherwise in good health can begin an exercise program. Pregnant women who are new to exercise show obtain clearance from their physician before starting an exercise regimen.

The Royal College of Obstetricians and Gynecologists states that exercising during pregnancy is not associated with adverse pregnancy or neonatal outcomes. They indicate that pregnant women should be encouraged to participate in both aerobic and strength conditioning exercise. The goal of aerobic conditioning should be to maintain a good fitness level during pregnancy rather than to try to obtain a peak fitness level or train for athletic competition. Aerobic exercise during uncomplicated pregnancy can be performed for 30 minutes or more on most days of the week. The degree of intensity should be mild or moderate. Resistance training is a valuable addition to aerobic training during pregnancy. It can be done as frequently as every other day. The resistance training should be mild or moderate in intensity. Heavy lifting during pregnancy is not appropriate. After the first trimester, exercises in the supine position should be avoided. A typical strength-training (resistance training) regimen consists of 1-3 sets of exercises for each of the major muscle groups. For the upper body, one set typically consists of 10-12 repetitions; for the lower body, 12-15 repetitions. Care should be taken when lifting not to strain or hold the breath, and tight gripping of barbells or handles should be discouraged. Supine exercises (i.e., those done lying on the back, such as crunches or sit-ups) should be avoided after the first trimester. Supine exercises can reduce blood return to the heart. Whereas otherwise healthy women can begin an aerobic exercise program during pregnancy, women who have never participated in a resistance-training program should be cautioned about beginning such a program during pregnancy.

Contraindications to exercise during pregnancy include, but are not limited to: pregnancy-induced hypertension, preterm rupture of membranes, preterm labor, incompetent cervix, cerclage placement, second or third trimester bleeding, placenta previa, and intrauterine growth retardation, among other conditions. If you are pregnant, be sure to check with your obstetrician before beginning an exercise program, and consult with your obstetrician if you have any questions or concerns during your pregnancy.

If you have been cleared by your doctor to engage in exercise during your pregnancy, low impact or nonimpact aerobic activities are advised. Walking is a good choice. It does not require any special equipment, other than a comfortable supportive pair of shoes and loose fitting clothing. Indoor cycling is also a good exercise choice. Many women enjoy the mind and body benefits of yoga. Aqua aerobics and swimming are particularly well suited for the pregnant exerciser. The buoyant effect of water helps support your weight and lessens stress on joints. It can make exercise more comfortable. The cool environment of the pool helps moderate body temperature.

High impact exercise should be avoided during pregnancy, as should those activities with an increased risk of falling. This includes activities such as downhill skiing, skating, and horseback riding. Such activities could lead to unintentional trauma to the abdomen and the baby. Scuba diving should be avoided because it could potentially cause gas bubbles to form in the blood and may lead to decompression sickness in the fetus.

Be alert to warning signs if you are engaging in physical activity.

If you experience any of the following symptoms, stop exercising and contact your obstetrician or physician:
  1. Increased uterine contractions
  2. Vaginal bleeding
  3. Amniotic fluid leakage
  4. Shortness of breath
  5. Dizziness or faintness
  6. Persistent nausea or vomiting
  7. Heart palpitations or chest pain
  8. Numbness
  9. Back or hip pain
  10. Calf pain or swelling

In conclusion, remember that, in most cases, exercise is safe for both mother and baby during pregnancy. Women should be encouraged to enjoy the health benefits of exercise during their pregnancy.

References:
  • ACOG Committee, Opinion no. 267: Exercise During Pregnancy and the Postpartum Period, Obstet Gynecol 2002;99;171-3.
  • Dempsey J, Butler C, Williams M. No Need for a Pregnant Pause: Physical Activity May Reduce the Occurrence of Gestational Diabetes Mellitus and Preeclampsia. Exercise and Sport Sciences Reviews 2005; 33(3):141-149.
  • Pivarnik JM. Potential Effects of Maternal Physical Activity on Birth Weight: Brief Review. Med Sci Sport Exerc 1998; 30(3):400-406.
  • Royal College of Obstetrics and Gynecologists. Exercise in Pregnancy. RCOG Statement No. 4 - January 2006: 1-6. (Accessed July 19, 2006 from here)
  • ACSM Certified News, Vol. 17, Issue 1; pages 8 & 9 (January-March, 2007).

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