By Amy MacQueen, MD
In 1985 the American College of Obstetrics and Gynecology (ACOG) published recommendations about exercising during pregnancy. They warned women about the potentially adverse effects of exercise during pregnancy, and advised them not to exceed a heart rate of 140 beats per minute. In the last 25 years, however, the recommendations for exercise during pregnancy have changed significantly.
What do the latest recommendations say?
Updated guidelines in 2002 from ACOG, the Centers for Disease Control, and the American College of Sports Medicine recommend an individualized exercise program for pregnant women that is similar to what they do when they not pregnant. If you are an active healthy woman without certain contraindications, you can continue to be active during pregnancy. The current recommendations state that pregnant women should get 30 minutes of moderate exercise on most, if not all, days of the week. This is similar to their non-pregnant counterparts. Ideal exercises include brisk walking, swimming, or stationary bicycling at a level of intensity that leaves you a little breathless. I recommend the “talk test” to my patients, which simply means that if you experience a little bit of difficulty keeping up a conversation during exercise, you are exercising at a moderate level.
What are the benefits of regular exercise during pregnancy?
As it turns out, regular exercise conveys benefits to both the mother and the baby. Studies have proven that exercise during pregnancy lowers the mother’s risk of developing gestational diabetes, pregnancy-induced hypertension, post-partum depression, and urinary incontinence. Women who exercise during pregnancy are less likely to deliver babies weighing nine pounds or more, and these children are less likely to be obese at two and five years of age.
Women who do aerobic and weight-bearing exercise while pregnant also have fewer pregnancy-related symptoms, such as low back pain.
What kinds of activities are to be avoided?
In general pregnant women should engage in low impact activity, with low risk of trauma to the belly and low risk of falling. If you weight train it is important to avoid using weights so heavy that you have to strain while lifting them, and you should not lift weights on your back during the second and third trimesters. You should also avoid activities that could cause you to fall, such as horseback riding, bicycling, skiing, and martial arts. Team sports where collision is possible, such as basketball or soccer, are not recommended for pregnant women. Yoga, with an emphasis on breathing, is usually excellent to maintain flexibility, but inverted poses are not recommended because they can affect blood flow to the baby so it is advisable to work with yoga instructors who are experienced in working with pregnant participants. If you are exercising and you experience any vaginal bleeding, dizziness, headache, chest pain, leaking amniotic fluid, or decreased fetal movement stop exercising immediately and call your doctor.
Are there conditions that make exercise dangerous?
Women with medical or obstetrical complications, such as heart or lung disease, high blood pressure, preeclampsia, or placenta previa, should talk with their doctors before engaging in exercise. Basically, if you have any question about whether or not you should be exercising, talk to your doctor.
What’s the takeaway message for pregnant women who want to exercise?
I recommend exercise to my patients who are healthy pregnant women without contraindications. There is evidence that pregnant women who exercise may have shorter labors. They experience a lower incidence of labor interventions like Pitocin and may have a decreased risk of having a c-section. They also reduce their risks for developing cardiovascular disease later in life.
Dr. Amy MacQueen is a sports medicine specialist who serves on the medical staff of Cayuga Medical Center. She is board certified in family medicine and sports medicine, and is in practice at Sports Medicine and Athletic Performance where she can be reached at (607) 252-3580.