Pregnancy and exercise

Exercise can have a positive impact on your pregnancy. For example, exercise may help you:

increase your energy level
relax
sleep better
maintain a healthy pregnancy weight
reduce backaches, leg cramps, swelling and bloating
prevent constipation
build your muscles and bones
feel good about yourself
prevent or help control gestational diabetes
prepare for labor and delivery
shorten your recovery time after childbirth

Preparing to exercise
Before beginning an exercise program, it's important to discuss it with your doctor. As your pregnancy progresses, be sure to discuss any changes you make in your exercise program with your doctor.
Exercises that are particularly suited for pregnancy include:

walking briskly
swimming at a comfortable pace
cycling on a stationary bike
Some land and water aerobic exercises are specifically designed for pregnancy. You may also want to try a yoga program designed for pregnant women. Classes for group aerobics or yoga during pregnancy are sometimes available through local hospitals, fitness centers or YMCAs.

If you didn't exercise regularly before becoming pregnant, begin gradually. If you were exercising regularly or participating in sports prior to your pregnancy, many activities can be continued during pregnancy. Your doctor may suggest certain modifications or decreasing the intensity as your pregnancy progresses, however.


General exercise guidelines
Exercise regularly. The American College of Obstetrics and Gynecology (ACOG) recommends 30 minutes or more of moderate exercise for pregnant women on most, if not all, days of the week, unless you have a medical or pregnancy-related problem that prohibits it.

Dress appropriately. Wear appropriate clothing, including well-fitting, supportive shoes and bra. Dress in loose-fitting clothing to avoid overheating.

Avoid overheating. This is especially important during the first trimester. Exercise in a cool area. Avoid exercising outdoors during hot, humid weather.

Warm up and cool down. Start your exercise routine with five minutes of warming up and end with five minutes of cooling down. Try gentle, gradual stretching.

Consider your heart rate. Ask your doctor about an appropriate maximum heart rate during your workout. This will vary depending on your age and overall condition. During your workout, you should be able to carry on a normal conversation without feeling short of breath. If you become short of breath, you may be exercising beyond your maximum heart rate.

Don't push it. To avoid exhaustion, stop exercising if you become tired.

Drink up. To prevent dehydration, drink water during and after your workout.

Eat well. With regular exercise, you'll need extra calories to maintain a healthy weight gain.

Know when to stop. If you develop any specific symptoms during exercise, stop working out and call your doctor or seek medical care. Symptoms to watch out for may include abdominal pain, vaginal bleeding, leaking of fluid from the vagina, dizziness, feeling faint, rapid heartbeat, shortness of breath, chest pain, difficulty walking, extreme fatigue, severe headache, uterine contractions and decreased fetal movement.


Limitations to exercise
Of course, pregnancy brings physical changes that can affect the ease and safety of some types of exercise. As your pregnancy progresses, your balance, stability and posture will be affected by the weight and position of your growing abdomen. Your abdominal muscles and the ligaments that support your joints will stretch, making them more susceptible to injury. Due to these changes, it's a good idea to avoid exercises that involve:
pulling on the abdomen, such as a full sit-up or double leg lifts
bending deeply
greatly extending any joint
curving your back inward
jumping, jerking movements or quick direction changes
holding your breath and straining, as you might with heavy weight lifting
lying flat on your back or stomach after the first 12 weeks of pregnancy
It's also best to avoid certain exercises that have a high risk of falls or abdominal injury, such as:

downhill skiing
horseback riding
waterskiing, surfing or diving
bicycling after the first trimester
contact or extreme sports, such as soccer, basketball or ice hockey
high-impact aerobics
It's important to avoid air pressure extremes as well, such as exercise in altitudes over 6,000 feet. If you're not acclimated to the high altitude, the amount of oxygen your baby receives may decrease. Scuba diving is also a poor choice because it puts your baby at risk for decompression sickness.


When exercise should be avoided
Your doctor may recommend avoiding exercise if you have certain pregnancy complications or medical conditions, such as:
persistent vaginal bleeding
placenta previa after 26 weeks of pregnancy
incompetent cervix
cervical cerclage
risk factors for preterm labor
multiple pregnancy (twins or higher order multiples)
premature rupture of the membranes
pregnancy-induced hypertension
chronic medical conditions, such as certain types of heart or lung disease
poor fetal growth