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Exercise During Pregnancy

Is it safe to exercise during pregnancy?

When I found out I was pregnant, I wondered how my exercise routine would be impacted. I had been doing Insanity workouts prior to getting pregnant and tried one of these workouts when I was eight weeks along. Oh wow, was that a mistake! I didn’t feel awful right away, but my body ached for about a week afterward.

Many anatomic changes occur in your body when you are pregnant. Some of these changes include weight gain, a shift in your center of gravity, increased ligamentous laxity, and vascular changes. With all these changes in your body, it can be difficult to naviage an appropriate exercise routine. As long as you do not have a medical reason to not participate in exercise during pregnancy, exercise is safe and recommended throughout pregnancy.

Benefits of Exercise During Pregnancy

Some of the benefits of exercise during pregnancy include decreased:

  • excessive weight gain
  • gestational diabetes mellitus
  • cesarean birth
  • operative vaginal delivery
  • postpartum recovery time
  • postpartum depression
  • hypertension
  • preeclampsia
  • musculoskeletal pain
  • sleep disturbance

How Should I Exercise During Pregnancy?

If you exercised regularly and vigorously prior to getting pregnant, you can continue to exercise. But you may need to make adjustments to your routine due to your changing body. Below are contraindications to exercise based on guidelines from the American College of Obstetricians and Gynecologists:

  • Vaginal bleeding
  • Abdominal pain*
  • Regular painful contractions
  • Leaking amniotic fluid
  • Shortness of breath at rest*
  • Dizziness*
  • Headache*
  • Chest pain*
  • Muscle weakness affecting balance
  • Calf pain or swelling

For those items with an asterisk, take into account your baseline level and do not exercise if your symptoms are significant or have increased. For example, if you have had a headache and mild dizziness throughout your entire pregnancy, these may not be contraindications for you. If you have any doubts, strictly follow the list above.

Apart from these contraindications, listen to your body. Before I got pregnant, I was exercising vigorously. When I was just eight weeks pregnant, I completed an exercise routine I had previously been doing. I was able to get through the routine fine, but my body ached like I had the flu for at least three days afterwards. This exercise routine was too much for my body, so I stopped doing that routine.

How Much Should I Exercise During Pregnancy?

Pregnant women should get at least 150 minutes of moderate intensity exercise per week. Exercise should also include strengthening or resistance training, such as lifting weights. I’m not talking about becoming a body builder. But adding some light weights to your exercise routine to build muscle and strength.

150 minutes per week is the same as 30 minutes, five days per week. Moderate intensity means that you want to get a little out of breath, but not so much that you were unable to have a conversation with someone. Take this with a grain of salt, though. For me, I could go up one flight of stairs, at times during my pregnancy, and be very out of breath. I would take a short break and then continue, as long as I felt okay otherwise.

Some examples of ways to get your aerobic exercise include:

  • riding a bike
  • walking
  • climbing stairs
  • elliptical machine
  • rowing
  • hiking
  • swimming
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What Exercises Should I Avoid?

If you have musculoskeletal complaints during pregnancy, there are exercises to avoid if you do not want a flare in symptoms. This is not an exhaustive list. If you have any doubts or questions, seek the guidance of a physical therapist specifically trained in treating pregnant women.

Exercise involving laying on your back after 20 weeks gestation

image of woman exercising on back

For some women, laying on their backs after about 20 weeks of gestation results in hypotension. If you get dizzy, nauseous, or have blurred vision when laying on your back, you should avoid this position.

Not all women experience this, so pay attention to your body. If you do experience these symptoms, avoid exercises where you lay flat on your back. You can use a wedge or pillows to raise the top portion of your body (not just your head) to help.

Diastasis Recti Abdominis

If you have a significant diastasis recti abdominis (spreading or separation of abdominal muscles), or if you are having multiples, you may be greater limited in your exercise activities during pregnancy. If you aren’t sure if you have diastasis recti abdominis (DRA), sign up for our Freebie Library. We have a handout on how to check for and measure for DRA.

If you have significant DRA, you should avoid any position in quadruped (hands and knees) or positions where you are bent over significantly. These positions can put increased tension over the abdomen, which is already compromised. You will know if you have a significant DRA if your abdomen continues to dome or you cannot activate your abdominal muscles in the above positions. Refer to the diastasis handout for more information on what is considered to be significant DRA.

Abdominal Exercises

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In general, I am not a fan of crunches, sit-ups or V-sits during pregnancy. If you do them and you notice that your abdomen domes like a hot dog in the center, you should avoid these exercises. 

Asymmetric Leg Exercises

If you have pelvic girdle pain (pain in your pubic bone or sacroiliac joints), this may be exacerbated by asymmetric leg exercises. Some exercises that load your legs asymmetrically include:

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  • climbing stairs
  • lunges
  • elliptical machine
  • standing on one leg

If you experience an increase in pain while performing any of these exercises, it is best to avoid them to decrease exacerbating your pain.

Reference

Physical activity and exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 804. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;135:e178–88.

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