Exercise in Pregnancy by Dr. Soujanya Tummuru
Exercise in Pregnancy
In healthy women who don’t have any medical complications, exercise can be safe and healthy for both mom and baby! Pregnancy is also an ideal time to make positive lifestyle changes, which can include a healthy diet and increasing physical activity.
ACOG recommends at least 150 minutes of moderate-intensity physical activity weekly during pregnancy.
-Avoidance of excessive weight gain during pregnancy
-Prevention/reduction of lower back pain or pelvic pain
-Prevention of urinary incontinence
-31% decreased risk of delivering a macrosomic or large for gestestational age newborn
-Decreased risk of developing gestational diabetes and preeclampsia
-Possible decrease in the length of labor
– 15% reduced risk of cesarean delivery
-In women with Gestational Diabetes, physical activity can lead to better glycemic control, and less need for medications during pregnancy
-No increased risk of preterm birth or miscarriage
-Infants of women who engage in physical activity while pregnant may avoid becoming overweight or developing Diabetes later in life
Hyperthermia (increased core temperature >102.2)
-unlikely during normal exercise
-increased risk during intense exercise in a “Hot” room or running outside on a very hot summer day
-avoid exercise in extreme heat (>95 degrees)
Maternal trauma (i.e. falling)
-can lead to obstetrical complications such as placental abruption if severe trauma
Women with any of these complications should avoid exercising during pregnancy. Always talk to your Doctor first if you are unsure!
-Persistent 2nd or 3rd trimester bleeding (Placenta previa )
-Premature labor during the current pregnancy
-Hypertensive disorders of pregnancy
-Restrictive lung disease
-Intrauterine Growth restriction during current pregnancy
-Extreme morbid obesity OR Extreme underweight
-Unevaluated Cardiac Arrhythmia
-Avoid contact sports, exercises with increased risk of injury/falling, jumping, inverted yoga poses, heavy weight lifting
-Avoid working out in extreme heat (>95 degrees)
-Avoid scuba diving (risk of decompression sickness in mom and baby)
-Avoid exercise in high altitudes for 3-4 days until body acclimates (increased risk of altitude sickness)
-Avoid supine positions after 1st trimester (Laying flat on your back)
-Avoid heavy weight lifting/strength training
-Prolonged intense exercise can lead to dehydration and/or hyperthermia. Make sure to HYDRATE!!! Dehydration can lead to uterine contractions…. HYDRATE!!!!
-30 min/day, 5-7 days/week
-Previously sedentary women- start at low to moderate intensity and build up intensity gradually
-Previously active individuals may safely continue to engage in high intensity exercises
“Talk Test” :
-You should be able to hold a normal conversation while engaging in physical activity
Heart Rate Monitoring:
-If you don’t already have a heart rate monitor, it is a good idea to get one to monitor exertion during exercise
Age <20 years: 140-155 bpm
Age 20-29: 135-150 bpm
Age 30-39: 130-145 bpm
Age > 40 years: 125-140 bpm
STOP EXERCISING and consult your physician if:
-vaginal bleeding, regular painful contractions, leakage of amniotic fluid, new shortness of breath, dizziness, headache, chest pain, muscle weakness affecting balance, calf pain/swelling
When can I return to an exercise routine post-partum?
-After an uncomplicated delivery, you may return to light physical activity in 1-2 weeks, and gradually increase intensity. Listen to your body and avoid any strenuous activity until cleared by a physician.
Does exercise affect breastfeeding?
-No change in breast milk production with moderate intensity exercise
-Nursing before exercising avoids discomforts of engorgement
-Adequate fluid intake is necessary with any exercise to avoid decreasing milk supply
What exercises should I avoid in pregnancy?
-contact sports (i.e. ice hockey, soccer, boxing, basketball)
-skiing, surfing, gymnastics, road cycling, horseback riding
-hot yoga/hot pilates
Recommended weight gain in pregnancy
The amount of weight gain that is recommended during pregnancy depends on pre-pregnancy starting weight. These recommendations are based on a singleton pregnancy. Your doctor or health care provider can help you determine your starting BMI at your initial visit.
Weight Gain Recommended
Underweight (BMI < 18.5)
Normal Weight (BMI 18.5-24.9)
Overweight (BMI 25-29.9)
Obese (BMI >/= 30.0)
*Increased maternal weight gain can increase risk of c-section
*Low weight gain is associated with an increased risk of low birth weights, while higher weight gain is linked to higher birth weights and increased risk of having a macrosomic infant.