Exercise During Pregnancy

Maintaining a regular exercise routine throughout your pregnancy can help you stay healthy and feel your best. Regular exercise during pregnancy can improve your posture and decrease some common discomforts such as backaches and fatigue. There is evidence that physical activity may prevent gestational diabetes (diabetes that develops during pregnancy), relieve stress, and build more stamina needed for labor and delivery.

If you were physically active before your pregnancy, you should be able to continue your activity in moderation. Don't try to exercise at your former level; instead, do what's most comfortable for you now. Low impact aerobics are encouraged versus high impact.

The pregnant competitive athlete should be closely followed by an obstetrician.

If you have never exercised regularly before, you can safely begin an exercise program during pregnancy after consulting with your health care provider, but do not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of moderate exercise per day on most if not all days of the week, unless you have a medical or pregnancy complication.

Who Should Not Exercise During Pregnancy?

If you have a medical problem, such as asthma, heart disease, or diabetes, exercise may not be advisable. Exercise may also be harmful if you have a pregnancy-related condition such as:

• Bleeding or spotting
• Low placenta
• Threatened or recurrent miscarriage
• Previous premature births or history of early labor
• Weak cervix

Talk with your doctor before beginning an exercise program. They can also give you personal exercise guidelines, based on your medical history.

What Exercises Are Safe During Pregnancy?

Most exercises are safe to perform during pregnancy, as long as you exercise with caution and do not overdo it.

The safest and most productive activities are swimming, brisk walking, indoor stationary cycling, step or elliptical machines, and low-impact aerobics (taught by a certified aerobics instructor). These activities carry little risk of injury, benefit your entire body, and can be continued until birth.

Tennis and racquetball are generally safe activities, but changes in balance during pregnancy may affect rapid movements. Other activities such as jogging can be done in moderation, especially if you were doing them before your pregnancy. You may want to choose exercises or activities that do not require great balance or coordination, especially later in pregnancy.

What Exercises Should Be Avoided During Pregnancy?

There are certain exercises and activities that can be harmful if performed during pregnancy. They include:

• Holding your breath during any activity.
• Activities where falling is likely (such as skiing and horseback riding).
• Contact sports such as softball, football, basketball, and volleyball.
• Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
• Activities that require extensive jumping, hopping, skipping, bouncing, or running.
• Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.
• Bouncing while stretching.
• Waist-twisting movements while standing.
• Heavy exercise spurts followed by long periods of no activity.
• Exercise in hot, humid weather.

What Should a Pregnancy Exercise Program Consist Of?

For total fitness, a pregnancy exercise program should strengthen and condition your muscles.

Always begin by warming up for 5 minutes and stretching for 5 minutes. Include at least 15 minutes of cardiovascular activity. Measure your heart rate at times of peak activity. Follow aerobic activity with 5 to 10 minutes of gradually slower exercise that ends with gentle stretching.

Here are some basic exercise guidelines for pregnant women:

• Wear loose fitting, comfortable clothes as well as a good support bra.
• Choose shoes that are designed for the type of exercise you do. Proper shoes are your best protection against injury.
• Exercise on a flat, level surface to prevent injury.
• Consume enough calories to meet the needs of your pregnancy (300 more calories per day than before you were pregnant) as well as your exercise program.
• Finish eating at least 1 hour before exercising.
• Drink water before, during, and after your workout.
• After doing floor exercises, get up slowly and gradually to prevent dizziness.
• Never exercise to the point of exhaustion. If you cannot talk normally while exercising, you are probably over-exerting yourself and should slow down your activity.

Stretching Exercises for Pregnancy

Stretching exercises make the muscles limber and warm, which can be especially helpful when you're pregnant. Here are some simple stretches you can do before or after exercise:

• Neck rotation. Relax your neck and shoulders. Drop your head forward. Slowly rotate your head to your right shoulder, back to the middle, and over the left shoulder. Complete four slow rotations in each direction.
• Shoulder rotation. Bring your shoulders forward and then rotate them up toward your ears and back down. Do four rotations in each direction.
• Swim. Place your arms at your sides. Bring your right arm up and extend your body forward and twist to the side, as if swimming the crawl stroke. Follow with your left arm. Do the sequence 10 times.
• Thigh shift. Stand with one foot about 2 feet in front of the other, toes pointed in the same direction. Lean forward, supporting your weight on the forward thigh. Change sides and repeat. Do four on each side.
• Leg shake. Sit with your legs and feet extended. Move the legs up and down in a gentle shaking motion.
• Ankle rotation. Sit with your legs extended and keep your toes relaxed. Rotate your feet, making large circles. Use your whole foot and ankle. Rotate four times on the right and four times on the left.

Kegel Exercises During Pregnancy

Kegel exercises help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles during your pregnancy, you can develop the ability to relax and control the muscles in preparation for labor and birth. Kegel exercises are also highly recommended during the postpartum period to promote the healing of perineal tissues, increase the strength of the pelvic floor muscles, help these muscles return to a healthy state, and increase urinary control.

To do Kegels, imagine you are trying to stop the flow of urine or trying not to pass gas. When you do this, you are contracting the muscles of the pelvic floor and are doing Kegel exercises. Try not to move your leg, buttock, or abdominal muscles. In fact, no one should be able to tell that you are doing Kegel exercises. You can do them anywhere!

Try to do five sets of Kegel exercises a day. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax. Repeat this 10 times for one set of Kegels.

Tailor Exercises for Pregnancy

Tailor exercises strengthen the pelvic, hip, and thigh muscles and can help relieve low back pain.

• Tailor sit. Sit on the floor with your knees bent and ankles crossed. Lean slightly forward, and keep your back straight but relaxed. Use this position whenever possible throughout the day.
• Tailor press. Sit on the floor with your knees bent and the bottoms of your feet together. Grasp your ankles and pull your feet gently toward your body. Place your hands under your knees. Inhale. While pressing your knees down against your hands, press your hands up against your knees (counter-pressure). Hold for a count of five.

What Pregnancy Changes May Affect Exercise?

Physical changes during pregnancy create extra demands on your body. Keeping in mind the changes listed below, remember that you need to listen to your body and adjust your activities or exercise routine as necessary.

• Your developing baby and other internal changes require more oxygen and energy.
• Hormones produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
• The extra weight and the uneven distribution of your weight shift your center of gravity. The extra weight also puts stress on joints and muscles in the lower back and pelvic area and makes it easier for you to lose your balance.

Warning for Pregnant Women

Stop exercising and consult your health care provider if you:

• Feel chest pain.
• Have abdominal pain, pelvic pain, or persistent contractions.
• Have a headache.
• Notice an absence or decrease in fetal movement.
• Feel faint, dizzy, nauseated, or light-headed.
• Feel cold or clammy.
• Have vaginal bleeding.
• Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily.
• Notice an irregular or rapid heartbeat.
• Have sudden swelling in your ankles, hands, or face, or calf pain.
• Are short of breath.
• Have difficulty walking.
• Have muscle weakness.

How Soon Can I Exercise After Delivery?

It is best to ask your health care provider how soon you can begin your exercise routine after delivering your baby.

Although you may be eager to get in shape quickly, return to your pre-pregnancy fitness routines gradually. Follow your health care provider's exercise recommendations.

Most women can safely perform a low-impact activity 1 to 2 weeks after a vaginal birth (or 3 to 4 weeks after a cesarean birth). Do about half of your normal floor exercises and don't try to overdo it.

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