Exercise in Pregnancy
SAFE EXERCISES IN PREGNANCY
DR NEHA GUPTA
Reprinted with permission of the American College of Sports Medicine
Pregnancy Physical Activity
Pregnancy is a unique time and opportunity to optimize health behaviors. All women without contraindication should be physically active throughout their pregnancy, including previously inactive, those with gestational diabetes and those overweight and obese.
Women should discuss pregnancy Physical Activity with their health care provider.
Regular physical activity promotes many health benefits in all phases of life, including pregnancy and the postpartum period.
Benefits of Pregnancy Physical Activity:
- Physical Activity during pregnancy has minimal risks and has been shown to benefit most women, with some possible modifications necessary due to anatomical and or physiological changes and/or medical complications.
- Regular Physical Activity during pregnancy may:
- Improve or maintain physical
- Help with weight management.
- Reduce the risk of gestational diabetes.
- Enhance psychological well-being.
- Minimize potential perinatal complications for mother and fetus.
Recommendations:
- Physical activity recommendations for pregnant women follow those for the general non-pregnant population, with minor modifications.
- Women should accumulate 150 minutes of moderate Physical Activity each week.
- Physical Activity is encouraged everyday, but should occur over a minimum of 3 days per week.
- A variety of physical activities should be incorporated, both aerobic and resistance in nature, along with yoga and gentle stretching.
- Pelvic Floor related exercises (e.g., Kegels) should be performed
- Warm-up and cool-down periods should be included in any Physical Activity regimen.
- Physical Activity programs should be individualized for each woman based on situation, experience and current health status.
Stop Physical Activity and consult a medical professional if any of the following occur:
- Persistent excessive shortness of breath that doesn’t resolve with rest.
- Severe chest pain.
- Regular and painful uterine contractions.
- Vaginal
- Persistent loss of fluid from the
- Persistent dizziness or faintness that doesn’t resolve with
Safety Precautions:
- Avoid physical activity in the heat, especially with high
- Including “hot” yoga/pilates.
- Avoid activities with increased fall
- Including downhill/water skiing, surfing, off-road cycling, horse-back riding and
- Avoid scuba
- Avoid sky
- Avoid contact sports or activities with increased risk of abdominal contact/trauma.
- Including ice hockey, boxing, soccer and
- Maintain adequate nutrition and hydration-drink before, during and after physical
Special Physical Activity considerations:
- Women considering athletic competition or Physical Activity significantly above recommended levels; please consult with a health care provider about associated benefits and risks.
- Women considering Physical Activity at altitude should also consult a health care provider about associated risks.
Safe Activities to Initiate or Continue Include:
- Walking
- Swimming
- Stationary cycling
- Low-impact aerobics
- Yoga-modified
- Pilates-modified
- Running/Jogging *
- Resistance training
- Racquet Sports *
*these may be safe with regular participation prior to pregnancy
Health Care Provider Resources:
- PARmed-X for Pregnancy can be found at https://csep.ca/en/
publications/parmed-x-for-pregnancy
- ACOG: Committee Opinion number 650-PA and Ex during pregnancy and the postpartum period.
- 2019 Canadian guide for PA throughout
Special considerations for postpartum period:
- Pre-pregnancy Physical Activity routines can be resumed gradually as soon as physically and medically safe, which will vary depending on mode of delivery, health status and other individual factors.
- Mild Physical Activity with pelvic floor exercises and stretching should be able to be resumed
- Consult with a health care provider if there are any questions.
References:
- Mottola MF, Davenport MH, Ruchat S-M, et 2019 Canadian guideline for physical activity throughout pregnancy. BRITISH JOURNAL OF SPORTS MEDICINE. 52(21):1339-1346. doi:10.1136/bjsports-2018-100056.
- Kuhrt, , Hezelgrave, N. L., & Shennan, A. H. (2015). Exercise in pregnancy. Obstetrician & Gynaecologist, 17(4), 281–287. https://doi.org/10.1111/tog.12228
- ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum (2015). Obstetrics & Gynecology, 126(6), e135–e142. https://doi.org/10.1097/ AOG.0000000000001214
Staying Active Pays Off!
Those who are physically active tend to live longer, healthier lives. Research shows that moderate physical activity—such as 30 minutes a day of brisk walking— significantly contributes to a longer life. Even a person with health risk factors like high blood pressure, depression, diabetes or a smoking habit can gain real benefits from incorporating regular physical activity into their daily life.
As many dieters have found, exercise can also help you achieve weight loss goals. What’s more, regular exercise can help lower blood pressure, control blood sugar, improve cholesterol levels and build stronger, denser bones. Exercise helps improve your mental well-being too.
A Complete Physical Activity Program
Regular physical activity provides many health benefits. While it’s not required, working with an exercise professional can help you reach your fitness goals, tailor exercises to your abilities and most importantly, minimize your risk of injury. You should expect the
exercise professional to ask you to fill out an exercise pre- participation health screening. This form will ask if you exercise regularly and if you have any health concerns that should prompt you to see your healthcare provider before getting started. The following precautions will help you safely participate in exercise programs:
If you DO NOT exercise regularly:
If you have not been diagnosed by a doctor with, AND do not have signs or symptoms of cardiovascular, metabolic or kidney disease, THEN you can start right away with light to moderate intensity exercise. You can gradually build up to vigorous exercise if you stay free of any symptoms of health problems.
If you have ever been diagnosed by a doctor, with OR have signs/symptoms of cardiovascular, metabolic or kidney disease, THEN it is recommended to seek medical clearance before beginning an exercise program. Once you get medical clearance, you should start with light to moderate intensity. You can gradually build up to vigorous exercise if you stay free of any symptoms of health problems.
If you DO exercise regularly:
If you have not been diagnosed with, AND do not have signs or symptoms of cardiovascular, metabolic, or
kidney disease, you can continue with moderate exercise or gradually build to vigorous exercise intensity.
If you have been diagnosed with cardiovascular, metabolic, or kidney disease AND do not have any sign/ symptoms of health problems, then you can continue exercising at a moderate intensity. If you received medical clearance within the last 12 months AND your symptoms have not changed, then can continue with moderate exercise or gradually build to vigorous exercise intensity.
If at any time you develop a sign or symptom of cardiovascular, metabolic or kidney disease, discontinue exercise and seek a doctor’s clearance right away. Then, after getting medical clearance, you may continue your moderate intensity exercise program and gradually progress your effort.
Getting Started with an Exercise Program
A well-rounded exercise program includes aerobic, strength training exercises, but not necessarily in the same session. This blend helps maintain or improve overall health and function. So, it is important to choose exercises you enjoy and can fit into your schedule.
Not all exercise programs are suitable for everyone. Activities should be carried out at an effort level that is comfortable for you. You should stop participation in any exercise activity that causes pain. In such event, you should consult with your health care professional immediately.
ACSM recommends you accumulate at least 30 minutes of moderate-intensity physical activity (working hard enough to break a sweat, but still able to carry on a conversation) most days per week, or 20 minutes of more vigorous activity three days per week. Combinations
of moderate- and vigorous-intensity activity can be performed to meet this recommendation.
Examples of typical aerobic exercises are: walking, running, stair climbing, cycling, rowing, cross country skiing and swimming. Examples of common strength training exercises are: weight machines, free weights and resistance bands. Flexibility exercises can include: stretches of muscles around different joints and yoga.
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ACSM grants permission to reproduce this brochure if it is reproduced in its entirety without alteration. The text may be reproduced in another publication if it is used in its entirety without alteration and the following statement is added: Reprinted with permission of the American College of Sports Medicine.
Copyright © 2020 American College of Sports Medicine. This brochure was created by Patricia Bauer, Ph.D., CSCS, ACSM-EP, ACSM-EIM and is a
product of ACSM’s Consumer Outreach Committee. Visit ACSM online at www.acsm.org.