Pregnancy is a time where there are many unknowns and there is a lot of information being thrown at you. One common concern we hear from our patient is about whether or not they should be exercising during pregnancy. Exercising during pregnancy can seem scary but it doesn’t have to be!

We know there is a lot of information out there, so it can feel very overwhelming to try and figure out how to safely exercise in a way that is best for you & your baby throughout your pregnancy. However, staying active during pregnancy has been shown to have minimal risks and many benefits for the mom-to-be and her baby. Some benefits of exercising throughout pregnancy include:

-increased energy

-improved mood

-decreased stress levels

-better sleep quality

-maintaining a healthy weight

-maintain muscle strength & endurance

-decreased risk of swelling

-decreased risk of constipation

-decreased risk of gestational diabetes

-decreased postpartum recovery time

The key thing about exercising safely throughout exercise is knowing how to modify. This is where your women’s health pelvic floor physical therapist comes in!

If we consider all of the physiological changes that occur during pregnancy, it makes sense that we may need to exercise differently during certain stages. Before starting or continuing any exercise program during pregnancy, I recommend checking in with your OBGYN. They can check for certain medical conditions or situations that would warrant avoiding aerobic exercise such as:

-Hemodynamically significant heart disease

-Restrictive lung disease

-Incompetent cervix or cerclage

-Multiple gestation at risk of premature labor

-Persistent second- or third-trimester bleeding

-Placenta previa after 26 weeks of gestation

-Premature labor during the current pregnancy

-Ruptured membranes

-Preeclampsia or pregnancy-induced hypertension

-Severe anemia

Women who have regularly engaged in higher-level aerobic exercise (think running) or are “highly active” prior to pregnancy, can continue to perform this level of exercise as long as they remain healthy and are checking in with their doctor & physical therapist to learn how & when to modify exercise throughout their pregnancy.

For women that have been cleared by their doctors as “uncomplicated pregnancies”, it is recommended to get at least 150 minutes of moderate-intensity aerobic exercise per week. What is moderate intensity though? Think of it as a brisk walk or an activity that you could talk or have a conversation during but are still working up a sweat & raising your heart-rate. Another thing to think about is making this activity something you enjoy and look forward to.

Finding a form of movement that brings you joy increases the chances you’ll stick with it. You also want to consider picking forms of exercise that you can continue throughout your entire pregnancy. Finding balance in your exercise is also crucial. I recommend patient’s perform a mix of aerobic exercise, strength training and stretching to reap the most benefits of exercise during & after pregnancy. Pilates, yoga, swimming, cycling and walking are all great forms of exercise during pregnancy. There are some types of exercise are considered unsafe activities, and you want to avoid them during your pregnancy. A few examples are listed below:

-Contact sports

-Skydiving

-Hot yoga or hot pilates

-Scuba diving

-Activities performed over 6,000ft if you do not already live at that altitude

-Activities that could result in a fall: horseback riding, gymnastics, skiing, off-road cycling,Skateboarding, rock climbing

Now that you’ve learned different types of exercise that you can do during your pregnancy, let’s talk about what to think about while you’re actually exercising.

Things to consider while exercising during pregnancy include:

-Hydration: Pregnancy limits the capacity of your bladder, so you may need to urinate more frequently and therefore hydrate more often. Make sure you are drinking adequate amounts of fluid before, during & after exercise. An easy way to make sure you hydrated enough during your session is to weigh yourself before & after. If you weigh less, you lost more fluids through sweat. If you weigh more, you drank more than necessary. If you weigh the same, you replenished fluids adequately. Some common signs of dehydration include: dizziness, headache, pounding heart, decreased urine output, dark yellow urine, muscle cramps, and fatigue.

-Snacks: high intensity exercise for longer than 45 minutes can leads to hypoglycemia so making sure to have adequate calorie intake prior to exercise is important.

-Clothing: Make sure you’re comfortable! This often includes a supportive sports bra and elastic waist pants or shorts. You may get hot more easily, so loose fitting clothing & layers can be very helpful. Your feet will widen during pregnancy due to “loosened” ligaments, so checking on the fit of your shoes while exercising is important as well.

-Temperature: You want to avoid overheating and extreme temperatures due to increased progesterone levels that cause the blood vessel walls to relax, which can result in light-headedness/drops in blood pressure. Try to exercise in a temperature controlled room, or in the hotter months, trying to get outside in the early morning or in the evening to avoid high temperatures & humidity.

-Positioning: The uterus causes compression to the inferior vena cava (which returns blood from the Legs & pelvis to the heart) and the abdominal aorta (which brings blood from the heart to the uterus), making you feel dizzy & possibly reducing blood flow to your uterus. However, research is showing it is actually okay for most women to lay on their back during pregnancy as long as they are not experiencing symptoms of faintness, dizziness, difficulty breathing or if you just don’t “feel right”. It should be fine to lay on your back, but we recommend monitoring how you feel and avoiding it for extended periods. If you’re still too nervous to lay on your back, you can elevate yourself to about 20 degrees which should eliminate any potential compression of your inferior vena cava.

Separately, staying in one position with minimal motion can cause blood to pool in your legs and feet, which can lead to low blood pressure & possibly fainting. For this reason, try to avoid holding standing poses where you remain still or standing in place for long periods.

-Balance: Due to your growing belly changing your center of gravity and the hormone relaxin, which causes your ligaments that support your joints to relax , your balance may be off & you are at greater risk of falling. Avoid activities that may result in a fall such as skiing, gymnastics and skateboarding.

-Classes: If you’re taking a class, let your instructor know so that they can recommend special modifications and keep an eye on your form.

-Listen to your body: One of the most important things is to monitor yourself as you go. If you are feeling fatigued, dizzy, or short of breath--- listen to your body and take a break. You may need to decrease the workout intensity, duration or both during pregnancy and that’s okay!

Some signs that you need to stop exercise immediately and call your doctor are listed below.

-Bleeding from the vagina

-Feeling dizzy or faint

-Shortness of breath before starting exercise

-Chest pain

-Headache

-Muscle weakness

-Calf pain or swelling

-Regular, painful contractions of the uterus

-Fluid gushing or leaking from the vagina

If you are interested in learning more about how to exercise during pregnancy and understanding how to work with the changes occurring in your body, try our “For The Moms” program. In this program we take a comprehensive and proactive approach to exercising safely during pregnancy to help you feel your best while carrying your baby and after they arrive.

Learn more

By Dr. Sarah Casali, PT of The Pilates Rx.