How can I exercise safely during pregnancy?

Exercise is helpful during pregnancy to maintain good circulation, aid constipation, and relieve insomnia, among other benefits. However, if you experience certain complications during your pregnancy, if you are expecting twins, or if you have high blood pressure or an incompetent cervix, you probably would benefit from little or no exercise. That said, walking is an excellent exercise for pregnant women, and yoga is becoming popular. When exercising, drink lots of water, and wear good shoes and a support bra. If you experience shortness of breath, chest pain, dizziness, or extreme fatigue, stop exercising and notify your obstetrician. Follow these additional tips:

• Exercise for shorter periods of time, and rest frequently;
• Avoid impact exercise, such as running or aerobics;
• Switch out weight-bearing exercise (such as weight machines) in favor
         of non-weight-bearing exercise (such as bicycling, swimming);
• Avoid getting your heart rate above more than 140 beats per minute;
• Avoid stress to your lower back;
• Avoid doing full sit-ups and raising both legs while lying flat.

Once you are given clearance by your doctor to exercise during pregnancy, there are some considerations to take into account to ensure safety for both you and your baby.

If you are used to working out regularly prior to pregnancy, keep in mind that your exercise routine may need some adjustments. For example, your cardiovascular system is working even harder now, therefore you may not be able to push yourself, as you did pre-pregnancy. Remember, at this stage, you are doing what is best for you AND baby, not just yourself anymore. 

Low impact exercise is recommended during pregnancy. Your sense of balance will be compromised due to the growing fetus, therefore ensure supportive footwear. For this reason, core exercises, as well as flexibility will be important components to your exercise routine, since your posture will be altered. Also, exercises in a standing or sitting position will be beneficial, as prone (on stomach) and supine (on back) positions are not advised during the 2nd and 3rd trimesters.

If you are just starting an exercise routine, start slow…very slow. This is not the time to be worried about losing weight or hitting new cardio or weight training goals. It is about maintaining your fitness levels to ensure a smooth pregnancy, delivery and post-partum recovery.

If you are pregnant and if you can find an exercise that feels good, then do it as often as you can. Trust your body, it knows what it likes! In particular, the stretches should always feel good. It's a good idea to begin with stretching to identify the exercise(s) that will do the most good for you. During the first week or two, I typically begin with stretches such as the all-fours rocking stretch, or tensor fascia lata (TFL) & quadriceps stretch. These will really reduce your back pain.

Exercise is shown to be safe in pregnant women who are healthy and have a release from the doctor prior to beginning a program. Remember that pregnancy is not the time to dive in to a hard core training program or any type of weight loss venture. It is however, beneficial to both mom and baby to continue with an exercise regimen. First, speak with your physician to make sure there are no contraindications to continuing a workout program.

Once you have obtained your doctors go ahead, keep in mind that your body no longer belongs to you alone and you may need to modify the pace a bit. Recent studies have shown that women who are active prior to pregnancy can continue a very active lifestyle through full term so long as the pregnancy is free of complications. Resistance training, cardiorespiratory training, and flexibility training are all used during prenatal training phases throughout all 3 trimesters. Just remember to listen carefully to your body and don't try to push past any discomfort. If you have been relatively sedentary up until pregnancy, take it very slowly. This is NEVER to time for weight loss.

Being active during healthy pregnancies has shown to decrease post partum depression, decrease labor time and pain associated, and increase the bodies ability to return to a healthy pre pregnancy state sooner.

Always check with your doctor before embarking on any new regimen. Also, consider hiring a personal trainer or prenatal fitness coach during this time to ensure your safety.

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The American College of Obstetricians and Gynecologists (ACOG) recommends aerobic exercise, strength training, and flexibility exercises during pregnancy unless you have medical conditions that prevent you from exercising, such as a complicated pregnancy or significant heart or lung disease. Strength training should generally be limited to using only light weights. You should also limit isometric exercises when you're pregnant.

The ACOG recommends a daily total of 30 minutes of aerobic exercise for healthy pregnant women. They provide free educational pamphlets on exercise and fitness during pregnancy at their website.

For most women, exercise during pregnancy is safe. In fact, several studies suggest that women who exercise during pregnancy will have a healthier pregnancy. We don't know, however, if the exercise or other health habits of the exercising women are responsible for the improvement.

Most types of exercise — in moderation — are OK for pregnant women. By moderation I mean that the woman works to maintain her fitness rather than pushing herself to a new level of performance.

As the pregnancy advances, it will be harder to keep up the pace, endurance and routine of any exercise routine the woman had before she became pregnant. A ten-minute mile, the yoga pose called "downward facing dog," or touching your toes may be easy in the first trimester, but for many, these will be nearly impossible in the third trimester.

Women who exercise during pregnancy should drink plenty of water. Also, slow down and reduce your level of exertion if you feel dizzy or exhausted. Avoid exercises and activities in which there is a risk of falling and hitting your abdomen — or having others hit you. Avoid activities that require good balance. Your center of gravity changes during pregnancy, increasing the risk of a fall.

In the second half of pregnancy, avoid activities that have you flat on your back for more than 20 to 30 minutes at a time. This position can reduce blood flow to the uterus.

Finally, swimming is great exercise during pregnancy, but stay away from scuba diving. "The bends" (bubbles of gas in the blood stream) are dangerous to the fetus.

The American College of Obstetricians and Gynecologists says that "recreational and competitive athletes can remain active during pregnancy." However, in certain cases, doctors may recommend limited activity. These conditions may include:

• bleeding during pregnancy, especially heavy recurrent bleeding late in pregnancy
• a placenta that covers the cervix (placenta previa) in the third trimester
• a history of prior preterm birth

If you did not exercise regularly before pregnancy, have a medical condition (such as heart disease) that may limit activity, or have had or have pregnancy complications, check with your doctor or midwife before planning any exercise during your pregnancy.