Exercise in Pregnancy
Exercise is such an important component of health and well being for everyone, and pregnant women are no exception. Studies have demonstrated that physically well-conditioned women suffer from less prenatal and postpartum depression, have shorter labours, and are less likely to have obstetrical interventions than other women. Questions about exercise recommendations and contraindications are certainly among the most common questions asked by my pregnant patients. Women are concerned about getting enough exercise, about not overdoing it and, now, more than ever, about being able to maintain the same level of athleticism they achieved prior to pregnancy. There needs to be a balance between doing exercise that is going to provide you with the desired health benefits for you an your baby, and not pushing yourself past that point where it stops being healthy for either of you and becomes something else entirely.
There are many things to consider when putting together a plan for exercise during your pregnancy including which trimester you’re in, risk of joint injury, risk of abdominal trauma, temperature, oxygen demands, and caloric requirement. There are also some absolute and relative contraindications to exercise in pregnancy, so be sure to discuss your exercise regimen with your doctor or midwife. There is not one exercise regimen that is right for everyone in pregnancy, or even one regimen that is right for the same woman throughout her pregnancy. Limitations change as pregnancy progresses. The key is to be aware of what your body is telling you is too much.
In the first trimester, it’s generally safe to continue doing whatever you were doing prior to pregnancy, being aware of not overheating your core and your increased predisposition to injury because of the increased laxity in your joints. My recommendation is typically 30-40 minutes of exercise at least 4 times per week. I don’t recommend trying out new, physically demanding activities, but it’s generally safe to start walking, swimming, or even light jogging. After the first trimester, it typically becomes more difficult to do weight-bearing exercise, but many women are still able to continue with whatever they were doing in the first trimester, with some modifications as the body continues to grow and change. Also, the caloric requirement in pregnancy is a little higher so it’s important to incorporate more good calories (lean protein, unsaturated fat, and complex carbs) and adequate hydration. Typically, the body needs an extra 150 calories/day in the first two trimesters and an additional 300 calories/day in the third trimester.
There are often discussions around safe positions in pregnancy, and specifically, whether or not it’s safe to do floor work on your back. I’ve done enough research to feel comfortable with my patients continuing to do some exercise on their backs, with the understanding that core work will get more difficult to do beyond the first trimester, and that they will stop if they experience any lightheadedness. It’s also important to consider the risk of abdominal trauma as a result of exercise, such as in mountain biking or downhill skiing.
My biggest concerns have been around those patients of mine who identify themselves as highly athletic and have a hard time letting that part of themselves go as they progress through pregnancy. They seem to have trouble decreasing the intensity of their workouts because they are so used to achieving a certain level and just don’t feel like they’re getting the same workout if they don’t hit that high. These women are used to pushing their bodies past that point that has most people pulling back, so my advice of just “listening to your body” doesn’t really work for them. I’ve been most successful in talking to these women about changing the way they view their workouts and letting go of the bar they’ve set for themselves - temporarily. Pregnancy is about building another human being, and setting your body up to be able to provide this growing baby with what it needs, and exercise is an important piece of that but it has to be something that is restorative and nurturing, not something that is depleting.
Exercise in pregnancy is important for so many reasons, so it’s important to create a program for yourself that makes you feel strong and energized. Check in with yourself throughout your pregnancy to make any adjustments that you need to make, and keep your doctor or midwife in the loop so they can help you stay on track with a plan that works for you, and let you know if you have any contraindications to exercise as you progress.