THE BENEFITS OF WORKING OUT (& HOW TO START) WHEN PREGNANT
by Alison Brunson, PT, DPT, CSCS, PCES
During the first trimester, it was important for me to feel knowledgeable about all the changes in my body. So, I became certified as a PCES - Pregnancy and Postpartum Corrective Exercise Specialist.
As we all know, yes- you should exercise. And, yes- you could most likely continue whatever you have been doing (with some modifications). I started to document my personal experience as a pregnant woman paired with my knowledge as a PCES, Doctor of Physical Therapy, and Certified Strength and Conditioning Specialist.
Disclaimers: Consult your obstetrician-gynecologist before starting any exercise for a proper evaluation. If you have any questions regarding safety of exercise, contact your OBGYN, physician, or physical therapist.
Precautions: Check blood pressure before exercise - elevated BP could be early sign of preeclampsia.
If you were lifting weights or running long distances, your body is very much capable of continuing training that way. If you were not so active before pregnancy, it is safe for you and your baby to start a fitness journey, after clearance from your doctor. Overall, my take on this topic is to be active, go on walks, strengthen your muscles, just be cognizant of how you are feeling along the way. Are you unsure what’s important now that you’ve reached a new trimester? -> check out helpful exercise tips here.
Check out this journal article from the American College of Obstetricians and Gynecologists (ACOG), the committee opinions are ACOG committee assessments of emerging issues in obstetric and gynecologic practice and are reviewed regularly for accuracy.
What to Keep in Mind During Your Pregnancy:
Avoid prolonged exposure to heat (no hot yoga, saunas, hot tubs)
Avoid exercises lying on belly, generally after first trimester
Avoid laying on your back after 20 weeks of gestation
Why? It may result in decreased blood flow to the baby due to the compression of the abdominal aorta and inferior vena cava from the weight of the baby.
Consider choosing other exercises that don’t stay on your back
Avoid holding your breath (exhale with excursion)
Pay attention to hydration and caloric intake
If you were sedentary before pregnancy, follow a more gradual progression of exercise
Reminder: It’s okay to modify! It’s okay to decrease your volume! It’s okay to take a week off!
Why Should I Stay Active?
Exercise will increase your energy levels, improve sleep quality, reduce pregnancy discomfort, prepare for L&D and PP recovery
Exercise is shown to have a lower incidence of: excessive gestational weight gain, gestational diabetes, hypertensive disorders, cesarean birth, and lower birth weight for the baby
Exercise is seen to be an essential factor in the prevention of depression during the postpartum period
Exercise will strengthening abdominal, back, and lower extremity muscles, which could minimize risk of low back pain.
Because of the increase in weight and shift of gravity (due to the baby), there is a progressive lordosis (curve of the spine) that increases the forces along the spine. More than 60% of pregnant women experience low back pain during pregnancy.
What Should I Do Now? How Do I Start?
General Recommendation:
Time/Duration: 30 to 60 minutes, 3-4x/week (up to daily)
Intensity: 60-80% of age predicted max heart rate or 50-75% max Vo2
~ followed by a 15 minute recovery period, such as gentle walking or cycling
If you were previously performing vigorous-intensity aerobic activities, you can continue these activities - but be careful in warmer environments
If you were sedentary prior to pregnancy, you should start at a lower intensity (50% Vo2) with 10-minute stretches and 10-minute breaks between sets. Duration and intensity can be increased to 30-45 minutes over the next 2-4 weeks.
Check out my other blog for a full breakdown of workouts based on trimester - here.
Want the simplified version, right now? Cardio (like walking) is great to get your heart rate up - stay active!
1st Trimester: Main priorities: hydration & nutrition. Modify your typical work out if you feel too tired or too nauseous.
2nd Trimester: It’s recommended to eliminate activities on your back. Continue the abdominal exercises - but change them up - bird dogs, side planks, and bear crawl planks will become your new best friend.
3rd Trimester: Work on posture, mobility, and lower body strength to prepare for labor. Some of my favorite stretches were - adductor rocks, child’s pose, deep squat holds, and seated windshield wipers.
Stop Exercising & Speak to Your Doctor If You Show Signs of:
Vaginal bleeding
Abdominal pain
Regular painful contractions
Amniotic fluid leakage
Shortness of breath before exertion
Dizziness
Headaches
Chest pain
Calf pain/swelling
Muscle weakness, affecting balance
Hypoglycemia:
Prolonged high-intensity exercise of >45 minutes can potentially lead to exercise-induced hypoglycemia. Hypoglycemia symptoms include shaking, sweating, dizziness, faster heart rate, confusion, extreme hunger. Which is why adequate caloric intake before exercise is essential, if you are feeling these symptoms try eating a candy, cup of OJ, or 1 TBSP of honey. Other modifications to prevent hypoglycemia is limiting the intensity or length of exercise.
REFERENCES
Pregnancy and heart disease. ACOG Practice Bulletin No. 212. American College of Obstetricians and Gynecologists . Obstet Gynecol 2019 ; 133 : e320 – 56
Berghella V, Saccone G. Exercise in pregnancy! Am J Obstet Gynecol 2017;216:335–7
Magro-Malosso ER , Saccone G , Di Tommaso M , Roman A , Berghella V . Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis . Acta Obstet Gynecol Scand 2017 ; 96 : 921 – 31
Kolomanska-Boguck D , Mazur-Bialy Al . Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review . Medicine (Kaunas) 2019 ; 55 : 560
(Wang SM , Dezinno P , Maranets I , Berman MR , Caldwell-Andrews AA , Kain ZN . Low back pain during pregnancy: prevalence, risk factors, and outcomes . Obstet Gynecol 2004 ; 104 ( 1 ): 65 – 70)
(Evenson KR, Hesketh KR. Monitoring Physical Activity Intensity During Pregnancy. Am J Lifestyle Med. 2021 Nov 25;17(1):18-31.)
(Berghella V, Saccone G. Exercise in pregnancy! Am J Obstet Gynecol 2017;216:335–7)
(Newtown ER & May L. Adaptation of maternal-fetal physiology to exercise in pregnancy: The basis of guidelines for physical activity in pregnancy. Clinical Medicine Insights. 2017; 10: 1-12)
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Alison Marks Brunson Physical Therapy PLLC owns and manages this Website. The information provided on this Website is not medical or professional healthcare advice. It is only for informational and educational purposes. Please contact your primary care provider to discuss your health concerns, diagnoses, or treatments. In a medical emergency, call 911. Your website-related activities and communications do not create a provider-patient relationship between you and us and do not create a duty for us to follow up with you. To learn about our services, please contact us directly.
