When it comes to the topic of exercising while pregnant, opinions seem to be all over the board. I’ve heard people say everything from “you shouldn’t exercise at all because you don’t want to risk anything” to “you don’t need to make any adjustments to your training because you need to be strong for birth”. It’s no wonder that most of my pregnant patients are a little confused at what they should or should not be doing during pregnancy. So let’s dive in a little further to clarify!
Of course, I want to preface this by saying that you should always be in communication with your OB or midwife as everyone experiences pregnancy differently and there are a few complications which do require bed rest. Only you and your doctor know your personal precautions based on your medical history. That being said, it’s generally safe to exercise during pregnancy! If you think about what we do during our daily lives, we’re usually:
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Lunging to tie our shoes
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Lifting groceries
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Squatting to sit on the toilet
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Running after our pets or kids
You get the idea. We’re active people!
However, for a while, medical providers believed that bed rest was healthy during pregnancy, so commonly told their patients not to exercise during this time. While this theory has long since been disproven, commonly held beliefs don’t transform overnight. So unfortunately, many people continue to believe that pregnant women shouldn’t be active. But that couldn’t be further from the truth!
The ACOG (which stands for the American College of Obstetricians and Gynecologists, the national organization for OB/GYNs) has formally recommended that pregnant women get at least 150 minutes, or 2 and a half hours, of moderate-intensity aerobic activity every week. This recommendation is actually the same amount that the CDC recommends for the general population! So pregnant women are advised to be as active as anyone else!
When deciding what exercise to participate in during pregnancy, let’s start with the obvious. Contact sports, hot yoga, or scuba diving will probably not be for you during this time. But you likely already knew that. (And if you didn’t, doctors generally advise against those activities due to risk of abdominal injury, overheating, and decompression injuries, respectively).
It’s actually more important to look at your pre-pregnancy activity levels when determining how to exercise during pregnancy. So just because the general recommendation is 150 minutes of exercise per week, if you weren’t exercising prior to pregnancy, you’ll still have to work your way up to that amount or you could be at risk of injury. (Even though I think that mamas are superheroes, they aren’t quite invincible so you don’t want to do too much too soon too fast!) But on the flip side, if you were a super active person prior to pregnancy, you don’t have to suddenly stop doing all of your favorite workouts just because you’re pregnant.
We can’t deny that the body does change with pregnancy, so let’s go over some changes that will likely affect the way that you move as your pregnancy develops. First, it’s common knowledge that fluctuating hormones during pregnancy can cause joints to “loosen”. This is a good thing when it comes to a baby having an easier exit from the birth canal! However, this can cause you to feel less stable than you typically do. And this feeling can often be exacerbated by a growing belly which changes your center of gravity and can lead you to feeling off-balance. Also, as I alluded to above, pregnant women may be prone to overheating. And as the baby grows, it might become harder to take a deep breath.
These changes have led to the general advice to avoid impact exercises like running or CrossFit during pregnancy. However, I have seen many patients run and do WODs well into their pregnancy without issues because they were well adapted to those exercises beforehand. So when you hear this advice, just know that it is very dependent on your fitness level when you became pregnant. And even if you were an athlete pre-pregnancy, know that during pregnancy, you may need to make some slight adjustments; for instance, you may not want to push through a run at noon in July (duh). Even the age-old advice to avoid exercises performed while laying on your back does not always ring true; I have seen some of my patients do abdominal work well into their third trimester. So with all this back and forth, how do you know what’s safe for you!?
Again, I always encourage open communication with your medical provider (whether that’s your OB or your Pelvic Floor Physical Therapist!) so that you can make your exercise routine specific to your body. However, here are some general guidelines to follow:
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If you do feel unsteady on your feet, begin strengthening in stable positions before you move on to ones where you may lose your balance (for example, practice squatting to a chair before progressing to exercises like lunges).
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Some women do fine lying on their backs for short periods, but as you grow bigger, you may be more comfortable propped up (for example, doing abdominal exercises on a wedge or an inclined bench).
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Speaking of abdominal exercises, these are generally fine to include if you’re able to control your core muscles so that you do not have large coning during them (mild coning can be normal, especially in the later stages of pregnancy, but if you feel like you cannot control it at all, it may be best to swap out any exercise where it happens).
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Focus on your breath while you exercise. It’s usually not optimal to hold your breath while training during pregnancy as that can cause increased blood pressure and put additional pressure on your pelvic floor.
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Avoid overheating and try to stay hydrated.
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Above all, pay attention to how you feel! Here are some potentially-concerning symptoms to monitor for:
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Feeling dizzy or lightheaded
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Chest pain
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Extreme shortness of breath
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Headache
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Calf pain or swelling
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Painful contractions
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Excess fluid or bleeding from the vagina
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If you experience any of the above, stop exercise and contact your OB or medical provider.
So now that we’ve gotten through general guidelines, let’s go over some specific exercises that may be helpful!
Deep breathing is always my go-to place to start because our breath is so important, especially when preparing for labor. Try this:
(Again, if laying down doesn’t feel good to you, you can be seated or in a reclined position.)
Having a strong core and hips can help a ton to support your growing belly. Here are some of my favorite exercises to help build strength in my pregnant patients:
Finally, the question everybody always asks me. What about my pelvic floor? How many kegels should I do?? Well, this might surprise you, but I would actually say that if you incorporate the above exercises, you may not have to do any kegels! You see, our pelvic floor works together with the rest of the body. Which means that often if we strengthen our core and hips, our pelvic floor strengthens as well.
If you are experiencing specific pelvic symptoms like urinary incontinence, hip/lower back/pelvic pain, or pelvic pressure, I’d urge you to consult with a Pelvic Floor Physical Therapist. There is plenty we can work on during pregnancy to help resolve these issues and help you feel good until your birth!
Sources:
https://oce.ovid.com/article/00006250-201306000-00023/HTML
https://www.acog.org/womens-health/faqs/exercise-during-pregnancy
