How to Exercise Safely During Pregnancy

This is an excerpt from an article I wrote with Drs. Lamikanra and Halim on “Female Athletes: Unique Challenges Facing Women Warriors” published in The American Journal of Orthopedics in January 2016.

pregnancy exercise

Women in sports can typically continue their athletic regimens during pregnancy.  It is advantageous to do so if medically warranted for both physical and mental health!   I am always the first to encourage staying active, but it is important to be well-informed on the science behind exercise in pregnancy. It is always recommended to check with your obstetrician before starting any exercise while pregnant.

Changes in the body that occur during pregnancy can affect how your body responds to the stresses of exercise. More blood is circulating through the body, the heart has to be stronger and push that blood through the body and your cells that move iron around get bigger. The unborn baby can experience a slower heart rate. So, it is important to carefully monitor your exercise intensity.

The American College of Obstetrics and Gynecology recommends to maintain less than 70% of maximal heart rate during exercise while pregnant.

It can be tough to deal with the hormonal change in pregnancy. One physiologic change that occurs during pregnancy is ligamentous laxity, which is caused by the hormone relaxin. Ligamentous laxity has the potential to put pregnant athletes at risk for soft-tissue and bony injury during impact sports. However, the positive effects of exercise during pregnancy include improved appetite, sleep, and emotional health. Aerobic exercise during pregnancy may reverse insulin resistance as demonstrated in animal studies; though this outcome has not been demonstrated in human studies, women should be reassured that moderate exercise has overall beneficial effects.

Pregnant women should keep their exercise routines to less than 60 minutes, should exercise in a thermally regulated environment, and should keep themselves hydrated to avoid to much heat being experienced by the unborn baby.

During third trimester, women should avoid supine exercise, as blood flow from veins is poor with the body in that position.

READ MORE:5 Easy Ways to Stay Lean and Toned

Elite athletes who continue training during pregnancy should be carefully counseled about adjusting their training regimens. Because of increased cardiac output and blood volume, the heart rate will be lower than usual, demanding an adjustment in interpretation. Blood cell counts do not increase as much as plasma volume does—often leading to relative anemia. For elite athletes, this means iron supplementation is crucial. Thermal regulation may be more difficult, as training regimens may demand prolonged exercise. Physicians should recommend adequate hydration for these athletes.

Although continued exercise is generally safe for a pregnant athlete and her unborn baby, caution is required when there is increased risk for premature delivery, or other special conditions exist. Multiple gestation, placenta previa, history of early labor or premature births, and incompetent cervix all may contraindicate aerobic exercise during pregnancy. With these exceptions in mind, physicians can safely counsel pregnant women to do moderate exercise 30 minutes every day. Other recommendations are listed at the American College of Obstetricians and Gynecologists website. 

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