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Exercise in Pregnancy:  Too Much, or Not Enough?

7/10/2018

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How much exercise is recommended during pregnancy?
Believe it or not, the American Congress of Obstetricians and Gynecologists (ACOG) still recommends 30 minutes of activity and exercise on most, if not all, days of the week. Why is staying active important? In addition to helping with mood, energy, posture and overall health, exercise also helps to improve sleep quality (best to take advantage now, before your baby gets here). It can also prevent/treat gestational diabetes and can improve back pain, bloating and constipation.

How do pregnancy-related changes in the body affect my exercise routine?
One of the biggest changes is related to hormonal changes that relax the ligaments supporting the joints. This increase in joint mobility may cause a slight increase in the risk of injury. Also, as the baby grows, the extra weight in the front of the body can affect balance, which can make you more likely to fall as your pregnancy progresses. This change in the center of balance is one of the causes of back pain later in pregnancy.

What kind of exercise is safe in pregnancy?
Studies have shown the baby tolerates 30 minutes of even strenuous activity as performed by both active and generally inactive mothers-to-be.  Walking, swimming, aerobics and cycling are all safe during pregnancy, although outdoor cycling should be avoided if you are unfamiliar with the balance necessary to avoid falling. If you were running prior to pregnancy, you can often continue during pregnancy with a few modifications to your regimen. In fact, my mom actually ran all the way into the third trimester while pregnant with me, and she tells me I’m perfect :)

What activities should be avoided?
Apologies to our hockey-playing moms, but contact sports and sports with a high risk of falling such as gymnastics, water skiing and horseback riding should be avoided.  Even more unfortunately, down-hill skiing should generally be avoided not only to reduce the chance of falling but also because of the risk of hypoxia at higher elevations. It is advisable to avoid “hot yoga/pilates” as well.  Lastly, scuba diving should also be deferred until after pregnancy due to concern for decompression sickness that results from pressure changes around the body.

What about strength training?
Lifting and resistance exercise is generally well-tolerated by those who have been participating in strength training prior to pregnancy. As long as the expectant mother understands how pregnancy will affect her body and is able to perform the exercise with safe form, she can often continue her routine while making accommodations as needed.  That being said, lifting that might cause the weights to be dropped on the baby or mom and/or loss of balance should be avoided.

How do I know if I’m doing too much?
We generally advise a target heart rate less than 160 beats per minute.  If you experience regular contractions, vaginal bleeding, rupture of membranes, dizziness and headache, chest pain, trouble breathing BEFORE exercise, muscle weakness affecting balance, and calf pain/swelling.

Generally, speaking activity is well-tolerated by women who are pregnant, and in fact, it should be encouraged for expectant mothers.  However, there are some absolute contraindications to exercise during pregnancy such as heart/lung disease, incompetent cervix/cerclage, twins or higher gestations, persistent vaginal bleeding, abnormal placental implantation, premature labor, ruptured membranes, anemia and pregnancy-induced high blood pressure among others.  To help plan your healthy and active pregnancy, talk to your OBGYN today!

For more information on exercise in pregnancy, check on the link below as a maternal-fetal medicine specialist (high-risk OB) offers further insight.

http://fox13now.com/2016/04/28/this-utah-mom-did-crossfit-until-the-day-before-she-delivered-her-baby/

Dr. Nick
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