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Exercise Dos And Don’ts For Expecting Mothers

  • By Dana Reid, DPT
  • Published Jul. 9, 2013
Marathoners Kara Goucher (left) and Paula Radcliffe stayed active and ran through most of their respective pregnancies. Photo: PhotoRun.net

Maintaining a healthy lifestyle during pregnancy is good for both mom and baby.

There remains much confusion and fear regarding the safety of exercise during pregnancy.  Recently, the medical research has begun to show the benefits of maternal exercise to both mother and fetus.

Some potential health benefits include: reduction in weight gain, release of mood elevating chemicals, decreased musculoskeletal pain, reduction of edema, lower risk of gestational diabetes/hypertension and perhaps an easier delivery.  Benefits to the fetus include: decreased fat mass, increased tolerance to stress, and positive cardiovascular adaptations.

The following are anatomical and physiological changes that occur during the course of pregnancy which may affect the type and/or intensity of exercise:

1) Increased resting heart rate and blood volume, as well as decreased maximal heart rate. As a result, the aerobic zone will be reached with less effort than is typical.  Additionally, heart rate is not an accurate measure of effort.  Using the walk-talk test is a simple way to ensure remaining in the aerobic zone. You should be able to say a short sentence or about half of a long sentence before taking a breath.  If you can talk longer than this, it is time to pick up the pace; if less than this, slow down! This will keep you in the cardiovascular conditioning zone, which is typically thought to be safer.

2) Lower tolerance to heat. It is important to maintain a stable core temperature during pregnancy.  This is perhaps one of the biggest fears regarding pregnancy and exercise.  The old adage is, “You don’t want to cook the baby”.   The body is an amazing thing, however, and adapts quickly to maintain a safe environment for the developing baby.  When pregnant, women sweat faster and often more profusely to maintain core temperature.  This creates some interesting challenges for exercise.  First, it creates the need to increase hydration during exercise.  In warmer climates and seasons, it may also mean that women should seek indoor or aquatic options for exercise to assist in remaining cool.

4) Increased caloric need. While there is a need to take in more calories, it is a fallacy to think of eating for two.  The increased caloric need during pregnancy is a mere 200-300 calories per day.  In general, a healthy weight gain for a woman of normal weight is 25-35 pounds.  Typically, physicians will recommend for thin women to gain a bit more and overweight women to gain less weight.  Remember that during exercise this means you do not need to consume twice what you normally would for the same workout!

5) Increased lumbar lordosis – more curvature in the low back. This occurs to maintain postural stability.  The largest impact of this physical change is related to low back and pelvic pain.  Just because this change is a normal part of pregnancy does not mean a woman has to accept pain.  Exercise, even mild to moderate exercise, can improve strength and fitness, while decreasing pain.  Land-based exercises may become challenging or painful, but often, aquatic exercise is the answer and can be a fun change of pace.

6) Flattening of the feet. While a seemingly small issue, women are self-conscious about their feet.  Women will often continue to wear shoes that are too small because they don’t want to go a larger size.  This can cause a cascade of other pains.  Think of the foot as your platform.  If it does not give you a solid base, everything else on top of the platform will suffer.

When undertaking any new exercise program, it is important to be mindful of your body and listen to what it tells you.  Pain is never acceptable.  If abdominal pain, cramping, or spotting/bleeding is experienced, it is time to go to your physician.

General Things TO Do:

1)   Aerobic exercise is a wonderful way to maintain a healthy lifestyle during pregnancy.  Walking, running, stationary cycling, swimming and more can be great options!

2)   Pregnancy is not the time to take up a new sport!  The recommendations regarding cycling, downhill skiing, long distance running, etc. are only such that you exercise in a manner to which you are already accustomed.  Regardless of pregnancy status, crashing is not good for the body!

3)   Light, resistive exercise can be good for overall muscle strength and help prevent pain.  Consider resistive elastic bands or light weight on machines or light free weights.  Keep the weight light enough to perform 2 sets of 20-30 repetitions.

4)   Respect your body and changes in tolerance to exercise.  An elite marathoner may be able to maintain a higher level of exercise than the weekend warrior, but both women can be healthy throughout their pregnancy.

5)   Do consult your physician for individual considerations and concerns.

General Things NOT To Do:

1)   Avoid impact sports (especially if they are new). You want to provide a level of safety to the developing baby.

2)   Do not push through pain, especially abdominal or pelvic pain.

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About The Author:

Dana Reid is an avid endurance athlete and Doctor of Physical Therapy in Hood River, Oregon.

Sources:

1) Wolfe LA, Weissgerber TL. Clinical physiology of exercise in pregnancy: a literature review. Obstet Gynaecol Can. 2003 Jun;25(6):451-3.

2) May LE, Suminski RR, Langaker MD, Yeh HW, Gustafson KM. Regular Maternal Exercise Dose and Fetal Heart Outcome. Med Sci Sports Exerc. 2012 Jan 3.

3) Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010 Jun 1;40(6):493-507.

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