How to Exercise During Pregnancy

Pregnant women who exercise regularly not only put on fewer pounds than sedentary counterparts, but regular workouts can regulate glucose levels in their blood - important in reducing the risk of gestational or pregnancy-related diabetes. There's even evidence that exercise during pregnancy yields emotional dividends like a more positive outlook.

Our notions of exercise and the pregnant woman have come full circle. As early as the third century B.C., Anstotle connected difficult births to a sedentary lifestyle. But by the late 18th century, the pendulum began to swing in the other direction, especially in the United States.

And by the time the Victorians came on the scene, a pregnant woman was cautioned against doing much of anything. Even as recently as the 1970s and '80s, doctors took a somewhat conservative view on exercise during pregnancy simply because there wasn't much scientific data on exercise's effects on mother and fetus. But recent scientific data have shown pregnant women aren't suffering any more injuries or injuring their fetuses. Indeed, they can continue to follow their exercise programs if they use "common sense."

Common sense dictates, for example, that women exercise only during the coolest parts of the day - early morning or after sunset - and slow down in the heat. There has been no demonstrated increase in neural tube or other birth defects even in women who exercise vigorously during early pregnancy. Yet, there is no need for women to push too hard during hot weather - or any time, for that matter - particularly during the first 16 weeks of pregnancy.

Pregnancy, after all, not only raises a woman's basal metabolic rate but the amount of heat her body generates. Not only do pregnant women report they have more energy when they work out, physically fit women also bounce back from labor and delivery quicker. Exercise not only makes the postpartum period easier, it can make pregnancy easier too.

While common sense dictates that a rousing game of racquetball or handball isn't in a pregnant woman's - or her fetus' - best interest, other questions about exercising during pregnancy aren't so cut and dry.

How to exercise during pregnancy

• Before you take your first step, swim the first lap or pedal your first mile, be sure to get your doctor's OK. You may have a condition that makes you a poor candidate for working out.

• "Non weight-bearing" activities such as swimming and cycling - not only minimize the risk of injuries, but make it easier for women to continue an exercise program throughout their pregnancies.

However, think twice about any workout that poses a risk of a fall or blow to the abdomen, such as downhill skiing or horseback riding. Additional activities you should refrain yourself from include scuba diving (the gear may restrict circulation, and decompression sickness can harm the fetus), high-altitude mountain climbing (insufficient amounts of oxygen pose risks to the woman and fetus) and water skiing and platform diving (there's a risk of trauma to the abdomen)

• Modify the intensity of your workout according to how you feel. Because pregnant women have less oxygen available to use during exercise, you're more likely to get winded at a lower level of intensity than a woman who's not pregnant. Stop exercising when you're fatigued, and never exercise to the point of exhaustion.

• If you've been sedentary and start an exercise program during pregnancy, don't go overboard. Start with what fitness experts call "low-intensity" activities such as walking or swimming, and build intensity very gradually.

• After the first trimester, avoid exercises that are performed lying on your back. In most pregnant women, this supine position causes the heart to pump less blood. And because the remaining blood will be distributed away from the uterus and nearby organs during vigorous exercise, you should avoid this position when exercising during pregnancy. Women should also avoid standing without moving for long periods of time.

• Pregnancy not only makes your body blossom, it can throw off your balance, especially as your due date approaches. That's because larger breasts and a swelling uterus lead to a shift in the center of gravity for a pregnant woman. Take that into consideration when weighing the pros and cons of a sport that requires balance, such as ice skating.

• Avoid exercising during pregnancy when the outside temperature or humidity is high, or when you have a fever. That's because exercise can raise what doctors call the body's "core temperature" and potentially put the fetus at risk. Women who exercise in the first trimester should take steps to hasten their body's natural cooling process. Drink plenty of water before and during exercise and wear clothing that permits the evaporation of sweat. Don't exercise to exhaustion. And when it's hot outside, exercise during early morning or after sunset, the coolest parts of the day.

• Eat more. Even non-active pregnant women need to eat about 300 extra calories each day, and thus women who exercise during pregnancy should be particularly careful to ensure an adequate diet. If you exercise for an hour at a mild to moderate level, there's an average loss or expenditure of about 300 calories that you must make up.

• You are advised to begin each exercise session or sports activity with a 10 to 15 minute warm-up period that includes large, slow movements such as walking, stationary cycling at low resistance, arm circling or gentle stretching exercises of the neck, trunk, shoulder, hip, calf and hamstring. End each workout with a 10 to 15 minute cool-down session that includes walking around until your heart rate and breathing have returned to normal. Repeat the same gentle muscle stretching that you used during your warm-up.

When to avoid exercise during pregnancy

But even the most physically fit woman cannot exercise if she has certain complications during pregnancy. Avoid exercise if you have any of the following conditions:

• Pregnancy induced high blood pressure
• Pre-term (early) labor during a prior or current pregnancy
• Pre-term rupture of membranes
• Incompetent cervix cerclage
• Intrauterine growth retardation
• Persistent bleeding during the second or third trimester

Women with the following medical conditions should be evaluated by their doctors carefully to determine whether an exercise program during pregnancy is appropriate:

• Chronic blood pressure
• Thyroid disease
• Vascular disease
• Lung disease