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Your UCP: National August 25, 2003
Sports & Leisure

Exercise & Fitness

Exercising During Pregnancy

Exercise during pregnancy has many benefits. Strict guidelines have been established to lead pregnant women through safe and effective exercise programs. Below you will find the guidelines and key points. Enjoy yourself and remember to always listen to your body, as you are exercising for two.

BENEFITS OF EXERCISE
Increased sense of well-being. Fewer leg cramps. Lower weight gain. Larger placenta (the nutritional base for the baby). May assist pregnant women with stress incontinence. Relief of musculoskeletal irritants, constipation, swollen extremities, and fatigue. Studies show that women who exercise are less likely to require epidural analgesia and have fewer operative births. Shorter labor and easier delivery (for some people).

PRELIMINARY STEPS TO EXERCISE
Obtain physician consent. Make sure you have good shoes, as feet usually swell and increase by half a size.

NORMAL PHYSIOLOGICAL RESPONSES TO EXERCISE
Rise in heart rate and breathing rate. Rise in body temperature; maternal temperature should never rise above 102 degrees Fahrenheit.

GENERAL EXERCISE RECOMMENDATIONS

  • If you have never exercised before pregnancy, start slowly and gradually build up. Individualized programs with lower intensity exercise is recommended.
  • If you were exercising before pregnancy, then the goal should be to maintain your current exercise program with a few adaptations.
  • Gaining weight is good.
  • Medical supervision is recommended when exercising. Avoid contact sports.
  • Avoid exercise in which loss of balance could occur: rocky terrain, unstable ground.
  • Avoid exercise in extremely hot weather.
  • Wear appropriate clothing.
  • Avoid high intensity exercise.
  • Always warm-up and cool-down.
  • Communication with professionals is key.
  • Listen to your body.

RECOMMENDED TYPES OF EXERCISE
Specialized pre-natal exercise classes. The instructors are trained to monitor your response to exercise and can share important knowledge. Floor work. Cardiovascular training, particularly low impact aerobics. Strength and endurance training.

RECOMMENDATIONS FOR EXERCISE IN PREGNANCY AND POSTPARTUM (American College of Obstetricians and Gynecologists)
There are no data in humans to indicate that pregnant women should limit exercise intensity and lower target heart rates because of potential adverse effects. For women who do not have any additional risk factors for adverse maternal or perinatal outcome, the following recommendations may be made: During pregnancy, woman can continue to exercise and derive health benefits even from mild-to-moderate exercise routines. Regular exercise (at least three times per week) is preferable to intermittent activity. Women should avoid exercise in the supine position after the first trimester. Such a position is associated with decreased cardiac output in most pregnant women; because the remaining cardiac output will be preferentially distributed away from splanchnic beds (including the uterus) during vigorous exercise, such regimes are best avoided during pregnancy. Prolonged periods of motionless standing should also be avoided. Women should be aware of the decreased oxygen available for aerobic exercise during pregnancy. They should be encouraged to modify the intensity of their exercise according to maternal symptoms. Pregnant women should stop exercising when fatigued and not exercise to exhaustion. Weight-bearing exercises may, under some circumstances, be continued at intensities similar to those prior to pregnancy throughout pregnancy. Morphologic changes in pregnancy should serve as a relative contraindication to types of exercise in which loss of balance could be detrimental to maternal or fetal well-being, especially in the third trimester. Further, any type of exercise involving the potential for even mild abdominal trauma should be avoided. Pregnancy requires an additional 300 kcals per day in order to maintain metabolic homeostasis. Thus, women who exercise during pregnancy should be particularly careful to ensure an adequate diet. Pregnant women who exercise in the first trimester should augment heat dissipation by ensuring adequate hydration, appropriate clothing, and optimal environmental surroundings during exercise. Many of the physiologic and morphologic changes of pregnancy persist 4-6 weeks postpartum. Thus, prepregnancy exercise routines should be resumed gradually based on a woman’s physical capability.

Contraindications to Exercise
The aforementioned recommendations are intended for women who do not have any additional risk factors for adverse maternal or perinatal outcome. A number of medical or obstetric conditions may lead the obstetrician to recommend modifications of these principles The following conditions should be considered contraindications to exercise during pregnancy: Pregnancy-induced hypertension Preterm rupture of membranes Preterm labor during the prior or current pregnancy or both Persistent second– or third–trimester bleeding Intrauterine growth retardation

In addition, women with certain other medical or obstetric conditions, including chronic hypertension or active thyroid, cardiac, vascular or pulmonary disease, should be evaluated carefully in order to determine whether an exercise program is appropriate.

American College of Obstetricians and Gynecologists. Exercise During Pregnancy and the Postpartum Period (Technical Bulletin No. 189), Washington, DC, © February, 1994.

ADDITIONAL RECOMMENDATIONS
A women should always check her working heart rate during peak levels of activity. Avoid extreme movements of joint flexion and extension, examples are deep knee bends. When weight training, work on improving muscle definition (tone). Avoid prolonged periods of motionless standing.

FOR MORE INFORMATION
American College of Obstetricians and Gynecologists (ACOG), offer a pamphlet on exercise and pregnancy. Call 1-800-762-2264 to order or check out their Web site

Maternity Exercise Clothing by Mothers in Motion

Cotton, R.T., and Goldstein, R.L. (Ed.) (1997). Aerobics Instructor Manual: The Resource for Group Fitness Instructors. San Diego: American Council on Exercise

More information on this and related topics may be available in the NCPAD Citation Database. Try searching with keywords: pregnancy, etc.

Source: NCPAD

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