MSK: Exercise and Pregnancy

Exercise Safety During Pregnancy

Goodpath’s exercise therapy for pregnant women considers the body changes of pregnancy as well as the appropriate safety precautions. 

Exercise is generally low-risk during pregnancy.  In fact, exercise has many clear benefits.

Women have fewer Cesarean births (C-sections) and preterm births, less gestational diabetes (diabetes of pregnancy), gestational hypertension (high blood pressure of pregnancy), etc.

It’s best to talk with your doctor about your current activity level before you start any new exercise program. 

The American College of Obstetrics and Gynecology (ACOG) states “in the absence of obstetric or medical complications or contraindications, physical activity in pregnancy is safe and desirable, and pregnant women should be encouraged to continue or to initiate safe physical activities.” Organizations in other countries have similar guidelines.

Unsafe Exercise

It is unsafe to exercise during pregnancy if you have any of the following medical problems or pregnancy complications:

  • Certain heart or lung conditions

  • Very low level of red blood cells (anemia)

  • Procedure to close cervix to prevent preterm birth (cervical cerclage) 

  • Preterm labor with or without ruptured membrane

  • Multiple gestation (more than one fetus) with risk factors for preterm labor

  • Placenta previa (placenta covering part of cervix) after 26 weeks

  • Preeclampsia (high blood pressure related to pregnancy)

Certain types of exercise may not be safe due to the risk of injury. For example, contact sports like basketball or soccer, skiing, and horseback riding. 

Your Pregnant Body and Exercise

Some of the body changes associated with pregnancy may impact exercise. Some considerations:

  • Extra body weight (It may affect your exercise routine, however, exercise helps to prevent excessive weight gain).

  • Increased stress on joints and muscles, especially in your lower belly (pelvis) and lower back

  • Looser joints and ligaments due to pregnancy hormones. 

  • Change in your center of gravity affects your balance.

  • Increased oxygen requirements may impact your ability to participate in strenuous types of exercise.

The Basics of Safe and Effective Exercise during Pregnancy

How can I get the most benefit from exercise and still be safe?

When can I start and when should I end? You can start during the first 12 weeks and exercise until you deliver. 

How long should I exercise each time and how many times a week?  You may exercise for 30-60 minutes, 3 to 4 times a week or more, for the most benefit.

How intense should my exercise be? Your exercise can be moderately intense. Examples of moderately intense exercises are included below - see aerobic exercise).  Women who regularly engage in very intense aerobic exercise before pregnancy can usually continue during pregnancy.

Safe Exercises

The following are some of the types of exercise that are good choices. They are considered to be safe during  pregnancy

  • Stretching exercises. Note: Gently stretching loose joints and ligaments can help prevent injuries.

  • Strengthening or resistance training with weights or special elastic bands. Note: Low back pain and discomfort are common in pregnancy. Exercises that strengthen your belly (abdominal) and back muscles help to lessen the risk of low back pain.

  • Aerobic exercise (e.g. brisk walking, gardening, water aerobics, jogging, swimming, riding a stationary bicycle)

  • Yoga and pilates (except hot yoga/hot pilates)

Dos and Don’ts

The following are important dos and don’ts:

Do Stay Cool 

Drink water before, during, and after exercise. Wear loose, comfortable clothing. Make sure any indoor environment is cool and exercise indoors if it’s hot and humid outside.

Don’t Lie on Your Back

Avoid lying on your back while exercising. Due to the increasing weight of your uterus, it may cause low blood pressure.

Do Wear a Supportive Bra

A well-fitting bra will help support your breasts as they change in preparation for breastfeeding. Note: You may need to increase your bra size.

Cautions While Exercising

You should not begin to exercise and you should stop if you have any of these symptoms. Make sure to contact your doctor. They include: 

  • Vaginal bleeding

  • Leaking of fluid from the vagina

  • Uterine contractions

And:

  • Dizziness, feeling lightheaded, weakness

  • Shortness of breath

  • Chest pain

  • Headache

  • Pain or swelling in your lower legs

Selected Exercises

You received exercise videos to follow as part of your program. Here are four additional exercises that are very beneficial for pregnant women. They are modified to allow for your body changes. The four exercises are Kegel, Warrior Pose 2, Rows with a resistance band, and modified Plank.

As with any exercise during pregnancy, follow the safety information provided above.

Kegel Exercise

Kegel exercises strengthen your pelvic floor muscles. These are the muscles that support your lower abdomen and the organs located there - your bladder, vagina, uterus, and rectum. 

You can perform Kegel exercises at any time and in various positions. The following is one method.

Steps:

  1. Lie on the floor with your knees bent and slightly apart, feet flat on the floor, and arms by your sides.

  2. Raise your lower back and buttock off of the floor while squeezing your pelvic floor muscles like you're holding in urine. You should feel the muscles tightening.

  3. Hold for 3 to 5 seconds. Release and slowly lower your back to the floor.

  4. Repeat 10 times.

Warrior Pose 2

Warrior Pose 2, a common yoga position, stretches your chest and shoulders, stretches and strengthens your core (belly [abdomen] and lower back), and legs. It also helps with balance. 

Note: You can do this pose using a chair to help you balance.

Steps:

  1. Stand with your feet wide apart.

  2. Turn your left foot to the side at 90 degrees.

  3. Breathe in and raise your arms so they’re parallel to the floor.

  4. Breathe out and bend your right knee. Make sure it doesn’t extend past your ankle.

  5. Keep your back straight and turn your head. Focus your gaze past your fingertips.

  6. Breathe in while you straighten your legs and lower your arms.

  7. Repeat on the other side with your right foot to the side and left knee bent.

  8. Repeat on both sides 2 times for 15-second holds.

Rows with Resistance Bands

Rows with resistance bands help stretch and strengthen your upper back, shoulders, and arms. 

  1. Sit on the floor with your legs in front of you. 

  2. Place the resistance band around your feet, holding both ends.

  3. With your knees bent, pull back on the band. Keep your lower arms parallel to the floor. You’ll feel a stretch in your upper back and shoulders.

  4. Slowly release the tension on the band.

  5. Repeat for 2 sets of 10 repetitions.

Wall Squats

Wall squats help strengthen your abdominal muscles, as well as your glutes and thigh muscles.

  1. Lean against a wall. 

  2. Bend your knees, sliding your back down the wall.

  3. Your knees should not extend beyond your toes.

  4. Hold for 1 second and slide back to the starting position.

  5. Repeat 2 sets of 10 repetitions (“reps”).

Although there are some pregnancy-related considerations, exercise helps to keep you healthy and prevent problems. In addition to the four exercises above, please see the exercise videos that are part of your program.

If you have any questions or concerns, talk with your Goodpath coach or your doctor.