Fit Pregnancy

December 5, 2020

Physical activity improves cardiorespiratory fitness, decreases risk of obesity and associated disease, and increases longevity. It is important in all stages of life, including or potentially most importantly during pregnancy. My baby boy turned ONE last month and with the celebration of his life I found myself reflecting on pregnancy. Given that it was my third pregnancy, I felt more prepared. I had a better handle on what I could eat and drink, the changes my body would go through and most importantly what I was still capable of doing while carrying a child. 

However, I once also had all those jitters that newly pregnant women have. I found myself nervous about pushing my body too hard during exercise, concerned that I would harm my child and had no idea how much I could exercise? I had all the questions that I hope to address here. I was no pregnant marathoner, but did feel like I maintained my fitness, had relatively easy labor and decreased some pregnancy related symptoms by staying active. I was able to complete a triathlon and a bike race during my pregnancies. No PRs for sure, but I was able to push myself and still do things I loved.

Pregnant women experience more fatigue, especially during the first trimester (I used to liken it to waking up feeling like I had already run a marathon.) However, pregnancy is not an illness and should not be an excuse to spend nine months on the couch. Women all over the world work, often doing manual labor, up until delivery. Physical activity during pregnancy has minimal risk and is beneficial to most women. Regular physical activity during pregnancy improves mood1, helps with weight management, maintains physical fitness and decreases risk of gestational diabetes and preeclampsia. However, questions I often hear (and once asked myself) are: How much exercise should I be doing? What kinds of exercises are safe? What are my limitations?

Fit Pregnancy

How Much Should You Exercise While Pregnant?

The American College of Obstetrics and Gynecology recommends 150 minutes of moderate to vigorous intensity aerobic exercise a week for women with uncomplicated pregnancies, equating to 20-30 minutes daily.2 If you are an athlete or exercising regularly prior to pregnancy, those pre-pregnancy activities and intensity levels can be continued. Modifications due to anatomic and physiologic change will likely be needed and effort will potentially be less as pregnancy progresses. It would be wise for those who do not exercise to get into a routine prior to becoming pregnant, but if already pregnant, starting an exercise routine with gradual increase in intensity has benefits for both mom and baby. 

Personally, I found that it was really hard to motivate myself to exercise during the first trimester of each pregnancy. When I finally got out the door and moving, however, I noticed remarkable benefits – my energy increased post-workout and nausea decreased. My motivation to move was that post-work out nausea-free, heightened energy state so I kept pushing myself through that initial fatigue. 

What Kind of Exercises Can You Do?

Exercises that are safe to perform while pregnant include:

  • Walking
  • Running
  • Stationary cycling
  • Swimming
  • Yoga, but avoid hot yoga
  • Pilates
  • Strength training
  • Low impact aerobics

This is a limited list but the idea is to choose an activity with low impact and low risk of injury.

What Are Your Limitations When Exercising?

High impact exercises should be avoided during pregnancy due to concern of destabilizing the placenta. These include sports with higher risk of falls or abdominal blows such as:

  • Contact sports like hockey, boxing, soccer and basketball
  • Activities with high risk of falling such as downhill snow skiing, water skiing, surfing, mountain biking, horseback riding
  • Scuba diving
  • Sky diving (yes, I had a friend get turned away for trying)

You also want to limit core strengthening exercises like crunches and sit ups while pregnant as hardening of the abdominus muscles during pregnancy can result in diastasis recti, a separation of the rectus abdominal muscles. 

There are additional limitations for those who have specific obstetric or medical diagnoses so check with your OB prior to beginning an exercise plan if you have a complicated pregnancy.

Physical activity carries special importance during pregnancy. It helps with psychological well-being and energy levels during pregnancy, decreases need for C-section, improves labor, and decreases recovery time post-partum. It is sometimes necessary to push through some initial fatigue but listen to your body and modify exercises as needed.  Regardless of activity, stay well hydrated to compensate for your expanded blood volume and most importantly, have fun! Choose activities and sports that excite you, get outdoors and include a friend. 

1J Sports Med Phys Fitness. 2007 Mar;47(1):103-11.

2Obstet Gynecol. 2015 Dec;126(6):e135-42. doi: 10.1097/AOG.0000000000001214.

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Mary Brittain Blankenship, MD, FAIHM

Dr. Blankenship

Mary Brittain Blankenship, is the founder and physician at Spruce MD Integrative Medicine. Board certified in both Internal Medicine and Integrative Medicine, she sees patients locally at her practice in Greenville, SC and virtually nationwide.

Registered Dietician

Integrative and Functional Medicine Providers