Exercise in Pregnancy, How Much and What Kind?

In most cases, exercising during pregnancy is safe and even recommended. Women who were physically active before becoming pregnant can generally continue to be active – though perhaps not at the same level – as long as it is comfortable and there are no complicating factors. Those who did not exercise regularly before pregnancy are generally advised by their healthcare provider to begin a program of moderate exercise. "Regular exercise is beneficial for expectant mothers," says obstetrician-gynecologist Dr. John Thoppil. "It can reduce the effects of some of the common discomforts of pregnancy, such as backache and fatigue, it can improve energy and mood, and it can help build the stamina needed for labor and delivery."

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Which exercises are best during pregnancy?
The safest exercises for pregnant women are those that have the least risk of injury, involve the entire body, and are easy on the joints and muscles. Good choices include brisk walking, swimming and water workouts, stationary cycling, low-impact aerobics, and yoga and Pilates that have been modified for pregnant women. Women who are experienced joggers or racket-sports players may be able to continue those activities with medical approval.

Which activities should be avoided?
Activities that increase the risk of injury include those most likely to cause a fall, such as snow or water skiing, surfing, horseback riding, and gymnastics; contact sports, such as softball, basketball, and volleyball; and any exercise that includes jarring motions, rapid changes in direction, or extensive jumping, hopping, or bouncing. "Changes to the body during pregnancy must be taken into account in choosing exercises," says Dr. Thoppil. "For example, your center of gravity changes, particularly late in pregnancy, affecting balance and making falling more likely; that's why stationary cycling is safer than a standard bicycle. Also, pregnancy hormones make the joints more flexible and subject to injury, which explains why sudden movements and high-impact motion are best avoided."

How much exercise is recommended for pregnant women?
The Centers for Disease Control and Prevention recommend 150 minutes of moderate-intensity aerobic activity every week, which could be 30 minutes all at once five days a week or broken up into smaller increments during the day. Those who are new to exercise should start with as little as five minutes a day and add five minutes each week, working up to 30 minutes of sustained activity.

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When should exercise be avoided or stopped?
Exercise may be inadvisable for women with certain medical conditions, such as heart disease or asthma, or for those with high-risk pregnancies due to a history of miscarriage, pre-term labor, or cervical insufficiency. Exercise should be stopped and a doctor consulted in the presence of warning signs such as dizziness or feeling faint, rapid or irregular heartbeat, chest or abdominal pain, vaginal bleeding or fluid leakage, muscle weakness, or any unusual or sudden physical irregularity.

Tips for exercising during pregnancy
Dr. Thoppil recommends these precautions and guidelines:

"Staying active during pregnancy is important and beneficial," says Dr. Thoppil. "Exercise strengthens the muscles, conditions the entire body, helps to maintain health, and keeps the pregnant woman feeling her best. Staying fit will help the expectant mother give her child the best opportunity for a healthy start in life."

Bio: John Thoppil, MD, leads River Place Obstetrics and Gynecology in Austin, Texas. A board-certified obstetrician-gynecologist and a Fellow of the American College of Obstetricians and Gynecologists, Dr. Thoppil also is an assistant professor at Texas A&M University College of Medicine and the president elect of the Texas Association of Obstetricians and Gynecologists. http://www.riverplaceobg.com

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