Guidelines & Recommendations for Exercise During Pregnancy
CONSULT your doctor before starting or continuing an exercise program. STOP exercising and consult your doctor immediately if any ill effects appear.
It is also very important that pregnant women read Exercise Precautions and Contraindications before starting or continuing and exercise program.
Over the last several years, recommendations for exercise during pregnancy has brewed much controversy. Fifteen years ago the American College of Obstetricians and Gynecologists (ACOG) published guidelines. Some of the recommendations in that report recommended exercise of no longer than 15 minutes, a maternal heart rate not to exceed 140 beats per minute, and a core temperature not to exceed 38oC (100.4oF) (1). These recommendations/guidelines were intended to ensure the safety of the majority of pregnant women but were thought by many to be too conservative for most trained athletes (2).
Then nine years later, the ACOG released another publication with revised guidelines and recommendations on exercise during pregnancy and the postpartum period. Their previous guidelines were eliminated and the guidelines were now modified to say that women who do not have a high-risk pregnancy "can exercise moderately to maintain cardiorespiratory and muscular fitness throughout pregnancy and the postpartum period." (2).
So not only is exercise safe during pregnancy, but it is now recommended in most cases (3). As long the exercise program that the pregnant woman is undertaking follows the appropriate guidelines and her doctor approves her program, she should be able to safely exercise right up to a few days before birth.
To view the 1994 American College of Obstetricians and Gynecologists (ACOG) guidelines for exercise in pregnancy just click here.
The ACOG guidelines are very general and are now a few years old, so additional guidelines and recommendations follow on this page in addition to the ACOG information.
Additional Guidelines and Recommendations:
Those women who have previously been exercising will most often want to continue and will do so. Pregnancy also provides an opportunity for previously sedentary women to make some positive lifestyle choices, one of which, might involve the inclusion of an exercise program into their lives.
For previously sedentary women:
The second trimester is the best time to start a new program
Avoid strenuous activity during the first trimester - poses the risk of overheating the baby at a critical time in its development (6)
Because of the potential risk of injury to joints, a jogging program should not be initiated at this time (3)
For previously active women:
In absence of obstetric or medical complications, most active women can continue to exercise at close to pre-pregnancy levels (3)
While most habitual runners can continue to participate until late in pregnancy, those who are just trying to maintain fitness (as opposed to competitive runners) are definitely advised to reduce the duration of their runs to under 45 minutes (3)
Previously weight training during pregnancy was unheard of. Now, many women continue to perform their weight training programs but should be instructed how to do so safely by their doctor. In all weight training exercises, use lower resistance than would be used in a non-pregnant state (3)
General Guidelines and Recommendations(2,3,4,5,6):
Avoid exercise in hot, humid, conditions to prevent fetal hyperthermia
Clothing worn during exercise should allow for adequate ventilation
Drink water before, during and after exercise to prevent dehydration
Supine exercises should be avoided especially after the fourth month - can compromise blood flow to the fetus
Exercises that require repetitive bouncing and jerky movements should be avoided, especially in the third trimester
Participation in competitive team sports is acceptable in the first 15 weeks of pregnancy if the woman understands that there are potential but unproven risks for fetal loss, from pelvic trauma, abdominal trauma, or both.
Exercises requiring significant use of Valsalva maneuver (holding one's breath), such as weight lifting, should be avoided especially in the third trimester
Do not increase the intensity of your program in the third trimester of pregnancy since growing fetal demands are greatest
Exercise sessions for recreational athletes should be limited to 45 minutes
If weight training, exhale on muscular contraction and inhale during muscle relaxation
Using a small fan while using an exercise cycle will help facilitate with heat dissipation
Ballistic stretching (bouncing) should be avoided at all times as this type of activity can injure muscle and connective tissue
Avoid deep flexion or hyperextension of joints
Avoid any stretches involving forward flexion of the spine
Cardiovascular activity should be familiar and not too skill dependent
Avoid activity where balance is required
Points of Interest
In a epidemiology study conducted by the Missouri Department of Health, 2,828 women who had recently given birth were surveyed on several topics regarding their pregnancy. The study determined that the mother's level of exercise, the number of hours she worked, and the specific activities she undertook while pregnant, did not increase the risk of fetal loss or low birth birth weight (2).
In most cases, a moderate exercise schedule is recommended during pregnancy. However, some highly conditioned women appear able to train safely at considerably more strenuous levels. A recent study found that a rigorous exercise program continued nearly to full term had no adverse effects on fetal growth. The study involved 42 well-trained women, some competing at the national level and others at the international level, who followed exercise programs that included strength training, interval training, and endurance training 6 days a week. There was a "high-intensity" group whose programs called for two 2.5 hour endurance training sessions per week and a "moderate" group group whose sessions lasted 1.5 hours. Most women continued to exercise to within 4 days of labor and there was no significant difference in mean birth weights between the moderate- and high-intensity exercise groups and the weights were within or higher than birth-weight ranges among healthy women recorded elsewhere. It should also be noted that neither the rate of complications nor any other indices of pregnancy outcome were adversely affected. Competitive athletes will most often experience a decrease in their performance during pregnancy (3)
References
1. American College of Obstetricians and Gynecologists. (1985). ACOG Home Exercise Programs: Exercise During Pregnancy and the
Postnatal Period. Washington: Author.
2. Araujo, D. (1997). Expecting Questions About Exercise and Pregnancy? The Physician and Sportsmedicine, 25 (4).
3. Artal, R. & Sherman, C. (1999). Exercise During Pregnancy. The Physician and Sportsmedicine, 27 (8).
4. Brooks, D. (1992, June). Exercise Program For A Pregnant Woman. IDEA Magazine. IDEA Resource Series: San Diego
5. Buxton, B. (1994, November). Prenatal Execise: How to care for your baby and yourself. Chatelaine, pp. 36.
6. Kochan-Vintinner, A. (1999) Active Living During Pregnancy: Physical Activity Guidelines for Mother and Baby. Ottawa: Canadian
Society for Exercise Physiology.
(Nutrition) (Exercise on your Body) (Effects of Pregnancy) (Exercise Guidelines)
(Precautions & Contraindication) (Benefits of Exercise) (Exercise Programs) (Perinatal Dangers)
(Hints for Around the House) (Tips for Fitness Instructors)