During pregnancy your body experiences dramatic physiological changes that require a carefully designed exercise program. These naturally occurring changes are not permanent, and the benefits of regular exercise are many. Always check with your health care provider for any limitations on your activity before attempting any exercises.

Benefits of exercise during pregnancy

• Improved posture and appearance
• Relief of back pain
• Stronger muscles in preparation for labor and support for loosened joints
• Improved circulation
• Increased flexibility
• Increased/maintained aerobic endurance
• Increased energy level and less fatigue
• Decreased muscle tension that promotes relaxation
• Promotion of feelings of well-being and a positive self-image

Guidelines and precautions for prenatal exercise programs

• Occasionally, exercise may stimulate uterine activity or cause other possible problems. Before beginning the exercises, review the precautions about premature labor. (See section on Premature labor.)
• Always maintain correct posture by tilting your pelvis and straightening your back.
• Monitor your breathing and maintain the ability to walk and talk comfortably while exercising. Stop exercising when tired and do not exercise to exhaustion.
• Exercise should be done regularly three times per week. During pregnancy, aerobic exercises should not exceed five times per week in so your body can recover and rest properly.
• Avoid any type of exercise that may potentially cause even mild abdominal trauma.
• Avoid rigorous bouncing.
• Avoid arching your back.
• Do not bring your feet over your hips, (e.g., candlestick or bicycling in- air position).
• Do not do sit-ups past 45 degrees.
• Breathe continually while exercising; do not hold your breath. In general, exhale on exertion.
Check separation of the abdominal muscles each week and take necessary precautions if indicated. (See section on Abdominal muscles.)
• Drink a lot of fluids before, during and after exercising to prevent dehydration.
• Avoid activities that require precise balance and coordination. As your pregnancy progresses, your coordination may be altered by your increasing weight, shifting center of gravity, and softening and increased mobility of your joints and ligaments.
• Muscles that are used in aerobic activity should be appropriately stretched before and after the exercising.
• Decrease your exercise level as your pregnancy progresses. Your increased body weight will require a larger energy output, so you will feel more tired. If you feel tired, reduce your exercise level and switch to simple stretching/strengthening exercises. Check with your health care provider.
• In general, continue doing any activity you enjoyed before you became pregnant as long as it feels comfortable. If you want to begin a new aerobic program, consult your health care provider or try a program with a trained professional.
• Consider using an approved pregnancy exercise video that follows the American College of Obstetricians and Gynecologists (ACOG ) guidelines to work out at home.
  

How much exercise should I do?

Exercise programs during pregnancy should be directed toward muscle strengthening to minimize the risk of joint and ligament injuries.

Frequency

• Daily: stretching, strengthening, Kegels, relaxation
• Three times a week: low or non-impact aerobic activity, such as swimming or cycling, with appropriate warm-up and cool-down
• Once a week: check for separation of abdominal muscles (See section on Abdominal muscles).

Intensity/duration
Stretching/strengthening:

• Work up to 5 to 10 repetitions per day.
• Hold each position or stretch for 20 to 30 seconds.
• Do not stretch to extreme discomfort as joints are looser during pregnancy.

Aerobic activity:

• Do not exercise beyond the point of moderately heavy perspiration.
• Sustain aerobic activity for 15 to 20 minutes as long as you are able to talk comfortably and are not short of breath.

Aerobic activity during pregnancy

Aerobic exercise can cause your body temperature to rise as your metabolism increases to provide energy. It is important for pregnant women to exercise but not to a point of increased body temperature. The constant movement of both arms and legs typical of most aerobic exercise programs provides a workout that can reach high levels of intensity. It is therefore important to participate in an aerobics program where the instructor is knowledgeable of the special needs of pregnancy and can adjust the exercise accordingly. Low or non-impact aerobics, swimming or cycling are recommended.

Benefits of walking
A good activity to begin during pregnancy is a walking program, three to five days per week. Walking is an inexpensive form of exercise, as the only requirements are a suitable pair of shoes and comfortable clothing. Also, it is an activity that can be readily integrated into daily schedules. During pregnancy, you can improve your aerobic fitness by walking on level ground at a comfortable pace. However, it may be necessary to use modified forms of walking to gain significant benefits. Walking at increased speeds, walking up and down hills, and walking while carrying weights can raise the heart rate to levels that will improve aerobic fitness.

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