Regular exercise during pregnancy can improve health, reduce the risk of excess weight gain and back pain, and it may make delivery easier.
Moderate exercise during pregnancy may give a newborn a healthier start.
A well-chosen exercise program can have the same benefits during pregnancy.
It is important to discuss any changes in exercise habits with a health care provider, to make sure you do the right kind of exercise at the right stage of pregnancy.
Suitable activities during pregnancy are brisk walking, swimming, indoor stationary cycling, prenatal yoga, and low-impact aerobics, guided by a certified aerobics instructor.
Some special exercises can help prepare for labor.
These carry little risk of injury, they benefit the entire body, and they can continue until delivery.
1. Brisk walking
If pre-pregnancy exercise levels were low, a quick stroll around the neighborhood is a good way to start.
This will provide a cardiovascular workout without too much impact on the knees and ankles. It can be done for free, almost anywhere, and at any time during pregnancy.
Safety tip: As pregnancy progresses, your center of gravity changes, and you can lose your sense of balance and coordination.
Choose smooth surfaces, avoid potholes, rocks, and other obstacles, and wear supportive footwear.
Swimming and exercising in water give a better range of motion without putting pressure on the joints. The buoyancy offered by the water may offer some relief from the extra weight.
Swimming, walking in water, and aqua aerobics offer health benefits throughout pregnancy.
Safety tip: Choose a stroke that feels comfortable, and that does not strain or hurt your neck, shoulders, or back muscles, for example, breaststroke. A kickboard can help strengthen the leg and buttock muscles.
- Use the railing for balance when entering the water, to prevent slipping.
- Avoid diving or jumping, as this could impact the abdomen.
- Avoid warm pools, steam rooms, hot tubs, and saunas, to minimize the risk of overheating.
3. Stationary cycling
Cycling on a stationary bike, also called spinning, is normally safe even for first-time exercisers. It helps raise the heart rate without putting too much stress on the joints.
The bike helps support body weight, and, because it is stationary, the risk of falling is low.
Later in pregnancy, a higher handlebar may be more comfortable.
Prenatal yoga classes keep the joints limber and help maintain flexibility.
Yoga strengthens muscles, stimulates blood circulation, and enhances relaxation. These may contribute to a healthy blood pressure during pregnancy.
The techniques learnt in yoga class can also help you to stay calm and in control during labor.
Safety tip: As pregnancy progresses, skip positions that could cause you to overbalance.
From the second semester, it is better to avoid poses that involve lying on the abdomen or flat on the back.
Lying on the back can cause the weight of the fetus and the uterus to put pressure on major veins and arteries and decrease blood flow to the heart.
It can be tempting to overstretch, as the hormone relaxin increases flexibility and joint mobility during pregnancy. Overstretching could lead to injury.
5. Low-impact aerobics
Aerobic exercise strengthens the heart and lungs and helps maintain muscle tone. Low-impact aerobics excludes jumping, high kicks, leaps, or fast running.
In low-impact exercise, one foot should stay on the ground at all times.
Compared with high-impact aerobics, the low-impact option:
- limits stress on the joints
- helps maintain balance
- reduces the risk of weakening the pelvic floor muscles
A weak pelvic floor increases the chances of urine leakage.
Some aerobics classes are designed especially for pregnant women. This can be a good way to meet other pregnant women, as well as exercising with an instructor who is trained to meet your specific needs.
Women who already attend a regular aerobics class should let the instructor know that they are pregnant so they can modify exercises and advise about suitable movements.
6. Preparing for labor: Squatting and pelvic tilts
The American Pregnancy Association recommends some exercises specifically for pregnancy, as they prepare the body for labor and delivery.
Squatting: During labor, squatting may help to open the pelvis, so it may be a good idea to practice during pregnancy.
- Stand with the feet flat on the floor, shoulder-width apart, and the back straight.
- Lower yourself slowly, keeping your feet flat and your knees no further forward than your feet.
- Hold for 10 to 30 seconds, then slowly push up.
Pelvic tilts: These can strengthen the abdominal muscles and help reduce back pain.
- Go down on the hands and knees.
- Tilt the hips forward and pull the abdomen in, arching the back.
- Hold for a few seconds.
- Release, and let the back drop.
- Repeat this up to 10 times.
During pregnancy, exercise should aim to:
- increase heart rate steadily and improve circulation
- keep the body flexible and strong
- support and control healthy weight gain
- prepare the muscles for labor and birth
Exercise during pregnancy can help:
- shorten the labor process
- increase the chances of an unmedicated birth
- decrease the need for pain relief
- speed up recovery after delivery
- reduce the risk of gestational diabetes and hypertension
- decrease the likelihood of preterm labor and birth
It may also give an infant a healthier start.
Research shows that when pregnant women exercise, fetal heart rate is lower. Newborns may also have a healthier birth weight, a lower fat mass, improved stress tolerance, and advanced neurobehavioral maturation.
Women who were exercising regularly before pregnancy, and who are healthy during pregnancy, should be able to continue exercising as before, with slight changes depending on the trimester.
Women who have not been exercising before pregnancy will benefit from taking up a low-intensity program and gradually move to a higher activity level.
Health authorities in the United States recomend that adults should do at least 150 minutes a week of moderate-intensity physical exercise, including during pregnancy and in the first year after delivery.
Most exercises are safe to perform during pregnancy if done with caution.
Tips for healthy exercise during pregnancy
Physical changes during pregnancy create extra demands on the body, so it is important to exercise with care.
How to exercise safely
A few tips can help you stay safe when exercising.
- begin by warming up for 5 minutes and stretching for 5 minutes
- finish with 5 to 10 minutes of gradually slower exercise that ends with gentle stretching.
Here are some useful tips:
- Wear loose-fitting, comfortable clothes, and a good support bra.
- Choose supportive shoes designed specifically for the exercise you have chosen, to help prevent injury.
- Exercise on a flat, level surface to avoid injury.
- Eat small, frequent meals throughout the day, and don’t exercise for at least 1 hour after eating.
- Drink plenty of water before, during and after exercise, to keep hydrated.
- Get up slowly and gradually to prevent dizziness.
- The body needs more oxygen and energy during pregnancy.
- The hormone relaxin, produced during pregnancy, causes the ligaments that support the joints to stretch, increasing the risk of injury.
- The mother’s changing weight alters the center of gravity, putting extra strain on the joints and muscles in the lower back and the pelvis and increasing the chance of losing balance.
Cautions when exercising during pregnancy
- Avoid overheating and exercising in high humidity.
- Avoid heavy weightlifting and activities that require straining.
- Avoid exposure to extremes of air pressure, as in high altitude exercise or scuba diving.
- Avoid activities that increase the risk of abdominal trauma.
- Never exercise to the point of exhaustion.
- If you cannot talk while exercising, slow down the activity.
Women who were exercising intensely, for example, jogging, before pregnancy may have to moderate their regime.
Activities may change as time goes on, because of bodily changes that occur.
Who should not exercise?
Exercise may not be advised if there is:
- vaginal bleeding or spotting
- low placenta, or low-lying or placenta previa
- a history or possibility of miscarriage or preterm delivery
- weak cervix
Stop exercising if you:
- feel fatigued
- develop persistent pain
- experience any vaginal bleeding
- have regular contractions more than 30 minutes after exercise, as this may be a sign of pre-term labor
A health-care provider can suggest personal exercise guidelines, based on the individual’s medical history.
Stop exercising and consult a health care provider if you:
- experience pain, including abdominal, chest, or pelvic pain
- have muscle cramps
- feel faint, dizzy, or nauseous
- feel cold or clammy
- notice vaginal bleeding
- have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily, possibly indicating a rupture of the amniotic membrane
- have an irregular or rapid heartbeat
- notice sudden swelling in the ankles, hands, face, or all of them
- experience increased shortness of breath
- have persistent contractions that continue after rest
- have difficulty walking
Regular physical activity can boost maternal and fetal health, and it can make pregnancy, labor, and post-delivery recovery easier. However, it is important to stay safe during exercise.