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Exercise and Pregnancy: Safety and General Recommendations

Most of us understand on some level that exercise is good for us, although the “how” and “how much” can be a bit confusing and overwhelming at times. Adding pregnancy into the equation makes figuring out how to exercise and take care of yourself all the more challenging. There are a lot of myths out there about exercising while pregnant: that it can cause harm to the baby, cause a miscarriage or premature labor, etc. However, unless you have specific obstetric or medical issues as identified by your physician, exercise is not only safe, but beneficial to both you and your baby.

Benefits to the pregnant parent include:

  • Psychological: improvements in mood, self-esteem, body image (so important during this time when our hormones are giving us an emotional rollercoaster ride!)
  • Physical: improved posture; increased energy levels, improved cardiac function and overall fitness
  • Decreased pregnancy-specific musculoskeletal aches and pains, varicosities, constipation, reduced risk of gestational weight gain and diabetes, reduced risk of hypertension

The baby also receives benefits of its own:

  • Improved placental growth and function (important for providing optimal oxygen and nutrients to your growing baby)
  • Increased fetal resilience during labor, resulting in reduced fetal distress during the birthing process
  • Decreased risk of meconium staining (Meconium is first stool the baby passes after they are born. Meconium staining refers to incidences where meconium comes out prematurely into the amniotic fluid where a baby can ingest it, making it difficult to breath when the baby is born and increase the possibility of infection.)

The American College of Obstetricians and Gynecologists (ACOG) encourages expectant parents to exercise throughout pregnancy, provided it has been approved by their OBGYN physician.

It is ABSOLUTELY inadvisable to exercise if the pregnant person has the following conditions:

  • Pre-eclampsia (pregnancy-induced high blood pressure)
  • Premature rupture of membranes (amniotic sac)
  • Multiple gestation at risk for pre-term labor
  • Placenta previa after 26 weeks gestation (where the placenta partially or completely covers the cervix)
  • Insufficiency of cervix (weakness of cervical tissues can result in premature birth)
  • Persistent 2nd or 3rd trimester bleeding
  • Restrictive lung disease
  • Significant heart disease

Exercise is POSSIBLY inadvisable if you have the following:

  • Severe anemia
  • Cardiac arrhythmia
  • Chronic bronchitis
  • Poorly controlled Type 1 diabetes, hypertension, hyperthyroidism, or seizure disorder
  • Extremes of morbid obesity, underweight, or sedentary lifestyle
  • Heavy smoker
  • Musculoskeletal or orthopedic limitations

Once you have approval from your physician, ACOG recommends an exercise program that includes a combination of aerobic, strength, and flexibility components. For people who are used to exercising regularly prior to pregnancy, you can continue your usual activities with modifications as needed, as long as you are drinking plenty of water, not exercising to fatigue, and not pushing through any significant discomfort. Your exercise program should not result in weight loss (unless medically advised to do so) and any new program or training regimen should be approved by your physician.

Exercises to avoid:

  • Sports that involve high impact potential like soccer, boxing or hockey
  • Sports with a high risk of falls such as skiing (water or snow), cycling or horseback riding
  • Scuba diving and sky diving
  • Hot yoga, pilates or anything in a hot and/or humid environment
  • Anything at high altitude, unless you have taken time to acclimate

Exercises that are generally considered safe during pregnancy include:

  • Walking, jogging, running (at a moderate level – see the “talk test” below for an easy way to assess this)
  • Swimming
  • Stationary cycling
  • Low-impact aerobics
  • Prenatal yoga or pilates (NOT “hot”)
  • Strength training with appropriate dosing (see below)

ACOG recommends exercising at a “moderate” to “somewhat hard” level, but what does that mean? Using the Rating of Perceived Exertion Scale where 1 = extremely light exertion and 10 = maximal exertion, you should be exercising at a 3-4. Another easy way to monitor your exercise intensity is with the “talk test” – you should be able to carry on a conversation while exercising. If you are breathing too hard to talk, you are working too hard! Heart rate monitors are not as effective with person who is pregnant due to cardiovascular and hormonal changes that occur during pregnancy.

Immediately STOP exercising and contact your physician if you are experiencing any of the following:

  • Feeling dehydrated or have low blood sugar (it’s recommended you drink 2 cups of water for every pound lost during exercise and are consuming an additional ~300 calories per day if you are at a healthy weight)
  • Difficulty breathing
  • Dizziness and/or nausea
  • Headaches
  • Chest pain
  • Are experiencing weakness in legs that may result in a loss of balance
  • Pain and swelling in your calves
  • Vaginal bleeding
  • Amniotic fluid leakage
  • Preterm contractions

Additionally, it is imperative to maintain your hydration and calorie levels before, during and after exercise. As previously mentioned, ACOG recommends drinking 2 cups of water for every pound lost during exercise and making sure to eat an additional ~300 calories/day for most women at a healthy weight. Again, these are general recommendations that should be reviewed and confirmed by your physician.

If you would like further information on exercises specific to your needs, whether they are to maintain fitness or to address the many various aches and pains that occur during pregnancy, you can make an appointment with one of the MTI physical therapists who specialize in pregnancy and post-partum training. Our therapists would be happy to evaluate your needs and help place you on a program that is sustainable, safe, and fun!


Sheila Oberhardt, PT, DPTSheila Oberhardt PT, DPT is a Doctor of Physical Therapy and Certified Orthopedic Manual Therapist who works at our Bellevue clinic. Sheila has additional training as a Pilates instructor and has taken courses through Herman & Wallace Pelvic Rehabilitation Institute on Pregnancy Rehabilitation. She is also expecting her first child at the end of August, 2020! If you have questions, you can contact her directly at sheilaoberhardt@mtipt.com.

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