By in large, the majority of pregnant women should be involved in an average of 30 minutes of “cardio or strength” conditioning, 5 to 7 days per week. In general, the exercise prescription should include 5-10 minutes of warm up, followed by the exercise for 30 minutes, then ending with a cool down of 5 to 10 minutes.
The American College of Obstetricians and Gynecologists (ACOG) updated its guidelines regarding physical activity and exercise in pregnancy in 2015. This organization sets the standards of care for the obstetric patient focused on many of the benefits of exercise in pregnancy, fetal and maternal risks, safety, and types of activity. According to Up to Date, some of the key conclusions of ACOG’s statement are:
• Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychological well-being
• Physical activity in pregnancy has minimal risks, but, benefits most women. Some modification to exercise routines may be required due to normal anatomic and physiologic changes in fetal requirements
• Before recommending an exercise program, clinicians should perform a thorough clinical evaluation to ensure that the patient does not have a medical reason to avoid exercise
• Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength conditioning exercises before, during, and after pregnancy.
• Bed rest, although frequently prescribed in the past, is rarely indicated, and in most cases allowing ambulation with walking should be considered.
Up to Date also sites additional benefits of exercise in pregnancy including:
• Maintenance or improvement of cardiorespiratory endurance, muscle strength and endurance, flexibility, and body composition
• Maintenance or improvement of agility, coordination, balance, power, reaction time, and speed
• Avoidance of excessive gestational weight gain
• Prevention or reduction of orthopedic symptoms, such as low back pain and pelvic girdle pain
• Prevention of urinary incontinence
• Reduction of risk of delivery of a macrosomic or large for gestational age newborn
• Possible reduction in risk of developing preeclampsia
• Possible reduction in the duration of the first stage of labor, but not in the second
• Possible reduction in risk of cesarean delivery
Important risks are always present and should be identified and avoided in an exercise routine. Some potential risks to consider include maternal trauma, hyperthermia or excessive heat, and reduction in blood flow to the uterus. When choosing an exercise program some things to avoid include:
• Activities with a high risk of falling or those with high risk of abdominal trauma because of risk of placental abruption
• Activities that require jumping movements and quick changes in direction that can stress joints and increase the risk of joint injury
• Activities in settings that are excessively hot. While traditional yoga is considered safe in pregnancy, this patient population should avoid “hot yoga” or “hot pilates”
• SCUBA diving should be avoided throughout the entire pregnancy
• Lowlanders should avoid exercise during the first three to four days of exposure to moderate or high elevations
When trying to decide what activity works for you, consider using large muscle groups in a rhythmic and continuous fashion. Some of the best programs include walking, aerobic dance, swimming, cycling, rowing, and jogging. Additionally, most pre-pregnancy routines can be continued with modifications if needed. Most importantly, find some physical activity that is FUN for you. As I often share with my patients, labor and the delivery process is the ultimate physically challenging experience. It’s important to train for it through regular exercise as your pregnancy progresses.
Sources: “UpToDate.” UpToDate. N. p., 28 Feb. 2017. Web. 24 May 2017. http://www.uptodate.com/.
Gwinnett Gynecology and Maternity
1800 Tree Ln # 300, Snellville, GA 30078
www.gwinnett-gyn.com
