Run, work, eat, sleep, repeat: this pattern plus/minus a few other key activities is the daily routine of many women we know…including ourselves. While fitting it all in can be a challenge, remaining fit is at the top of many of our lists (which for most of us tends to be very long!) Although the physical benefits are a plus, for many, the primary reason to pound the pavement while everyone else is still sleeping is the mental release these 30 minutes offer. Tuning out from the daily grind, forgetting about the constant to-do list, and the stress of trying to balance it all are key.
For us, a commitment to exercise started in college. In many ways, although it took fuel to power through a workout, the workout itself provided us with the mental clarity and physical strength to get through the 15 years of education to become a fertility specialist. The juice your brain gets from a run, a swim, or a bike ride can be as invigorating as a Starbuck venti (and cheaper!).
For all these reasons, plus many others, we maintained our exercise regimens during pregnancy. While there were definitely some double takes as our bellies bounced in and out of the saddle at cycling class, we both continued to go strong until the very end. So, as both moms who have done it and doctors who have spent a lot of time researching it, we are here to say pregnancy is not a reason to pass up peddling, paddling, or pushing on.
Let’s share some facts. The American College of Obstetrics and Gynecology (ACOG) makes it clear that, in the absence of either medical or obstetrical complications, moderate exercise for at least 30 minutes or more is recommended on most, if not all days of the week. So if the gurus of all things pregnancy give it the green light, why does exercise during pregnancy still conjure up so many negative emotions? Why do we rarely see a picture of a pregnant athlete? And why does a model that is fit and posts pictures of herself while pregnant cause so much negative buzz? Whatever the reason for the dirty looks, there is a widespread misconception that pregnancy is a handicap and women who continue to live their normal lives and engage in their normal routines are doing harm to their unborn child. They will cause themselves and their babies problems and should just relax. This is so NOT true. Yes, there will always be certain situations (see below) when an OB advises a patient to sit on the sidelines, but that is more the abnormal than the norm:
- History of preterm delivery
- History of short cervix/incompetent cervix
- Significant maternal heart disease
- Restrictive lung disease
- Persistent bleeding in your second and third trimesters
- Placenta previa after 26 weeks
- Premature labor
- Premature rupture of membranes
- Growth-restricted fetus (IUGR)
As avid athletes, OB/GYNs, and women who have worked out with a plus one in the womb, we are constantly asked by friends, patients, and even strangers at the gym, “What can and can I not do during pregnancy?” as it relates to exercise.
So here are the most frequently asked questions and our well-rehearsed answers….
I am a fitness fanatic…is there a time when I should stop exercising?
While you may have been given the green light to continue exercising during your pregnancy, you should consider stopping in the following scenarios:
- You start to experience vaginal bleeding.
- You are having difficulty breathing with exercise or feel dizzy, or
- You experience chest pain, muscle weakness, or headaches with exercise. You should also stop exercising ASAP if you note uterine cramping or leakage of any vaginal fluid, and consult your OB if these symptoms develop.
I like to hang glide, sky dive, and rock climb…are there any exercises that are dangerous?
Most exercise regimens are a go in pregnancy. However, any sport that can lead to abdominal trauma should be avoided after the first trimester. This includes extreme sports as well as contact sports like basketball and soccer. Additionally, while many skiers chose to continue swooshing down the slopes throughout their pregnancy, it is generally not recommended due to the risk of falling or collision, which can result in significant abdominal trauma. Furthermore, the higher altitudes associated with skiing can be more difficult to tolerate when pregnant. Don’t hold your breath: scuba diving is also not recommended during pregnancy. The risk of decompression syndrome (related to pressure changes) is real and therefore not a wise choice. Lastly, don’t forget that your center of gravity shifts while pregnant; this places pregnant women at slightly higher risk for falls. So put the tightrope down. Pregnancy is not the time to take that walk!
I want to achieve my personal record during pregnancy…Do I need to modify my workout during pregnancy?
Probably yes. But the best advice we can give you is to listen to your body. It will tell you when it’s had enough. Pregnancy is not the time to push your pace or take your athletic endeavor to the next level. Your heart, lungs, and circulation are working for two, and you will feel changes as early as that missed period. The physiologic changes that occur in the first trimester will make you feel more winded and short of breath. Hear what your body is saying, and take some time to cool down.
I never eat before I work out…should I start to snack before?
Talk about changes in metabolism and energy storage! During pregnancy, while your body feels heavy and full, it is less equipped to handle dehydration and drops in your blood sugar. Therefore, you need to pull out those water bottles and hydrate up. In addition, make sure to chomp on something before and after your workout. In general, pregnant women need to consume 200 more calories a day. If you are going to exercise while pregnant, just be aware that you need to fuel and then refuel your tank more frequently than when not pregnant.
I used to dream about my Sunday long runs, now I dread them…is something wrong?
Nope, your change of heart is normal. As pregnancy continues, what feels right and good will change (not to mention what tastes good!). As avid runners, we found running much less comfortable in the late second and third trimesters, causing muscle strain in the lower abdomen and groin. The hormones of pregnancy cause laxity (loosening) of your ligaments and muscles that can lead to discomfort and possibly injury. Be smart. If it’s a really hot and humid day, you may want to second guess that long run in the park during prime sun hours. Likewise, if it is very cold and icy, it’s probably not the right time to check out a trail run. Again, listen to your body…it knows what it wants and does not want to do!
I bought a heart rate monitor…Does my heart rate have to stay below 140 while I work out?
Old school ACOG guidelines (pre-1992) recommended that pregnant women keep their heart rate under 140 beats per minute. News flash…this dictum was removed over two decades ago, as there was NO scientific basis to support it. All women enter pregnancy in different cardiovascular shape. If we start differently, we will likely be able to achieve differently; some can go above 140, some below, and some way below. We like to recommend what we call the Talk Test. If you can talk or sing (sorry for all of those who have to listen to us belt it out off key) as you go about your workout, you are all good.
I just entered my third trimester…do I have to stop exercising?
Not really. Keep going unless you don’t feel right or if your obstetrician or midwife advises you that it is no longer safe due to a pregnancy complication. Otherwise, many women will exercise up until the day they give birth (we both did!).
Other than fitting into my skinny jeans sooner after delivery, are there other benefits to exercise in pregnancy?
Short answer is: yes. Fit moms who maintain their exercise regimen during pregnancy are less likely to develop gestational diabetes (diabetes during pregnancy), preeclampsia (high blood pressure), excessive weight gain, needing a C-Section, and low back pain. It also seems that women who peddle paddle and things in between push for a shorter amount of time and have a higher likelihood of a vaginal delivery. It should come as no surprise that if you are fit enough to make it through a cycling class, you are more likely to be fit enough to make it through labor.
Are there any risks to my fetus if I exercise during my pregnancy?
Despite the negative buzz and the whispering that goes on, no, not if you follow the advice of your doctor and exercise safely. In fact, you can tell those finger pointers to point somewhere else. There is a good deal of data to the contrary suggesting stronger cardiovascular systems in newborns of mothers who exercised during pregnancy. Additionally, the babies born from moms who move seem to have a lower incidence of obesity and diabetes.
When can I work out after I give birth?
Here are the “deets” on when you can get down and dirty again. While the general recommendation has always been six weeks, it’s not a mandatory sentence. If you had an uncomplicated vaginal delivery (no major tear), you can probably start back much sooner. Let’s face it, the first couple weeks post-delivery, you and your body are in survival mode. Your priorities are feeding your newborn and yourself and getting as much rest as possible. Exercising even for the most hard core is not at the top of your list. Ease back into it when you feel your body is ready; whether that is two weeks or six weeks, it’s up to you.
The bottom line is that exercise during pregnancy will not only keep your bottom line a bit trimmer but also have big-time benefits for you, your pregnancy, and your baby. While no one is expecting you to PR in a race, you can continue to move. Moms on the move are everywhere. Join the movement!
Key words: Exercise, pregnancy, heart rate, cycling, dehydration, nutrition, fitness, fit pregnancy, preeclampsia, gestational diabetes, postpartum