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 of your activity before attempting any exercises.
- Benefits of Exercise During Pregnancy
- Guidelines and Precautions for Prenatal Exercise Programs
- How Much Exercise Should I Do?
- Benefits of Walking
- Basic Prenatal Exercises
Benefits of Exercise During Pregnancy
- Improved posture and appearance
- Relief of back pain
- Strengthened muscles in preparation for labor and support for loosened joints
- Enhanced circulation
- Increased flexibility
- Increased/maintained aerobic capacity (endurance)
- Increased energy level: combats fatigue
- Decreased muscle tension; promotes relaxation
- Promotion of feelings of well-being and a positive self-image.
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Guidelines and Precautions for Prenatal Exercise Programs
- Occasionally exercise may stimulate uterine activity or initiate other possible complications. Before beginning the exercises, review the precautions about 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 fatigued and do not exercise to exhaustion.
- Exercise should be regular; three times per week. During pregnancy, aerobic exercises should not exceed five times per week in order to allow your body to recover and rest properly.
- Avoid any type of exercise involving the potential for even mild abdominal trauma.
- Avoid rigorous bouncing.
- Avoid arching your back.
- Don't bring your feet over your hips, i.e. candlestick or bicycling-in-air position.
- Don't do sit-ups past 45 degrees.
- Breathe continually while exercising; do not hold your breath. In general, exhale on exertion.
- Check for separation of the abdominal muscles each week and take necessary precautions if indicated.
- Drink fluids liberally before, during, and after exercising to prevent dehydration.
- Avoid activities which require precise balance and coordination. As your pregnancy progresses, your increasing weight, shifting center of gravity, and softening and increased mobility of your joints and ligaments may alter your coordination.
- Muscles that are used in aerobic activity should be appropriately stretched before and after the exercise.
- Decrease your exercise level as your pregnancy progresses. Your increased body weight will require a larger energy output, so you will feel more fatigued. 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 (available at Newborn Connections) that follows the ACOG (American Congress of Obstetricians and Gynecologists) guidelines to work out at home.
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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.
- Daily - Stretching, Strengthening, Kegels, Relaxation
- Three times/week - Low or non-impact aerobic activity with appropriate warm-up and cool-down; swimming or cycling
- Once each week - Check for separation of abdominal muscles
- Work up to five to 10 repetitions per day
- Don't stretch to extreme discomfort as joints are more loose during pregnancy
- Hold each position or stretch for 20-30 seconds.
- Don't exercise beyond the point of moderately heavy perspiration.
- Sustain aerobic activity for 15-20 minutes as long as you are able to talk comfortably and are not short of breath.
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.
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Benefits of Walking
A good activity to begin during pregnancy is a walking program, three to five days/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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Basic Prenatal Exercises
These few basic exercises will help increase your strength and flexibility. If you have limited time, these exercises are highly recommended and should take only about ten minutes per day. Check with a qualified prenatal exercise instructor if you are not sure you are doing the exercises correctly.
Arm/Upper Back Stretch (Flying Arm Exercise) - repeat 5 times:
- Raise your arms over your head, keep your elbows straight and the palms of your hands facing one another. Hold for at least 20 seconds.
- Lower your arms out to your side. Keep your upper back straight.
- Bring the backs of your hands together as far as possible behind your back and stretch.
Before beginning the next exercises—the pelvic tilt and sit-ups—review the following information on separation of the abdominal muscles.
During pregnancy, it is important to check for advanced separation of the abdominal muscles in order to take precautions to avoid any further separation.
- The abdominal muscle in the center is divided by a seam, so the muscle is really two halves.
- The hormones present during pregnancy cause this seam to soften and stretch as the abdominal muscles accommodate the growing baby. If the seam stretches enough, a separation of the abdominal muscle may occur.
How to Check for Abdominal Muscle Separation
You can check for separation anytime during your pregnancy by following these instructions:
- Lie on your back and bend your knees, feet flat on the floor.
- Slowly put your chin to your chest - raise your head and shoulders until your neck is 6-8 inches from the floor. Hold one arm out in front of you.
- With the other hand, check for a gap (usually present in the first few months of pregnancy or postpartum) or a bulge (present in last 3 months of pregnancy) in the middle of your abdomen. There may just be a soft region between the muscle, wider than two fingers' width.
- If any separation is found, avoid further separation by:
- Doing mild abdominal strengthening while crossing your hands over your abdominal area to support and bring the muscles together.
- Exhale as you lift your head; this decreases pressure in your abdomen and allows your abdominal muscles to work more efficiently.
- Avoid abdominal bulging by consciously contracting your abdominal muscle when lifting and avoid straining of any kind.
This exercise is very important because it is the building block of good posture; strengthens your abdominal and back muscles; and therefore decreases back strain and fatigue. Practice it often. (see pictures below)
- Lie on your back with your knees bent.
- Inhale through your nose and tighten your stomach and buttock muscles.
- Flatten the small of your back against the floor and allow your pelvis to tilt upward. (see example below on left)
- Hold for a count of five as you exhale slowly.
- Relax, repeat.
Other positions in which you can perform the pelvic tilt are while on your hands and knees or while standing upright.
CAUTION: DO NOT arch your back, bulge your abdomen or push with your feet to obtain this motion! (as in example on right)
There are two variations of sit-ups:
- Lie on your back with your knees bent and breathe in slowly through your nose.
- Breathe out through partially pursed lips as you raise your head, hands pointing to your knees or placed behind your head.
- Tuck your chin toward your chest and lift your shoulders off the floor (not more than 45 degrees).
- Lie on your back with your knees bent. Slowly breathe in through your nose.
- Point your right hand toward your left knee while raising your head and right shoulder. Breathe out slowly through your mouth. Keep your left knee bent slightly and your heel on the floor.
Kegel exercises tone the pubococcygeal (PC) muscle. This is the muscle you use to stop and start the flow of urine. Exercising this muscle helps prevent hemorrhoids, supports your growing baby, assists during and after labor, keeps the muscles of the vagina toned, and may increase sexual pleasure for you and your partner.
Learn to isolate this PC muscle by stopping the flow of urine a few times. Use this technique only to locate the muscle. Don't exercise the muscle this way as it may lead to a urinary tract infection. Another way to locate the muscle is to put your clean finger in the opening of your vagina and tighten. By feeling the muscle tighten around your finger you will know you are doing the exercises correctly.
- Squeeze the PC muscle for five seconds; relax for five seconds, then squeeze again. At first, do 10 five-second squeezes three times a day.
- Flutter exercises: Squeeze and release, then squeeze and release as quickly as you can.
- Work up to doing 100 Kegels each day.
- Move to the squatting position, knees over your toes.
- Keep your heels on the floor; feel the stretch in the back of your thighs.
- Hold for 20-30 seconds. Gradually increase the time to 60-90 seconds.
- Relax your head and arms throughout this exercise.
- Lean against a wall or firm surface.
- Reach one leg out behind you, keeping your heel on the floor.
- Lean into the wall to increase the stretch of your calf.
- Hold for 20-30 seconds.
- Repeat with each leg.
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