I am at an age where friends and family are pregnant! Such an awesome time, do not worry, my time will come. 😀 So I decided to write this blog post to help all of you understand the benefits, precautions, & adaptations to take while pregnant. But first and foremost, ALWAYS CONSULT WITH YOUR PHYSICIAN before beginning an exercise program! I always require my clients to have a waiver/release for exercise from their physician before I train them. 

1. Talk with your health care provider, and keep in contact during pregnancy to monitor symptoms.

2. Tell your family & friends, their support can be very beneficial. Also, having a training buddy makes exercise much more enjoyable.

3. Listen to your body! The phrase “no pain, no gain” DOES NOT APPLY to pregnancy. Do NOT be stubborn like myself and push through anything. Remember you have a little one inside you that needs protection.

4. Wear comfortable clothing! Use as excuse to go shopping  I will look for any excuse to get new workout gear. Ask my husband! Main reason I founded GymBelles Couture 

5. Be flexible. Be prepared to have to change up your workout routine or stop temporarily.

6. Avoid anaerobic pace (breathless), don’t want to restrict or have too high intensity to take away from the baby. See types of exercises below.

7. Exercise in your comfort range. Do not exercise to exhaustion or fatigue.

8. Avoid overheating and dehydration. Drink plenty of fluids before, during, and after exercise.

9. Minimize risks to ligaments &  joints. Warm-up & cool-down properly before exercise. Approx 5 minutes at a brisk walking pace.

10. Maintaining a healthy weight and seeing a gradual increase is a good sign you are eating enough. Increase caloric intake approximately 300+kcals.

11. Exercise about 20-45min, 3-5x/week in a cardiac zone determined by your fitness level. Sedentary-low: 30-40% maxHR for 10-20min (get permission from doctor); Moderate activity level-50-60% max HR 20-45min.

12. Healthy mom=healthy baby! 

SEE CHART BELOW for specific recommendations.

Types of Exercise

• Swimming/Water Aerobics
• Running (1-2 trimester, if already a runner)
• Low Impact Aerobics
• Dancing
• Resistance Training: low weight, higher repetitions (vary from person to person if allowed to participate in strength training workout)
• Yoga/Pilates —> PIYO (wink, wink)
• Stretching
• Cycling

Maternal Benefits of Exercise During Pregnancy

• Improved aerobic and muscular fitness
• Facilitation of recovery from labor
• Enhanced maternal psychological well-being that may help counter feelings of stress, anxiety, or depression frequently experienced during pregnancy
• Establishment of permanent healthy lifestyle habits
• More rapid return to prepregnancy weight, strength, and flexibility levels
• Fewer obstetric interventions
• Shorter active phase of labor and less pain
• Less weight gain
• Improved digestion and reduced constipation
• Greater energy reserve
• Reduced “postpartum belly”
• Reduced back pain during pregnancy

Physiological responses to exercise.

• There is increased oxygen extraction by the working muscles.
• Blood is shunted away from the internal organs and to the working muscles.
• The body temperature increases due to increased metabolism.
• Vasodilation occurs at the skin to maintain body temperature.
• Glucose levels can decrease to hypoglycemic levels.
• Resistance exercises can dramatically increase intrathoracic and intra-abdominal pressures.
• Impact activities are sometimes associated with high forces applied to the body.
• Exercise at altitude can be more difficult because of the lower partial pressure of oxygen (hypoxia) in the environment.
• Elevations in body temperature (hyperthermia) are more dramatic during exercise in a hot and humid environment.
• Improved hematocrit is associated with a higher oxygen-carrying capacity in the blood.
• Hormones are released that increase joint laxity during pregnancy to allow for skeletal adjustments for the fetus and increased ease of delivery. Because the hormones circulate throughout the body, all joints can be affected.
• Vasodilation at the skin increases during pregnancy.
• Hypotension (low blood pressure) can occur when the woman is in the supine position.
• Resting heart rate increases 10 to 15 bpm during pregnancy.
• The energy demand on the body increases by about 300 kcal per day during pregnancy.

Concerns, Facts, and Recommendations

Pregnant women’s bodies use carbohydrates to a higher degree during exercise, increasing the risk of hypoglycemia in the fetus. The reduction in blood glucose levels is most noted during longer duration exercise (greater than or equal to 45 minutes)

To avoid significant decreases of blood glucose during exercise, the pregnant woman should make sure that she consumes a relatively high level of carbohydrates in her diet. Exercise sessions should last less than 45 minutes.

With the shunting of blood (and oxygen) to the working muscle cells, the fetus may experience hypoxia (low oxygen).

During pregnancy, the improved hematocrit(oxygen-carrying capacity of the blood) and the oxygen extraction by the cells offset the possibility of fetal hypoxia during exercise.

Because of altered glucose levels during pregnancy, some women may experience fatigue, especially during the first trimester.

Because fatigue may signal lowered blood glucose levels, exercise should be stopped or reduced when the woman is feeling fatigued. She should be encouraged to eat more often (e.g., snacks, fruit drinks) to maintain blood glucose levels.

Elevated fetal heart rateshave been observed during exercise.

There appears to be no danger for the fetus when exposed to short-term increases in heart rate (of 5 to 15 beats per minute).

Joints loosen up during pregnancy, increasing the risk of injury. Additionally, because of the added weight and position of the fetus, the body’s mechanics are shifted, placing more stress on the lower back.

Contact sports and sports requiring a high level of agility should be avoided, not only to protect the fetus but to reduce the risk of joint injury to the pregnant woman.

Weight-bearing exercises should be reduced in women with a high degree of joint laxity (looseness) and should be replaced by weight-carrying exercises such as stationary cycling.

Strength training exercises that target postural muscles may be useful to counteract the changing body mechanics.

Exercise in a hypoxic environment, such as at altitude, exposes both the pregnant woman and the fetus to low oxygen levels.

Oxygen availability to the pregnant woman and the fetus may be compromised at altitudes over 8,250 feet. Exercise during pregnancy at altitude should only be undertaken after 4 to 5 days of exposure to the environment.

Both exercise and pregnancy increase metabolic rate, providing two sources of heat and increasing the risk ofhyperthermia.

Hyperthermia must be avoided during pregnancy, especially during the first trimester. Fortunately, vasodilation at the skin increases during pregnancy, thereby increasing the dissipation of heat and reducing the risk. However, pregnant women should not exercise in hot and humid environments, and maintaining fluid levels should be a priority during exercise.

During the second and third trimesters, the supine position is associated with a reduced cardiac output (the amount of blood pumped out of the heart per minute).

Supine exercises should be avoided, especially during the last two trimesters.

Physiological changes to the pregnant woman that accompany pregnancy continue for 4 to 6 weeks following the birth.

Changes to the exercise program should be maintained and only gradually shifted back to the pre-pregnancy routine.

Women starting an exercise program may have benefits inreducing the risk of gestational diabetes, but also take on a new stress physiologically.

Women who are on a regular exercise program before pregnancy can continue on the program (with a few adjustments).

Women who want to begin an exercise program while they are pregnant should consult with their physicians. The woman new to exercise should participate in low-intensity, low-impact activities such as walking, stationary cycling, and swimming.

The body’s demand for energy increases with exercise and with pregnancy. How will enough calories be provided for both?

If the woman was exercising before she became pregnant, she can increase her daily caloric intake by about 300 kcal to adjust for the calories needed for pregnancy.

If the woman is both pregnant and new to exercising, she has to adjust for both. Keep it at 300 kcal for the pregnancy, and use the activity calculator you used for Hannah to estimate the calories used during exercise. Add that many calories to the diet.

The higher the intensity of aerobic exercise, the higher the oxygen use by the working muscles and the greater the increase in body temperature. There may be an increased risk of hypoxia and hyperthermia.

There is no evidence that the intensities typical of aerobic exercise are detrimental to the fetus in terms of either oxygen availability or temperature. Pre-pregnancy moderate to moderately high intensities can be maintained. The pregnant woman should avoid extremely high intensities that are typical of interval training and experienced in maximal exercise tests (unless closely supervised by a physician).

Resources: 1. ACSM Guidelines for Exercise Testing & Prescription 6th Ed. (2000). Secondary reference based on information from the American College of Obstetricians and Gynecologists. 2. http://www.physsportsmed.com/issues/1999/08_99/artal.htm