Can I exercise during pregnancy,
and if so, which ones are safe to do?


The Centers for Disease Control and Prevention and American College of Sports Medicine recommendation for exercise, aimed at improving the health and well-being of non-pregnant individuals, suggests that an accumulation of 30 minutes or more of moderate exercise a day should occur on most, if not all days of the week. In the absence of either medical or obstetric complications, pregnant women can also adopt this recommendation.

A thorough clinical evaluation should be conducted before recommending an exercise program. Regular, moderate intensity physical activity should be encouraged. The American Diabetes Association has endorsed exercise for gestational diabetes mellitus when diet alone is not achieving the goals for glucose control.

Pregnant women after the first trimester should avoid lying flat on their backs as much as possible. Motionless standing is also not recommended, as this will reduce the amount of blood returning to the heart, due to pooling of blood in the lower extremities.

Strenuous exercise is not recommended, deficient diets may be linked to smaller than normal babies. The literature is still confusing on this matter. Of course, avoid sports with contact such as ice hockey, soccer, basketball, gymnastics, horseback riding, downhill skiing, and vigorous racquet sports. Scuba diving can increase risk for decompression sickness secondary to the inability of the fetal pulmonary (lung) circulation to filter bubble formation.

Exertion at altitudes up to 6000 feet appears to be safe. There have been no reports that hyperthermia associated with exercise is teratogenic (i.e. causing fetal abnormalities). A physically active woman with a history of or risk for preterm labor or fetal growth restriction should be advised to reduce her activity in the second and third trimesters. Resumption of exercise can usually be gradually occur after 4-6 weeks postpartum, check with your healthcare provider at the postpartum visit.

ABSOLUTE CONTRAINDICATION (DEFINITELY CANNOT EXERCISE) TO AEROBIC EXERCISE DURING PREGNANCY, are these conditions: significant heart disease, restrictive lung disease (COPD, emphysema, uncontrolled asthma), incompetent cervix, cervical cerclage, multiple gestation (twins, triplets, etc), persistent second or third trimester bleeding, placenta previa after 26 weeks of gestation, premature labor during the current pregnancy, ruptured membranes, preeclampsia, pregnancy-induced hypertension

RELATIVE CONTRAINDICATIONS TO AEROBIC EXERCISE DURING PREGNANCY:severe anemia, unevaluated maternal cardiac arrhythmia, chronic bronchitis, poorly controlled type 1 diabetes, extreme morbid obesity, extremely underweight (BMI< 12), history of extremely sedentary lifestyle, intrauterine growth restriction in current pregnancy, poorly controlled hypertension, orthopedic limitations, poorly controlled seizure disorder, poorly controlled hyperthyroidism, heavy smoker.

WARNING SIGNS TO TERMINATE EXERCISE WHILE PREGNANT: Vaginal bleeding, difficulty breathing before exertion, dizziness, headache, chest pain, muscle weakness, calf pain or swelling, preterm labor, decreased movement by the baby, amniotic fluid leakage.

CAN OBESITY AFFECT PREGNANCY?


1/3 of adult women in the United States are obese. Obese women are at increased risk for several adverse perinatal outcomes, including anesthetic, preoperative, and other maternal and fetal complications. Normal body mass index (BMI) of 18.5 - 24.9, obesity is defined as BMI of 30 or greater. Obesity can be further classified as Class I (30-34.9), Class II (35-39.9), and class III or extreme obesity (>40). Go to www.nhlbisupport.com/bmi to calculate you BMI. The problem is highest among non-Hispanic black women (49%) compared with Mexican-American women (38%) and non-Hispanic white women (31%).