I was chatting with a friend recently and remarked that if I could write a prescription for exercise for my pregnant patients, I would. I’ve heard many physicians and nurse practitioners say the same. But I sometimes find that it’s a difficult recommendation for patients to follow.

The bottom line is this: Exercise is probably the best thing one can do for their health at any stage of life, but especially during pregnancy.

Part of why exercise gets maligned during pregnancy is because there are some misconceptions (most of which amount to outdated advice) about exercise and pregnancy. It’s time to debunk these myths, and get to the facts.

Understanding the health benefits of exercise

It’s important to note that physical inactivity is the fourth-leading risk factor for early mortality worldwide. Broadly, exercise has the following benefits:

  • It decreases anxiety and depression, and dampens perceptions of pain, neurochemically
  • In a study of women, exercise significantly decreased feelings of depression; in head-to-head studies exercise for some women produces greater effects than antidepressant drugs
  • It’s a given that it helps with metabolism, weight loss, and cardiovascular health
  • It strengthens muscles, builds blood vessels, and helps combat bone loss (especially resistance or weight training)
  • It can actually increase your energy levels, giving you a boost in productivity
  • It aids your sleep, increases your libido, and helps brain health to prevent dementia

And much, much more! Pretty incredible, right?

The latest guidance on exercise for pregnant women

Now, let’s talk about pregnant women specifically, as there are many misconceptions about what pregnant women can and cannot do and the impact of exercise on pregnancy. In April 2020, ACOG, the American College of Obstetrics and Gynecology, updated their Committee Opinion on Exercise in Pregnancy, which helps provide the most up-to-date guidance on the benefits, risks, and improved outcomes that come with exercise during pregnancy. Here are the key takeaways from ACOG’s updated guidance.

  • What exercises can pregnant women do?
  • Women who habitually engaged in vigorous-intensity aerobic activity or who were physically active before pregnancy can continue these activities during pregnancy and the postpartum period
  • If a vigorous exercise regimen did not exist before pregnancy, during pregnancy is not the time to begin. Instead, focus on low-impact and moderate intensity workouts to keep your body in good health.
  • Women who exercise in pregnancy have a decreased risk of:
  • Gestational diabetes
  • Excess weight gain
  • Preterm birth, which is one of the leading drivers of NICU treatment and related costs
  • Cesarean Section delivery
  • Low birth weight baby
  • Women who exercise in pregnancy experience improved outcomes, such as:
  • Shorter labor
  • Less pain in labor
  • Faster postpartum recovery
  • Decreased risk for postpartum anxiety and depression
  • Types of exercises that are great during pregnancy include:
  • Walking and running (if that’s something you did before you were pregnant)
  • Cycling (stationary bike is preferable in the 3rd trimester)
  • Aerobic exercise
  • Dancing
  • Resistance training with weights and elastic bands
  • Swimming (especially in the 3rd trimester)
  • Stationary rowing (before the belly gets in the way)
  • Exercise is good for babies too!
  • Infants whose mothers exercised developed stronger, more athletic hearts even before birth
  • Babies performed better on almost all motor tests if their mothers exercised during pregnancy
  • Babies whose mothers exercised were slightly ahead of peers whose mothers did not exercise in their ability to grip, jostle, and control how they rolled
“The bottom line is this: Exercise is probably the best thing one can do for their health at any stage of life, but especially during pregnancy.”

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Top recommendations for exercise and pregnancy to keep in mind

Educating yourself about the benefits of pregnancy should come hand-in-hand with understanding how to avoid risks. There are fewer health risks than you might think, but here are some tips to keep in mind.

  • Key reminders:
  • You don’t have to worry about getting your heart rate up. An elevated heart rate doesn’t hurt blood flow or oxygen to the baby; ideally aim for < 80% maximum heart rate during exercise
  • Stay hydrated! This is really important and helps you stay cool and gives your body and your baby what they need.
  • Exercise in pregnancy does not cause miscarriage, poor fetal growth, musculoskeletal injury, or premature delivery
  • At least 150 minutes of moderate intensity aerobic activity per week--that’s just 2 hours and 30 minutes per week or a little over 20 minutes each day--during pregnancy and the postpartum period is recommended by the Department of Health and Human Services
  • Make sure to maintain balance while exercising in pregnancy to avoid falls, which might include using a balance aid like a wall, railing, or tree if you’re outdoors
  • Avoid exercises that involve:
  • Holding your breath
  • Falling, if it is likely (i.e., skiing, horseback riding, etc.)
  • Scuba diving
  • Contact sports
  • There are some warning signs during exercise that pregnant women should look out for. These include:
  • Vaginal bleeding
  • Abdominal, chest, or calf pain
  • Painful contractions
  • Amniotic fluid leakage
  • Dizziness or headache
  • 60% of all pregnant women experience lower back pain, so take care to avoid exercises that might exacerbate that pain. Some tips:
  • If you need to pick something up, squat down, bending at your knees and keep your back straight. Avoid bending over from your waist
  • Avoid activities that strain the back, like lifting and moving heavy objects
  • Wear shoes and a bra that provide good support
  • Sleep on your side with pillows between your knees for support
  • And of course, if you have any obstetric conditions, talk to your doctor before vigorous exercise. Some conditions might include:
  • Vaginal bleeding or spotting
  • Low placenta or placenta previa
  • Incompetent cervix or cervical insufficiency
  • Threatened or recurrent miscarriage
  • Previous premature births or history of early labor

This just scratches the surface of the exercise options that are available during pregnancy. Creating an exercise plan that fits your body and your health is key. Maven’s virtual clinic provides access to incredible physical therapists who can walk a woman through an exercise program that meets her goals and her physiological needs, all throughout her pregnancy journey.

Keep on moving!

Dr. Jane van Dis is Maven’s Medical Director, a board-certified OB-GYN, and a frequent writer and speaker about gender equity in medicine. On our blog, Dr. van Dis shares insights on improving outcomes during pregnancy and beyond, as well as the latest clinical guidance in women’s and family health. Follow her @JanevanDis.

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