Tips for Exercising During Pregnancy

From a Pelvic Health Physical Therapist

WRITTEN BY KELLEY KOONTZ

Pregnancy is a time full of changes going on in your body. With so much information out there, it’s hard to know what exercises are best, when you should modify them and what the recommendations are for exercising during pregnancy. Only 15-38% of pregnant women are reported to follow physical activity guidelines and up to 60% of women are inactive in pregnancy.

There are many benefits to exercise during pregnancy, and new research is coming out giving more access to those who have never exercised. Those who have no contraindications to exercise should be physically active during pregnancy, which includes currently active women, currently inactive women and those with gestational diabetes.

When shouldn’t you exercise?

When you have a contraindication, which means physical activity is not recommended for those who have the following:

» Ruptured membranes or premature labor » Unexplained persistent vaginal bleeding

» Placenta previa after 28-weeks’ gestation

» Preeclampsia » Incompetent cervix » Intrauterine growth restriction

» High-order multiple pregnancy (e.g, triplets)

» Uncontrolled type 1 diabetes, uncontrolled hypertension or uncontrolled thyroid disease

» Other serious cardiovascular respiratory or systemic disorder

These conditions mean exercise is not recommended.

There are a few conditions where it is recommended to talk to your obstetric care provider to discuss the advantages and disadvantages of physical activity before participating in exercise:

» Recurrent pregnancy loss

» History of spontaneous preterm birth

» Gestational hypertension

» Symptomatic anemia

» Malnutrition

» Eating disorder

» Twin pregnancy after the 28th week

» Other significant medical conditions

Any other circumstance whether you were active or not before you got pregnant gives you the green light to exercise during pregnancy.

What are the benefits of exercising during pregnancy?

Not only does exercise benefit you, it benefits the baby as well. A few benefits include:

» Reduced maternal weight gain

» Reduced risk of gestational diabetes

» Reduced risk of gestational hypertension

» Reduced risk of a C-section

» Less likely to have larger babies at birth

» Reduces risk of postpartum depression

» Potentially reduces length of first and second stages of labor

What are the recommendations for exercising during pregnancy?

The goal is to accumulate 150 minutes per week of moderate physical activity. Women should be active three times a week, ideally every day. There should be an incorporation of aerobic and resistance type exercises.

When do I have to modify movements?

This is person dependent. It can depend on a number of factors including your pre-pregnancy fitness levels or how many children you’ve had. You may hear blanket statements such as, “Don’t do planks in the second trimester” or, “You can’t do sit-ups at all during pregnancy.” These aren’t necessarily true. I’ve seen women perform sit-ups during the second trimester without any issues or continue to run in their third trimester. With modifying movements or exercises, give yourself guideposts as you go through your pregnancy.

These guideposts can be symptoms, and they include:

» Pelvic heaviness

» Urinary or fecal incontinence

» Pelvic pain

» Pelvic girdle or low back pain

» Diastasis

If you have these symptoms during an exercise, it does not necessarily mean you need to stop what you are doing. That’s where pelvic health physical therapy can help you figure out if you should continue the movement or if there is a way to modify it to continue to do the things you love safely.

There are times when you have to stop exercising if you have the following symptoms:

» Persistent excessive shortness of breath that does not resolve on rest

» Severe chest pain

» Regular and painful uterine contractions

» Vaginal bleeding

» Persistent loss of fluid from the vagina indicating rupture of the membranes

» Persistent dizziness or fairness that does not resolve on rest

Those are signs that you should consult with your healthcare provider and to stop physical activity.

A pelvic health therapist will be your best resource throughout your pregnancy to guide you throughout each trimester. As your posture changes, if you start to have any low back or pelvic girdle pain, if you notice pelvic heaviness or incontinence, all these things and more can be addressed with pelvic health physical therapy.

Kelley Koontz, PT, DPT APRS Physical Therapy. You can connect with Kelley at www.bozemanaprs.com or kkoontz@bozemanaprs. com.