By Jonathon Stavres MS, ACSM-EP-C
According to the Centers for Disease Control and Prevention, there were approximately four million births in the United States in 2014, and sixty-two out of every thousand women got pregnant. Physical activity becomes very important during pregnancy, especially in cases where mothers are overweight, at risk for developing gestational diabetes, or at risk for other pregnancy-related complications. Physical activity during pregnancy also helps to facilitate weight loss following pregnancy. Here are some basic principles/ recommendations of exercise prescription for pregnant women.
Recommendations for exercise prescription and pregnancy
The goals of an exercise program for an expectant mother are similar to the general guidelines for healthy adults, with some additions and special considerations.
The exercise program should promote general cardiovascular benefits, improve or maintain fitness levels, and improve muscular function. Other goals specific to pregnancy include stabilizing blood glucose levels, blood pressure, and maintaining a healthy pregnancy weight.
One very important note is that pregnant women should ease into their new exercise program dependent on what type and intensity of exercise they were performing before pregnancy. While vigorous exercise is acceptable during pregnancy, it is important to master form and technique before ramping up intensity.
Specific components of exercise
Pregnant women should participate in aerobic exercise three to five days per week for at least thirty minutes at a time. This regular exercise frequency will increase the time spent active and therefore promote glucose control, caloric expenditure, and blood pressure regulation. Pregnant women should also participate in light resistance training 1-2 days per week with at least 48 hours between sessions.
The prescribed exercise intensity should be largely based on the intensity of exercise before pregnancy. Form and technique should be mastered before increases in intensity or resistance. This reduces fall risks, or other unnecessary risks to the mother and fetus. This includes using resistance that does not require women to perform the Valsalva maneuver.
The Valsalva is defined by someone holding their breath to increase the pressure in the abdominal cavity in an effort to stabilize the core during a difficult contraction. This increases arterial carbon dioxide saturation and reduces arterial oxygen saturation.
For general health benefits, exercise should be performed at a moderate to vigorous intensity, based on rating of perceived exertion (RPE). Novice exercisers should start at a low intensity and gradually increase to the recommended moderate to vigorous exercise intensities.
Type and Duration of Exercises:
Pregnant women can benefit from a wide range of exercise modalities. One of the most common is water-based exercise. The buoyancy of the water will reduce the strain of the added abdominal weight on the lower back and joints. This also allow women to perform upright aerobic exercise without an increased fall risk. Ellipticals and recumbent cycles can also be used to reduce stress on joints.
As for resistance training, it is important to minimize the risk of weight falling on the abdomen. This means that over-head free weight exercise should be avoided. Also, exercising in the supine position should be avoided after the 1st trimester, as this can hinder venous return to the heart.
Women should strive to meet the required 150 min/week of moderate to vigorous intensity exercise, so each session should include at least 30 minutes of continuous or discontinuous aerobic exercise. This does not include rest periods. Women who are at a higher risk for excess weight gain or elevated blood glucose should consider increasing their exercise duration to meet 300 min/week of moderate to vigorous exercise.
Physical activity and exercise are very important for pregnant women. Exercise can maintain a proper body weight, reduce the risk of pregnancy related complications, all while maintaining or improving cardiorespiratory and muscular fitness. Pregnant women should strongly consider consulting with an exercise professional to design a safe and effective work out plan.
*For more examples of other variations/exercises look under Multimedia-VDF Exercise Tips
**Consult with a physician and/or medical healthcare provider before starting any exercise regimen
Pescatello, L. S. (2014). ACSM’s Guidelines for Exercise Testing and Prescription (L. S. Pescatello Ed. 9 ed.). Baltimore, MD: Wolters Kluwer.