Urinary Incontinence in Women
Regular exercise during pregnancy is important for your health and well-being. It can improve posture, prevent backaches, decrease fatigue, relieve stress, and build stamina you will need for labor and delivery. It may also help prevent a type of diabetes that develops during pregnancy (gestational diabetes).
Most aerobic, resistance, and flexibility exercises are safe during pregnancy, but because each woman and each pregnancy is different it's important to consult your doctor before starting any exercise program while pregnant.
Exercise and Heart Rate
In the past the American College of Gynecology recommended pregnant women not raise their heart rate above 140 beats per minute during exercise, but this is no longer a guideline. Most women who were physically active prior to becoming pregnant can maintain physical activity during pregnancy. You may have to reduce the intensity; work out at a comfortable level, such as with low impact aerobics versus high impact. Exercising at about 70% of your maximum heart rate causes no change in the fetal heart rate.
Whether you were active before your pregnancy or not, you can exercise while pregnant. The American College of Gynecology states, "If you are active, pregnancy need not cause you to alter your fitness routine," and, "If you have not been active, now is a good time to start." For most women, exercising during pregnancy is safe.
Who Should Not Exercise During Pregnancy?
However, some women should not exercise during pregnancy. If you have a medical condition such as asthma, heart disease, or diabetes, you should consult your doctor before exercising.
In addition, you may be advised to avoid exercise if you have certain pregnancy-related conditions, including bleeding or spotting, low-lying placenta, threatened or recurrent miscarriage, previous premature births or history of early labor, or a weak cervix. Talk to your doctor before starting exercise for some guidelines on what you can and cannot do.
Wet Your Whistle
Make sure you drink plenty of water when you work out during pregnancy. Try drinking 8 ounces of water 20-30 minutes before you start exercise, and 8 ounces every 20-30 minutes during your workout. Also remember to hydrate following your routine. If you are concerned you will need to use the bathroom more often because you are drinking more, work out at a gym where there is a restroom available, or if you walk or run outside, stay close to home in case you need to make a pit stop.
What Should a Pregnancy Exercise Program Consist Of?
Consult with your doctor for an individualized exercise program that is right for you. However, if you are healthy and your pregnancy is without complications there are some general guidelines for exercise that most women can follow. Begin workouts with a five-minute warm-up and five-minute stretch. Try to get about 15 minutes of cardiovascular activity and monitor your heart rate. Gradually slow down and lessen the intensity of your cardio, and finish up with some gentle stretches.
What Exercises Are Safe During Pregnancy?
When you're pregnant, you can do most types of exercise. Just don't overdo it. Activities such as swimming, walking, indoor stationary cycling, step or elliptical machines, or low-impact aerobics classes can be very beneficial with a low risk of injury to you or your baby.
Some other types of exercise can still be continued but you may find you need to modify your movements. For example, changes in balance may affect your tennis game, and your runs may need to be slowed to accommodate your pregnancy. As you progress in your pregnancy you may want to consider exercises that do not require balance or coordination.
Stretching is recommended exercise to keep your muscles limber, and to warm up before other more intense workouts. The following slides review some simple stretches you can do before or after your workouts.
Stretching Exercises: Neck Rotation
Neck rotation can help relieve the tension in your neck and shoulders. Start by dropping your head forward, then slowly rotate your head toward your right shoulder, then back to the middle, and over toward the left shoulder. Do four slow rotations in each direction.
Stretching Exercises: Shoulder Rotation
Shoulder rotations help retain range of motion. Start by bringing your shoulders forward, then rotate them up toward the ears, and back down again. Reverse directions by pulling shoulders back, up toward the ears, and then back down again. Complete four rotations in each direction.
Stretching Exercises: Swim
Swimming motions can reduce muscle tension and retain flexibility. Start with your arms at your sides. Bring your right arm up and extend your body forward while twisting to the side, as if you were swimming the crawl stroke. Repeat with the left arm, and complete this sequence 10 times.
Stretching Exercises: Thigh Shift
Keeping your legs limber and flexible can help maintain balance as your pregnancy progresses. To do a thigh shift, start by standing with one foot about two feet in front of the other, toes pointed forward. Lean forward with your body weight supported by your front thigh. Change sides and repeat, completing four stretches on each side.
Stretching Exercises: Leg Shake
A leg shake can help maintain circulation. Sit down with your legs and feet extended. Move your legs up and down in a gentle shaking motion.
Stretching Exercises: Ankle Rotation
Foot and ankle swelling during pregnancy is common and ankle rotations can help with circulation and may reduce some fluid buildup. Sit with legs extended and toes relaxed. Rotate your feet in large circles using your whole foot and ankle. Rotate four times on the right and four times on the left.
It is also important to exercise the muscles supporting the bladder, uterus, and bowels. Kegel exercises target these muscle groups and strengthening them during pregnancy can help you control these muscles during labor and birth.
To do Kegel exercises that target the pelvic floor, imagine you are trying to stop the flow of urine or trying not to pass gas. Try not to move your legs, buttocks, or abdominal muscles. Kegels are so subtle no one should notice you are doing them. Contract the muscles and hold for a slow count of five, then relax. Repeat ten times for one set. Do 5 sets per day.
Tailor exercises can help relieve low back pain by strengthening the pelvic, hip, and thigh muscles.
To perform a tailor sit: sit on the floor with your knees bent and ankles crossed. Lean forward slightly, keeping your back relaxed and straight. You can use this position throughout the day whenever possible.
To perform a tailor press: sit on the floor with knees bent and the soles of your feet touching. Hold onto your ankles and gently pull your feet toward your body. Place your hands under your knees and inhale. Press your knees down against your hands, and at the same time press your hands up against your knees for counter-pressure. Hold for a count of five.
Yoga has many health benefits, but it may not be the right type of exercise while you are pregnant. Only try a prenatal yoga class where the poses are specifically geared toward pregnant women. If you do attend a regular yoga class, make sure you inform the instructor beforehand that you are pregnant and ask them to modify poses for you. Avoid "hot yoga" classes while pregnant.
What Exercises Should Be Avoided During Pregnancy?
While you can do many exercises during pregnancy, some exercises and activities should be avoided, including:
- Holding your breath during any activity.
- Activities where falling is likely (such as skiing or horseback riding).
- Contact sports including soccer, football, basketball, and volleyball.
- Any exercise that may cause even mild abdominal trauma such as activities that include jarring motions or rapid changes in direction.
- Activities that require extensive jumping, hopping, skipping, bouncing, or running.
- Deep knee bends, full sit-ups, double leg raises, and straight-leg toe touches.
- Bouncing while stretching.
- Waist-twisting movements while standing.
- Heavy exercise spurts followed by long periods of no activity.
- Exercise in hot, humid weather.
What Pregnancy Changes May Affect Exercise?
As your pregnancy progresses extra demands will be put on your body. It is important to listen to your body and adjust your exercise as needed. Some changes you may experience include:
- Your developing baby and other internal changes require more oxygen and energy.
- Hormones produced during pregnancy cause the ligaments that support your joints to stretch, increasing the risk of injury.
- The extra weight and the uneven distribution of your weight shift your center of gravity.
- The extra weight also puts stress on joints and muscles in the lower back and pelvic area and makes it easier for you to lose your balance.
A Balancing Act
As your pregnancy progresses your center of gravity will shift which may cause balance problems. Activities that may increase the risk of falling such as tennis, skating, aerobics, or gymnastics should be avoided. Low impact exercises such as walking are ideal. You may feel clumsier than before you were pregnant because your larger abdomen pulls your weight forward. Stick to exercises you are already familiar with.
Warning for Pregnant Women
Always listen to your body when you are working out. Stop exercising and consult your doctor if you:
- Feel chest pain.
- Have abdominal pain, pelvic pain, or contractions.
- Have a headache.
- Notice an absence or decrease in fetal movement.
- Feel faint, dizzy, nauseous, or light-headed.
- Feel cold or clammy.
- Have vaginal bleeding.
- Have a sudden gush of fluid from the vagina or a trickle of fluid that leaks steadily.
- Notice an irregular or rapid heartbeat.
- Have sudden swelling in your ankles, hands, face, or calf pain.
- Are short of breath.
- Have difficulty walking.
- Have muscle weakness.
How Soon Can I Exercise After Delivery?
Ask your doctor when you can begin your exercise routine after delivery. Most women can start doing low-impact activities one to two weeks after a vaginal birth, and three to four weeks following a cesarean birth. Continue to do your pelvic floor exercises (Kegels) but do about half the amount you did while pregnant. Don't overdo it. Your body needs time to heal so use this post-delivery time to enjoy your baby!