Exercise in Pregnancy
Should I be Exercising throughout my pregnancy?
Written by Dr. Fiona Callender, ND
We know that exercise is important for our health and overall wellbeing, and this applies just as much to pregnant folks! Though there is often fear around what we can and cannot do in pregnancy, the research is pretty clear: exercise is good for us.
Exercise can help maintain a healthy weight and body composition, but it can also help reduce the risk of pregnancy-related complications and symptoms such as:
Gestational diabetes
Pre-eclampsia
Urinary incontinence
Back and pelvic pain
It also helps increase the likelihood of vaginal delivery and supports mental health. It may even improve tolerance to pain - an important consideration for labour and birth!
It’s important that we begin to shift our mindset towards an understanding that the risk of not exercising is usually greater than the risk of exercising in pregnancy.
What are the exercise guidelines in pregnancy?
Our current international guidelines on exercise in pregnancy suggest that folks exercise at a moderate intensity for 150 minutes per week - or about 20-30 minutes daily. This should be spread across at least three days - versus packing it all into one day. Those guidelines might sound familiar because they are the same as we have for our non-pregnant people!
But what does moderate really mean?
A simple way to think about this might be to think of this as an exercise you could do continuously and could still hold a conversation if needed - the talk-test. This might be about 60-80% of your maximal heart rate.
That said, there are some challenges with using heart rate to dictate our intensity in pregnancy. Our bodies undergo physiological changes in pregnancy that change our resting heart rate! Your resting heart rate is likely a bit higher, but the maximal heart rate you can reach may not be quite as high as pre-pregnancy. With this in mind, using heart rate on it’s own as a measure tends to underestimate how intense an exercise is when you are working really hard, and overestimate when you are exercising more gently. For my patients who love a high intensity workout - or for those of who are athletes - I would recommend we use a few different methods (not just heart rate) to tune in to how hard you are pushing yourself.
“Perceived exertion” is another way we can think about and gauge intensity. One way of looking at this is by looking at a scale like the one below. On this scale you likely want to aim to be somewhere between “fairly light” and “somewhat hard”, to be within that “moderate” category.
What about higher intensities? If 150 minutes is our minimum.. Is there a maximum?
This is an area of research that we definitely need more studies on! We’ve all seen (or maybe we are one of them!) the athletes who continue to train and compete through their pregnancies. We all probably know people who have continued their routines with running or lifting or cross-fit for their entire pregnancies and I am really eager to start seeing more research about where the limit is and what the benefits are!
From the limited studies we DO have, bouts of higher intensity - ex. 10 x 1 minute at 90% of maximal heart rate with one minute rest - doesn’t seem to have any negative effects on baby or mom. One of the fears or concerns is that blood flow will be compromised to the uterus at higher intensities. There has been a study on high level athletes indicating that with intense efforts that build progressively over 20 minutes or so, at high heart rates, there might be some impact on the fetus. Though we have some really promising findings for fetal wellbeing with high intensity exercise, we still don’t have enough information to confidently say what the limit to high intensity exercise really is in pregnancy.
From my perspective, whether you are a high performance athlete or a weekend warrior, something to keep in mind is that pregnancy is probably not the time for achieving personal bests or accomplishing massive athletic feats. It can (and should) however, certainly be a time for maintaining health, strength, and fitness. For most people who have been exercising pre-pregnancy, continuing with your current level (as your body allows) seems to be reasonable. Everyone’s case is individual and we would always recommend speaking with your doctor about your unique circumstances.
Some important considerations:
Avoid straining and/or breath holding
Avoid activities that make you likely to fall or lose balance
Avoid contact sports
No scuba diving
Stay hydrated and well fuelled
Avoid intense exertion in hot/humid environments - managing your temperature is important!
Monitor your own fatigue and symptoms.
When should you STOP exercise
Please stop exercising and seek medical attention if any of the following occur:
vaginal bleeding
regular painful contractions
amniotic fluid leakage
difficulty breathing before starting exercise
dizziness
headache
chest pain
muscle weakness
calf pain or swelling.
What about core exercises?
Learning how to activate your deep core muscles effectively can help with managing pressure in your abdomen (and preventing urinary leaks), while also managing pain and tension as your belly grows. Core exercises are important to continue but will likely need to be modified as pregnancy progresses. We can work together to develop this awareness and strength throughout your pregnancy.
Working with your naturopathic doctor/pelvic health therapist
Getting some guidance and support early can be really helpful in setting you up for success. There is research that indicates that if we are exercising pre-pregnancy, we are more likely to continue with exercise throughout our pregnancy. We also know that when we have others in our life who also exercise (and exercise with us!) it is easier to stick with it. If you are thinking about getting pregnant, now is a great time to get started on some exercise!
If you are already pregnant, we can work together to figure out a plan that might work for you. We will want to work within your energy levels, while also knowing that exercise may actually improve your energy. We can also work on your symptoms - whether that’s nausea, pain, incontinence etc. - to make it easier for you to get started and reduce any barriers for you. We can work on core stability and strength and build a plan that makes sense for you and your life.
Curious about how to manage symptoms and support your body through pregnancy? You are welcome to book a complimentary meet and greet appointment to discuss how we might be able to work together.
* None of the information provided above should be construed as medical advice. It is always important to talk to your doctor about your unique circumstances when starting a new exercise routine in pregnancy.