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Harvard Commentaries
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Reviewed by the Faculty of Harvard Medical School

Focus on Fitness Focus on Fitness

Exercising During Pregnancy (Part 1 of 2)

May 04, 2014

By Paulette Chandler M.D.

Brigham and Women's Hospital

Give yourself and your baby a head start. With a prenatal exercise routine you can improve posture, reduce back pain, get energized, and prepare for labor. Exercise also helps to prevent some of the common annoyances associated with pregnancy such as constipation, hemorrhoids, varicose veins, swelling in the ankles, and leg cramps by boosting circulation and stimulating the digestive process.

Women who exercise are less likely to miscarry and their labor may be easier. Obesity increases the risk of hypertension, preeclampsia, diabetes, and delivering a large baby. Women who are overweight should diet before they conceive and then switch to a maintenance diet of 1,800 calories a day while trying to get pregnant. Regular exercise can help avoid excessive weight gain.

But don't overdo the exercise to the point of losing too much weight. Being underweight also increases the risk of pregnancy complications. Preterm delivery and having a low-birth-weight baby are risks for women of average height who weigh less than 120 pounds.

The Best Exercises

One of the best and easiest ways to stay in shape is walking. Swimming and other water exercises also are good options because the buoyancy effect of water may increase your comfort by supporting your weight, reducing the weight on your back and pelvis, and decreasing any sensation of lack of balance. Whatever your choice exercise is, be ready to adapt it to your expanding belly. Be sure to begin your exercise routine with some warm-up and cool-down exercises and stretches that focus on hip, neck and shoulder movement and lower-back flexibility. Strengthen your legs, pelvic, and back muscles to prepare for the stress of pregnancy and work of labor. Try to exercise for at least 20 minutes five to seven days a week.

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Exercising Caution As Well As Your Body

Being pregnant necessitates taking some special precautions while exercising:

  • Prevent dehydration. Keep a water bottle nearby and drink frequently during exercise. Wear loose-fitting clothing.
  • Avoid exercises where there is a risk of hitting your belly. Contact sports such as soccer and activities in which there is a real risk of falling hard on your belly such as snow skiing should be avoided. Your center of gravity also changes during your pregnancy, so activities such as rollerblading and bicycling that require balancing can become more challenging and risky.
  • Avoid activities that require lying on your back for more than five to 10 minutes, such as full sit-ups and leg raises, after the first trimester since this position may reduce blood flow to your uterus and baby. Instead do stretching exercises on your side or standing.
  • Avoid overexertion. Exercise at a pace that allows you to still talk easily. As pregnancy progresses you may not be able to exercise for long periods of time. If something doesn’t feel right while doing an activity, stop.
  • Avoid rigorous exercise in hot, humid weather.
  • Contact your doctor if you experience vaginal bleeding, amniotic fluid leakage, increased uterine contractions, difficulty walking, persistent nausea or vomiting, or severe shortness of breath.

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Getting Started

You can start with 10-minute walking sessions. Check with the fitness centers in your area or a local YMCA for prenatal exercise programs. Before you begin a pregnancy fitness program, talk to your doctor. Look forward to improved posture and circulation as well as stronger muscles if you follow a well-designed exercise program.

Next month I will review specific exercises and stretches that can enhance your pregnancy fitness.

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Paulette Chandler, M.D., M.P.H., is a clinical instructor of medicine at Harvard Medical School and an attending physician at Brigham and Women's Hospital.

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