Pregnancy & Postpartum Exercise
Demystifying Pregnancy Exercise
Myths of Prenatal Exercise
You've likely heard these common pieces of advice about exercising during pregnancy:
"Just listen to your body"
"Don’t lift more than 20lbs"
"Keep doing what you were doing pre-pregnancy"
"Don’t start exercising during pregnancy if you weren't active before"
”Athletes can typically continue vigorous exercise"
"Exercise in pregnancy only helps you lose the baby weight faster postpartum/helps you keep your figure.”
Conflicting advice from different sources can leave women feeling confused and uncertain about exercising during pregnancy. Pregnant women are often treated as weak and feeble, but that is far from the truth! It's important to understand the reality behind these myths in order to make your own informed decisions about physical activity during pregnancy.
The Truth about Prenatal Fitness
Exercise has many benefits to the mother and developing baby beyond merely getting rid of postpartum baby weight. There are recommended activity levels and safety factors that a mama should consider when deciding whether to implement, increase, or modify a training program during each trimester of pregnancy and postpartum.
From the American College of Gynecologists and Obstetrics (ACOG),
“If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity. Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery.” (2022)
Benefits of Prenatal Exercise for Mom
A literature review of the strongest evidence (Ribeiro et al, 2022) found that the benefits of exercise during pregnancy can include:
Shorter labor & improved postpartum recovery time
Lower risk of pregnancy complications such as gestational diabetes, hypertension, and preeclampsia
Reduced need for a medical induction, which can positively impact your birth and postpartum outcomes
More comfortable pregnancy, with decreased back & joint pain, reduced constipation
Decreased risk of caesarean section
Strengthen heart & blood vessels
Improve overall fitness
Reduce anxiety & prenatal depression
Prevent urinary incontinence
Build mental and physical endurance
Benefits of Prenatal Exercise for Baby
Not only does exercise benefit mom, but it also gives benefits to baby (Bauer et al, 2020):
Increases baby’s supply of oxygen and nutrients by improving placental function
This supports healthy fetal growth and development.
Increased umbilical blood flow, which can increase placental circulation and improve baby’s cardiovascular function
Reduced risk of preterm birth
Can contribute to healthy birth weight for the baby
Improved brain and nervous system development, which can increase cognitive function, increased language skills, & improved motor function in the first years of life!
“Compliance with current guidelines is sufficient to achieve the main benefits [of exercise], and exercise type and intensity should be based on [a] woman’s previous fitness level.”
from the Journal of Perinatal Medicine (2022)
What are the Prenatal Exercise Guidelines?
The prenatal exercise guidelines are the same as they are for the general adult population. As long as there is no medical reason to avoid exercise, pregnancy is considered a great time to maintain or begin a fitness routine.
“...moderate-intensity exercise for at least 20–30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated.” (ACOG, 2020)
This generally means that if you are not already physically active for 20 to 30 minutes at least 5 to 7 times per week, you should gradually build up to this in increments to see how your body responds to each increase in activity level.
Moderate-intensity physical activity is working hard enough to break a sweat but still be able to carry on a conversation.
Working with a trained fitness professional, ideally certified in prenatal and postpartum exercise, can help to increase motivation as well as create your individualized plan to build up to the goal of 20 to 30 minutes of moderate-intensity aerobic exercise per day for an accumulated minimum of 150 minutes per week.
Including muscle-strengthening activities of moderate-intensity that involve all major muscle groups on 2 or more days per week can also provide additional health benefits. (USDHHS, 2018)
Safety Precautions for Pregnancy Exercise
These are conditions and pregnancy complications where exercise may require careful observation and close collaboration with your doctor and a physical therapist or personal trainer certified in pregnancy and postpartum exercise to help prepare for labor and birth (ACOG, 2022):
Certain types of heart and lung diseases
Cerclage
Twins or triplets (or more) with risk factors for preterm labor
Placenta previa (placenta covering the cervix) after 26 weeks of pregnancy
Preterm labor during this pregnancy or ruptured membranes (your water has broken)
Preeclampsia or pregnancy-induced high blood pressure
Severe anemia
Preeclampsia & Exercise
Preeclampsia is a condition that can develop after the 20th week of pregnancy, marked by high blood pressure and protein in the urine. It is a leading cause of health issues and complications for both mothers and babies in developed countries. Currently, the only way to treat preeclampsia is to deliver the baby.
While many studies show that regular exercise is beneficial for a healthy pregnancy, the effect of exercise on reducing the risk of preeclampsia is still debated. Because of this, ACOG does not currently recommend exercise specifically to prevent preeclampsia in women who are at risk.
However, there is strong evidence suggesting that exercise may play a protective role against preeclampsia. Studies focusing on physical activity early in pregnancy have found that women who are active have a significantly lower risk of developing preeclampsia compared to those who are sedentary. (Genest et al, 2012)
General Safety Precautions
Exercise is usually safe and beneficial during pregnancy. However, here are some safety precautions to keep in mind:
Avoid physical activity in extreme heat or humidity, including "hot" yoga/pilates.
Avoid activities with a high risk of falling, such as downhill skiing, surfing, and horseback riding.
Avoid scuba diving and sky diving.
Avoid contact sports or activities with a high risk of abdominal trauma, like ice hockey and soccer.
Maintain adequate nutrition and hydration before, during, and after physical activity.
Consulting healthcare professionals, especially those trained in pregnancy and postpartum care, is crucial for developing personalized exercise plans that prioritize safety and effectiveness.
What About Postpartum Exercise?
Physical activity can be resumed gradually as soon as physically and medically safe, which will vary depending on mode of delivery, health status, and individual factors.
Mild physical activity with pelvic floor exercises and stretching should be able to be resumed immediately.
Engaging in postpartum exercise continues to play a vital role in promoting overall well-being and preventing disease for mom. (Dipietro, 2019) Postpartum exercise can:
Decrease risk of deep vein thrombosis (DVT)
Improve cardiovascular health
Improve mood and relieve stress
Reduce risk of developing postpartum preeclampsia
Maintain pelvic floor function
Reduce symptoms of Postpartum Depression
Getting Started with an Exercise Program
A well-rounded exercise program includes both aerobic and strength training exercises, though you don't need to do them in the same session. This combination helps maintain or improve overall health and function.
Not all exercise programs are suitable for everyone. Choose activities that you find comfortable and enjoyable. Stop any exercise that causes pain or leaves you breathless. Aim for moderate-intensity exercise, which means you should be working hard enough to break a sweat but still be able to hold a conversation. If you can't talk without gasping for air, you're working too hard.
Examples of aerobic exercise:
Walking
Running
Stair climbing
Cycling
Rowing
Hiking
Swimming
Examples of strength training:
Weight machines
Free weights
Kettlebell
Resistance bands
Body weight exercises
Modified yoga
Modified Pilates/Barre
Resources
Pregnancy/Postpartum Exercise Training Program
Daesha, Christian Birth and Postpartum Coach - IG @daeshajoyfit - Training mothers for the natural birth and postpartum recovery of their dreams.
Birth FIT - https://birthfit.com/ - Strength & conditioning training for the motherhood journey.
Brianna Battles - https://www.briannabattles.com/ - Creator of The Pregnant Athlete Training Program which provides support through birth.
MamasteFit - https://mamastefit.com/ - Supports you during pregnancy, birth, and beyond with online courses & fitness programs.
Fit 4 MOM - https://fit4mom.com/ - Pre and postnatal health, wellness, and fitness programs for every stage of motherhood.
Pelvic Floor Physical Therapy
Find a certified Pelvic Floor Physical Therapist near you at https://pelvicrehab.com/
Desert Healing & Pelvic Health Physical Therapy in Tucson, AZ - https://www.deserthealingandpelvichealth.com/ - Offering support in somatic sex therapy & guidance, pelvic pain, vulva or vaginal pain, dysfunction or pain with sexual intercourse/dyspareunia, urinary/bowel issues, labor preparation, and post-partum recovery care & assistance.
Catalyst Physical Therapy in Tucson, AZ - https://catalyst-physicaltherapy.com/ - Address dysfunctions of the pelvic floor muscles such as pelvic pain, pain with intercourse, urinary or bowel dysfunctions, weakness, and prolapse. Great for preparing for labor.
Birth Prep Classes
AZ Support Birth Collective - https://www.supportbirth.org/classes - Support Birth Collective offers support, education, and guidance through pregnancy, birth, and into the postpartum period, including labor and birth prep classes.
Mama Natural Birth Course - https://mamanaturalbirth.com/ - A 12-hour virtual childbirth class with a year of access to go at your pace. Reimbursable or pay with by FSA/HSA/HRA.
References
Exercise during pregnancy. (2022). Retrieved from https://www.acog.org/womens-health/faqs/exercise-during-pregnancy
Ribeiro, M., Andrade, A. & Nunes, I. (2022). Physical exercise in pregnancy: benefits, risks and prescription. Journal of Perinatal Medicine, 50(1), 4-17. https://doi.org/10.1515/jpm-2021-0315
Bauer, I., Hartkopf, J., Kullmann, S., Schleger, F., Hallschmid, M., Pauluschke-Fröhlich, J., Fritsche, A., & Preissl, H. (2020). Spotlight on the fetus: how physical activity during pregnancy influences fetal health: a narrative review. BMJ open sport & exercise medicine, 6(1), e000658. https://doi.org/10.1136/bmjsem-2019-000658
Physical activity and exercise during pregnancy and the postpartum period. (2020). Retrieved from https://www.acog.org/-/media/project/acog/acogorg/clinical/files/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period.pdf
Physical Activity Guidelines for Americans, 2nd edition.(2018). U.S. Department of Health and Human Services, Washington, D.C.
Genest, D. S., Falcao, S., Gutkowska, J., & Lavoie, J. L. (2012). Impact of exercise training on preeclampsia. Hypertension, 60(5), 1104–1109. doi:10.1161/hypertensionaha.112.194050
Dipietro, L., Evenson, K. R., Bloodgood, B., Sprow, K., Troiano, R. P., Piercy, K. L., Vaux-Bjerke, A., Powell, K. E., & 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE* (2019). Benefits of Physical Activity during Pregnancy and Postpartum: An Umbrella Review. Medicine and science in sports and exercise, 51(6), 1292–1302. https://doi.org/10.1249/MSS.0000000000001941
Just a friendly reminder: While we've conducted our research, it's advisable for you to do the same! Compare our sources with your own and remember to apply good judgment at all times.
Thank you for taking the time to read our guide on demystifying pregnancy exercise. We hope this information has clarified the myths and truths surrounding prenatal fitness, emphasizing the numerous benefits it offers for both mothers and babies.
Staying active during pregnancy is crucial for your overall health and well-being. By understanding the guidelines and working with healthcare professionals and certified fitness experts, you can create a safe and effective exercise routine tailored to your needs.
If you are ready to take the next step in optimizing your prenatal fitness and health, we invite you to book a clarity call with us. Our team is dedicated to providing personalized support and holistic care, ensuring you receive the best possible guidance throughout your pregnancy journey.
Together, we can create a comprehensive healthcare plan that promotes a healthy, active pregnancy for you and your baby. Book your clarity call today and take the first step towards a healthier pregnancy.
