Whether you were a workout fanatic pre-pregnancy or didn’t exercise at all, you may be wondering if exercise is even safe during pregnancy and what movements you can and cannot do. Between conflicting advice from family and friends and influencers touting unsafe prenatal exercise practices online, it can be difficult to sort past the prenatal exercise misinformation and find evidence-based guidelines.
That’s why fitness experts in the Good Housekeeping Institute Wellness Lab sat down with P.volve’s Clinical Advisory Board to answer all of your questions on safe prenatal workouts, as well as the best pregnancy exercises by trimester.
What are the benefits of exercising during pregnancy?
From reducing back pain to promoting healthy weight gain during pregnancy, the benefits of prenatal exercise are vast. “Studies have shown that women who exercise during pregnancy are more likely to have an uncomplicated vaginal delivery and a quicker recovery post delivery,” says Dr. Suman Tewari, OBGYN, Clinical Advisory Board Member at P.volve.
Regular exercise during pregnancy can strengthen your heart and blood vessels and ease constipation (a pesky pregnancy symptom). Exercise is also important in the postpartum period, as it can help improve mood and decrease the risk of developing deep vein thrombosis.
Not only is movement great for you, but it’s incredible for your baby as well. “Women who exercised during pregnancy showed a lower incidence of complications such as excessive gestational weight gain, gestational diabetes, gestational hypertension, preeclampsia, preterm birth, lower birth weight, cesarean birth and operative vaginal delivery,” Dr. Tewari shares.
Is it safe to exercise during pregnancy?
Dr. Tewari says it is safe and highly recommended that women with uncomplicated pregnancies exercise throughout their pregnancy. “Exercise is essential for optimal health – both for your mind and your body – and living a vibrant life.”
“General guidelines advise that women who were engaged in vigorous physical activity prior to pregnancy can continue these activities during pregnancy and the postpartum period,” Dr. Tewari says, but don’t be surprised if you have to tone down the intensity of your workouts as you adapt to the many changes happening in your body. Dr. Tewari adds that it’s perfectly safe to exercise up until the end of your pregnancy, but that it’s important to consult with your obstetric provider who may recommend modifications to your exercise routine.
Although it’s ideal to be exercising before getting pregnant, many women are motivated to establish healthy habits during pregnancy and start a workout regimen which is great. “If you have a standard pregnancy, you can start exercising anytime; start with a mild intensity exercise routine and then gradually increase the intensity,” Dr. Tewari says, stressing that it’s important to listen to your body and always consult with your obstetric provider. “Our bodies are meant to be moving every day, pregnant or not.”
There are certain situations where pregnant women should not exercise until they have been further evaluated by their obstetrician, Dr. Tewari advises. Those include symptoms like vaginal bleeding, abdominal or pelvic pain, amniotic leakage of fluid per vagina, dizziness, headache, chest pain, calf pain or swelling, muscle weakness affecting balance, labor pains and regular contractions.
How much exercise is recommended during pregnancy?
“The current recommendation for pregnant and postpartum women is at least 150 minutes of moderate intensity aerobic activity per week,” Dr. Tewari explains. You can divide the 150 minutes into 30-minute bouts of exercise five days a week or smaller 10-minute workouts throughout each day. But don’t feel discouraged if you can’t hit the full 150 minutes per week; any activity and movement is better than none, especially during pregnancy.
Pregnancy Exercise Modifications
As your baby and belly grows, among the many other changes of pregnancy, some modifications will be necessary. Joints become relaxed, the extra weight in the front of your body shifts your center of gravity and breathing can also become difficult as your need for oxygen during pregnancy decreases. “Each person and pregnancy are different, so the rule of thumb is to always listen to your body and let it be the guide,” says Antonietta Vicario, Integrative Health Coach, VP of Talent and Training at P.volve. Here are some main exercise modifications to keep in mind as your pregnancy progresses:
- Avoid jerky and bouncy movements: Hormones that are made during pregnancy cause the ligaments that support your joints to become relaxed, which can increase risk of injury. The American College of Obstetrics and Gynecology (ACOG) recommends avoiding jerky, bouncy and high-impact motions throughout your pregnancy. Modifying for low-impact movements instead is a great option.
- Avoid exercising in high-heat environments: ACOG advises pregnant women to avoid exercising in high heat and humidity to protect against heat stress, particularly in the first trimester. It’s also important to stay hydrated during exercise and throughout the day, and if possible exercise in a temperature-controlled room. Hot yoga classes and the like should be avoided.
- Avoid performing exercises flat on your back: Exercising flat on your back (also known as the supine position) puts pressure from your growing uterus on a large vein that returns blood to the heart. Vicario says that you can prop yourself up on pillows or use a prenatal wedge if you’re doing anything on your back. It’s also important to avoid exercises that require you to lie on your belly, as well as uncontrolled twisting motions of the torso. You can try exercises in the side-lying position, such as side-lying lower body pilates work and side-lying savasana. “Side-lying also helps for comfort as to keep blood flow circulating toward the baby,” Vicario adds.
- Avoid abdominal crunches: Core exercises like crunches should be avoided to allow for flexibility in the rectus abdominis, the outermost layer of the abdominal wall, but there is no need to completely avoid core work during pregnancy Vicario explains. “Gentle abdominal work is important and can help keep the baby from weighing down on the bladder!”
- Avoid contact sports: Activities that put you at risk of getting hit in the abdomen, like basketball, soccer, boxing and ice hockey should be avoided during pregnancy.
What is the pelvic floor?
You may have heard about the importance of pelvic floor health during and after pregnancy. “The pelvic floor is a group of skeletal muscles at the base of the pelvis, that forms a bowl-shaped structure connecting our sit bones, our tailbone, and our pubic bone. In other words, it covers the entire bottom of our pelvis,” explains Dr. Amy Hoover, Doctor of Physical Therapy, Clinical Advisory Board Member at P.volve. The pelvic floor is also a vital part of core musculature Dr. Hoover shares, working with the diaphragm, abdominal and back muscles to help control the pressure system in the body as you move and function throughout your day.
Strengthening the pelvic floor during pregnancy is important as the demand of core stability increases as your baby grows and your joints become slightly more lax. “The mechanics of how we move change rapidly during pregnancy due to increased weight and stretching of the abdominal wall, as well as changes in our center of gravity” says Dr. Hoover. “Strengthening the pelvic floor during pregnancy may also help reduce the risk for urinary incontinence and pelvic organ prolapse both during pregnancy and postpartum.” Since the pelvic floor muscles are stretched to several times their resting length during vaginal delivery, the more strength you can build during pregnancy means a better recovery after delivery.
The Best Pregnancy Exercises By Trimester
The best pregnancy exercises focus on hip and core strength, as well as balance and pelvic floor strengthening. Vicario recommends the following exercises by trimester to help keep you strong and active during all phases of your pregnancy.
Move 1: Diaphragmatic Breath with Pelvic Floor Activation
Stand with feet wide, knees soft, eyes closed and hands on belly. Take deep breaths into the belly allowing it to expand and contract fully. As you exhale, think of stopping the flow of urine, contracting vaginally, rectally, and feeling how the tailbone naturally flexes without adding any movement there. As you exhale and contract the pelvic floor, add pulling the abdominals in and up as if you were riding an elevator from the basement to the top floor of a building. All of these sensations account for a properly executed Kegel.
Move 2: P.sit to Stand
Stand tall with feet, knees, and thighs together and turn your palms forward. Hinge back at your hips into a p.sit, keeping knees over ankles and spine long and straight to stretch the glutes while sweeping the arms overhead. Drive up through the floor, pressing your feet down to come back to stand with the arms by your side. Add the pelvic floor contraction as you stand back up.
Move 3: Standing Abs
Tap one toe straight forward, angling your hip bones up toward the ceiling and squeezing into your glutes while leaning back. Be sure to keep your ribcage hugged together in the front so you don’t sink into the lower back. Reach your arms overhead with palms facing forward. Lift your front leg up while pressing your arms down, recruiting your abdominals as you do in your everyday life and working on stability. If needed, feel free to hold onto the back of a chair.
Move 4: Pelvis Articulation
Step one foot back as if you are mid-step and lower your back heel down. Front knee is slightly bent. Start to open and close your hips, rotating your pelvis while keeping your feet pointing straight forward to get some movement in the hips. For an added challenge for the upper body, grab onto light weights and pull one elbow back at a time, moving the arms as you twist your hips.
Move 5: Butt Press
Start on all fours stacked with a neutral spine, hands in line with shoulders and hips over knees. Keep your abdominals lifting to the ceiling so your back stays neutral, feeling the sensation of hugging your baby in. Bend one knee up to the ceiling, pressing through a flexed foot and return to start position, pumping through the glutes.
Move 1: Step Back
Step one foot back as if you are mid-step and lower your back heel down, leaning your body forward to create one long diagonal line through the crown of your head and down through the back heel, arms reaching back behind you. Keeping your back leg straight, lift the heel high, squeeze the back glute and push through the ball of the foot to engage your glutes while reaching your arms overhead. Feel a huge stretch on the hip flexor which tends to get very tight from pregnancy. From there, return to start position.
Move 2: Stagger Row
Holding onto light hand weights or water bottles, sit your hips back into a p.sit, hinging at your hips with both knees deeply bent and weights reaching on a low diagonal. Keeping your knees in line, bring one foot back behind you pressing through the ball of the foot. Drive up through both feet to come to full hip extension and squeeze your weights in by your ribs, engaging the glutes and postural muscles.
Move 3: Rotating Stagger
From your stagger position, keep your standing foot forward and pivot your hips and torso toward your front leg, rotating on a 45-degree angle out to the side. Extend the weights in this internal stagger position. Come back to center, rowing your arms back.
Move 4: Internal 45 with Side Stretch
From your internal stagger position, drop the hand weights and stretch your back leg. Reach the arm of your extended back leg straight forward in line with your shoulder and bend the other elbow out to the side at a 90 degree angle. Reach your bent arm up overhead while allowing your hips to shift to the side, feeling an elongation from your hip all the way up through your fingertips, allowing breath to move into the sides of your body.
Move 5: Leg Lift
Start on all fours with a neutral spine, hands in line with shoulders and hips over knees. Keep your abdominals lifting to the ceiling so your back stays neutral. Extend one leg straight back behind you, tapping your toes to the floor. Lift and lower the leg while keeping your baby hugged into your spine, pumping through the glutes.
Move 1: Fire Hydrant
Lean your upper body forward with a soft bend in your knees and stagger one foot back behind you, interlacing your hands. Begin to lift and lower the back leg out to the side, squeezing the outer glute and engaging through the pelvic floor as you come back to stagger. Feel free to hold onto something for balance if needed.
Move 2: Kneeling Hip Flexor Stretch
From a kneeling position, step one foot directly out in front of you and reach your arms forward at shoulder height. Squeezing your back glute, shift your hips forward and stretch the arm of the kneeling leg up to the ceiling for a deep hip flexor stretch. Always maintain a squeeze on the kneeling glute. Come back to start position.
Move 3: Intercoastal Kneeling Stretch
From your kneeling inner thigh stretch, step your front leg out to the side, keeping knee in line with second toe and W the arms. Shift your weight into the foot on the floor, stretching open your inner thighs. Reach the arm of your kneeling leg up and over to corner of the room, breathing into all the muscles between your ribs that may not have full excursion of the breath due to your growing belly.
Move 4: Hamstring Press
Come to a side-lying position on a prenatal wedge or a stack of pillows to keep your heart above your baby. Bend your knees so they are in 90-degree angles, knees in line with hips and feet in line with knees. Lift your top leg and flex your foot and then extend the leg straight back behind you, working into the back of the leg and glute.
Move 5: Bridge
Come to lay on your back on a wedge with your knees bent, feet pressing into the floor. Relax your arms down by your sides. Press your hips up to the ceiling then lower down to a hover.
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