The information included in Dear Stephanie posts is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. Always consult your healthcare provider to determine the appropriateness of the information for your own situation, or if you have any questions regarding conception, pregnancy, or your prenatal treatment plan. For more Dear Stephanie posts, click here. Have a question for Steph? Click here to e-mail her.

Dear Stephanie,

Help! I’m pregnant and I love high-intensity exercise. How do I know if I’m working out at a safe level of intensity? – A Mama on Facebook

Dear Facebook Mama,

I am happy to hear you’re continuing to exercise during your pregnancy. Research has shown a wide variety of benefits for both you and your baby with exercise. Some of the benefits include:

  • A lower risk of pregnancy-related complications and symptoms like back pain, gestational diabetes, preeclampsia and constipation.
  • A decreased need for pain relief and other interventions.
  • Healthy weight gain during pregnancy, weight loss after delivery, and improved self-esteem.
  • Not to mention staying in shape so you can lift and chase your little one once he/she starts moving!

I know you want to make sure you and your baby are safe while you exercise. It can be hard to understand the risks when you’re bombarded with a wide variety of opinions. Health professionals, the media, and even other mamas sometimes spread fear about exercising throughout pregnancy.

As with many decisions you’ll make throughout your pregnancy, this question doesn’t have one right-or-wrong answer. It’s about what’s right for you. Let’s answer this question together, following this template (which applies to many questions you may have during pregnancy):

  • Understand your context (your health status, your lifestyle habits, your preferences)
  • Look at the research (including both conventional and alternative recommendations)
  • Ask a health professional that you know and trust
  • Trust your gut

Let’s use this template to answer your question.

Understand your context

Every pregnant women is starting out at different level of fitness. If you were sedentary before becoming pregnant, you would do well to follow a gradual progression of exercise. In that case, I’d highly encourage working with a prenatal fitness specialist to ensure safe, quality movement. Note: Pregnant women used to be discouraged from exercising if they were previously sedentary, but that’s an outdated recommendation as we now understand just how important exercise is for mom and baby.

A woman who has been following a high-intensity sport for months can probably continue that activity once she’s pregnant, especially with the help of a trainer skilled in prenatal fitness since modifications may be necessary.

In general, if you are healthy and your pregnancy is going well, it’s safe to continue with most types of exercise with modifications that honor the anatomical and physiological adaptations of pregnancy.

You also want to take into consideration how you’re feeling. Some weeks, especially in the first and third trimester, you may be exhausted. You may feel uncomfortable or be experiencing back pain. Instead of “pushing through it,” choose something more relaxing like short walks, stretching, and mobilizing.

Look at the Research

Check out resources like the American Congress of Obstetricians and Gynecologists (ACOG), PubMed, other country’s guidelines (such as www.nhs.uk), or books find books on the topic (like Exercising Through Your Pregnancy) to educate yourself on the current evidence.

Your question about a safe level of intensity during exercise has a pretty standard answer across the board, so you can walk away from the research feeling pretty confident about your choice. Other answers may not come as easily.

The controversy over intensity stems from an outdated fear that intense exercise (particularly having mom’s heartbeat going over 140 beats per minute) could restrict blood flow to the fetus. The recommendation was based on limited evidence, so the American College of Obstetricians and Gynecologists no longer make a standard recommendation for heart rate during exercise. Instead, they encourage pregnant women to use ratings of perceived exertion to monitor exercise intensity.

You can use the “talk test” while working out to monitor your intensity. You should be able to carry on a conversation while exercising. If you can do this, you are likely not overexerting yourself. Easy enough, right?

Ask a Health Professional You Know and Trust

Exercising during pregnancy sounds like a great idea for everyone, but there are certain situations and contraindications where exercise may need to be limited or avoided.

According to ACOG, women with the following conditions or pregnancy complications should not exercise during pregnancy:

  • Certain types of heart and lung diseases
  • Cervical insufficiency or cerclage
  • Being pregnant with twins or triplets (or more) with risk factors for preterm labor
  • Placenta previa after 26 weeks of pregnancy
  • Preterm labor or ruptured membranes (your water has broken) during this pregnancy
  • Preeclampsia or pregnancy-induced high blood pressure
  • Severe anemia

However, this is something you’d want to discuss with your provider as there are conditions and complications (such as diastasis recti) outside of this list that may warrant limiting or avoiding certain exercises.

While exercising, if you notice any of the following signs, please immediately stop exercising and talk to your provider:

  • Vaginal bleeding or fluid leaking from the vagina
  • Calf pain or swelling
  • Headaches
  • Dizziness or fainting
  • Chest pain
  • Shortness of breath before starting exercise
  • Muscle weakness
  • Regular, painful contractions of the uterus

Talk about exercise with a health professional you trust and seek additional opinions if you aren’t receiving an answer you’re satisfied with. Even though the current evidence shows that physical activity in pregnancy has minimal risks and numerous benefits in healthy women, I still see providers using extra precaution with exercise or inducing fear in women who would do well continuing their exercise routine.

Trust your Gut

Slow down and listen to your body throughout your pregnancy. Just because you were able to lift a certain weight before you became pregnant doesn’t mean that you can or you should continue to lift the same weight.

If your body is telling you it wants to take a nap instead of going to the gym, trust it. If it’s telling you that a certain movement doesn’t feel good, trust it. Just because you see another pregnant mama doing a type of exercise or lifting a certain weight doesn’t mean it’s the best choice for you.

The “talk test” may have informed you that working out at a certain intensity was reasonable last week, but you can barely catch your breath at that same intensity the following week. This will happen to you at some point, so please listen.

In order to answer your question, I could have just given you the basic information about the “talk test” and a few key warning signs to look out for. That would have saved me time writing this blog post and you time reading it, but that strategy would have robbed you of fully understanding how to approach these types of questions.

My ultimate goal is to have you understand how to answer your own questions, feel empowered with your choices, and be able to share this template with other mamas. Following this template will allow you to approach questions with less fear and feel satisfied with your decision.


 

Steph(hi)-6Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice, RockYourHormones.com.

 

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