While it’s true that, as a man, I’ll never experience the intense discomfort and pain of the miracle that is preg­nancy, my wife did not for one minute shirk from sharing hers with me during all three pregnancies of our children. I therefore have some inkling as to how the prospect of exercise can feel to a woman who is ″with child″; not good, to say the least. There are others who, while willing to be as healthy as possible during this challenging time, are un­sure of what exercises are safe, or even wheth­er any should be done at all.

Should I exercise if I’m pregnant?

The many benefits of regular exercise that apply to other healthy individuals also apply to pregnant women who do not have any complications that would limit their activity. Additional benefits for pregnant women who exercise consistently include a lower risk of developing pregnancy-spe­cific conditions such as gestational dia­betes, as well as some of the fun but very normal associated symptoms such as back­aches, constipation, and bloating. Most healthy women can continue to exercise throughout their pregnancy with minor modifications as their pregnancy progress­es and physiological changes occur.

What physiological changes?

Pregnancy temporarily alters a woman’s physiology, anatomy, kinesiology, and bio­mechanics; these changes may be hormonal, physiologic, and/or musculoskeletal. Each tri­mester brings various challenges that may in­terfere with consistent physical activity, and each pregnancy (even of the same woman) is different. Therefore, close communication with healthcare providers is always encouraged be­fore, during, and after the pregnancy. It’s es­pecially important for pregnant women with specific medical conditions such as hyperten­sion, gestational diabetes, and morbid obesi­ty to see their physician prior to beginning an exercise program; exercise intensity and pro­gramming will need to be adjusted according to functional capacity, fitness level, symptoms, and daily energy fluctuations. Also, don’t for­get, you turn into Super Elastic Woman…

Super-human powers?

The hormone relaxin greatly increases over the course of pregnancy, with up to 10 times pre-pregnancy concentration lev­els occurring within the first trimester. This hormone allows the ligaments and connec­tive tissue to stretch, which is vital during the delivery process. However, all connec­tive tissues surrounding joints will have the ability to stretch beyond their normal length, thereby compromising joint integ­rity and overall stability. Therefore, cer­tain movements need to be performed with caution, such as turns, quick chang­es of direction, high-impact exercises, exer­cises that place weight on the wrist while in extension, and exercises that work the lower back. End ranges should be avoided during stretching so as to not permanently stretch out the supporting structures of the involved joints.

So I can still do my aerobics?

Aerobic activity is important for keep­ing the heart and lungs strong, increasing circulation, and otherwise enhancing a woman’s overall energy level. However, the increased blood volume and decreased ve­nous return associated with pregnancy can compromise the cardiovascular system, so some precautions need to be followed in relation to intensity and volume of aerobic activity. That being said, moderate intensi­ty should be safe for most participants, es­pecially in the early stages of pregnancy. Ac­tivities such as low-impact aerobics, water aerobics, swimming, walking, and cycling are recommended for pregnant women of all fitness levels.

The recommended frequency for aero­bic exercise is a minimum of three times per week, and can be daily for those already partic­ipating in a program when they become preg­nant. Previously sedentary individuals should begin with a shorter duration (between 5 and 15 minutes) three days per week and gradual­ly lengthen their workouts (building up to 30 minutes) four to five days per week as they be­come more accustomed to regular exercise. Usually, women will feel the need to decrease intensity, duration, or frequency as pregnancy progresses, especially in the second and third trimesters.

How about “pumping iron”?

The goal of resistance training is to maintain one’s strength throughout preg­nancy and prevent some of the common­ly associated aches and pains. It’s extremely important to build the stabilizing muscles of the upper back and shoulder to (a) coun­terbalance the increased weight (see be­low), and (b) to be able to hold the newborn for extended periods of time without expe­riencing neck and shoulder pain.

While exercises such as squats and lung­es (not forgetting Kegel exercises) are bene­ficial, deep knee bends should be avoided. Maintaining lower body strength and flex­ibility is important for being able to move the newborn both into and out of the bassi­net. Be sure to walk around between resist­ance sets and after exercise; it’ll enhance circulation and venous return, mitigating the effect of a hypotensive response. Also, be careful transitioning from a lying to a standing position; move slowly and in stag­es rather than in one quick movement.

So wrestling matches and football games are out?

Yes, sorry. Contact sports and activities that may increase the risk of trauma to the abdominal area or present a high risk of falling—either of which may cause harm to the mother or fetus— should be avoid­ed. But it’s not all bad news…

Yay! You get to eat more…

The increased metabolic demand of preg­nancy requires the ingestion of an additional 300 calories per day. Therefore, make sure to eat a snack before exercising to ensure that ad­equate fuel is available.

But with great calories increase come great responsibilities…

…and an extra 25–35 lbs. too, primarily during the third trimester. This weight gain alters the center of gravity, and affects bal­ance. The distribution of this excess weight is mainly in the front, which can make it difficult to see your feet; therefore, activi­ties that challenge balance should be avoid­ed.

Also, the thermoregulatory system is compromised during pregnancy, increas­ing the risk of overheating, so be sure to exercise in a cool and well-ventilated en­vironment, wear loose-fitting clothes, and stay hydrated.

What about after the birth?

During the postpartum period, exercise can be resumed gradually, usually within four to six weeks after delivery, provided there are no complications. However, it’s crucial to resume exercise only when it is physically and medically safe to do so, and after you’ve been given the all clear from your doctor(s). Gradual progressions are recommended to enhance the new moth­er’s physical and mental well-being.

A healthy mother is more likely to give birth to a healthy baby, so be safe, be smart, be strong, and be well; you only get to do it once per child, so look after yourself and cherish this astounding miracle.

Chemmie Sokolic is an ACSM-certified Personal Trainer, and owner of Frum & Fit LLC. Chemmie can be reached at [email protected]. Visit www.Fru­mandFit.com or www.Facebook.com/FrumandFit for more information.

By Chemmie Sokolic