Not Medical Advice: See Disclaimer
Our female ancestors were hunting, gathering, and doing manual labor throughout their pregnancies. It seems women were designed to be able to move throughout their pregnancies. It’s not surprising that research consistently shows that the benefits of working out far outweigh the risks. Even so, being pregnant is all-consuming. Daily tasks may now give you pause. Are the ingredients in my face cream okay? What can I take for my headache? Should I be breathing in these cleaning chemicals? What about my cat’s litter box? We are no longer thinking about ourselves but are consumed with thoughts (rational or not) about if we are supporting our growing baby.
That final thought looms large while navigating exercise. What CAN I do while pregnant? How can I exercise in a way that benefits me AND my baby? I’m already tired; I cannot risk getting injured as well. How can I possibly work out while feeling this sick? Will working out cause a miscarriage? How intensely should I workout? How often do I workout?
I’m covering common questions about exercising safely during pregnancy. If interested, I have a free 90 workout prenatal series on YouTube - check it out! This is not medical advice; please be approved by your doctor to workout. The below is based on research and what is recommended by the American College of Obstetricians and Gynecologists (ACOG) & American College of Sports Medicine (ACSM).
Navigating the First Trimester
Starting with the first trimester, many women feel sick. For some, “morning” sickness doesn’t just last in the morning. Because of this, doing any workout at all may be completely out of the question. Some encouragement here,... if you can bring yourself to put on workout clothes and just start a workout, typically exercising, even for as little as 10 minutes, should help alleviate some of your first trimester discomfort. Any exercise at all only provides benefits to both you and your baby. (1)
What Should Workout Intensity Look Like?
The intensity of your workouts depends on you and your workout history. Please note that going “full out” or maximum intensity has never been tested in pregnant women and is not recommended. Elite athletes will be instructed and extensively monitored by professionals. For everyone else, it’s up to us to listen to our bodies. Each individual has a different background and health history. If you didn’t work out before becoming pregnant, your intensity will look much different than someone who has worked out their entire life, and that’s okay! The American College of Obstetricians and Gynecologists (ACOG) suggests a rate of perceived exertion (RPE) be between 12 to 14 on the Borg Scale.
12 - 65% effort
13 - 70% effort (Steady pace & somewhat hard)
14 - 75% effort
15 (for context): 80% effort (HARD)
If your pregnancy workout feels like one of the hardest in your life, you are probably going too hard. Follow the talk test: you should be able to speak a full sentence out loud during any point in your workout. If you cannot do that, you need to slow down and/or take a break.
How Often Do I Workout?
According to ACOG, you should be completing 150 minutes of moderate-intensity aerobic activity a week. “Aerobic” activity is anything that gets your heart rate up and makes you sweat. This could be a brisk walk, cleaning your home, or a workout. It doesn’t matter how you break this up; you can do two 10-minute workouts a day or 30 minute workouts five times per week. Do whatever works for you and fits into your schedule. There is more research on aerobic exercises vs. strength training, but of the studies we do have on strength training, it appears low to moderate strength training is safe during pregnancy.
Can I lie on my back?
After the first trimester and as your baby grows, lying on your back may become more uncomfortable. One study from ACOG recommended that you avoid lying on your back after the first trimester, but that recommendation has changed. Two studies have shown no adverse effects when lying on your back for two to three minutes at a time. In my YouTube prenatal workout series, we avoid back lying positions for the most part except during our prenatal core work at the beginning. During this time, we don’t stay on our back longer than three minutes. The reason you don’t lie on your back for extended periods of time in layman's terms is because the added weight of your baby, placenta, and so forth can slow blood flow through a major vein that leads back to your heart, and this can cause low blood pressure (2, 3). This actually happened to me when I was getting acupuncture during my first pregnancy. I was in my second trimester and woke up very lightheaded, sweaty, and sick-feeling. It was terrifying (especially with a bunch of needles in my body). I would guess I had been lying on my back for 15 minutes at that point.
How Do I Avoid Injury During Pregnancy?
As stated above, you don’t ever complete max effort lifts or exertions during pregnancy. What you can do is focus on having good form, always warming up and cooling down, and listening to your body during workouts. If something doesn’t feel right, stop the movement. There are plenty of ways to workout (walk, indoor cycling, strength training, yoga, pilates, group fitness classes) and it’s best to choose from the things that feel great on your body. Always avoid contact sports or anything with extra risk, like cycling outside on the busy streets. I was an avid cyclist before my first pregnancy, and the risk of getting hit by a car or crashing because of some unexpected obstacle just wasn’t worth it.
Can I Exercise in the Heat?
The answer to this is preferably not. It’s best to choose a climate-controlled environment. Your body works hard to keep you and your baby safe. You actually start sweating at a lower temperature when you are pregnant, and this keeps your baby safe. You want to avoid overheating, so head indoors if it’s the middle of the summer. The risk of overheating and causing birth defects is highest in the first few months of pregnancy. In animal studies, the threshold temperature associated with birth defects is a maternal temperature of 102.2 F or 39 C. In retrospective analyses in humans, heat exhaustion (or fevers) can increase the risk of neural tube defects. (4)
What types of workouts are safe?
Contact sports should be avoided as well as outdoor cycling. Indoor cycling where there is not chance of being hit by a car or crashing is a great choice. Aerobic exercise is great as long as you are following the Borg Scale in the 12-14 range (see above). There is less research on strength training, but low to moderate intensity strength programs seem to be safe. (5) Form is key here. Low weight and high reps is a good format. If you start losing your form, you need to stop as this increases your chance of injury.
Can I run during pregnancy?
If you enjoyed running before, you can continue to do so until you start getting uncomfortable. You need to make sure you are warming up, cooling down, strength training, and stretching. Make sure you are engaging your core muscles as you run and staying hydrated. Your hips and joints are changing. The hormone relaxin is relaxing your ligaments and joints, and you need to run with care. Make sure not to change directions abruptly as this increases your chance of injury. Concrete and pavement are brutal on your body, pregnant or not. Running on a track or softer ground is a better option. Make sure you are doing pelvic floor work throughout your pregnancy to keep it healthy.
What about Miscarriage?
As already stated, make sure you don’t allow yourself to overheat. Research actually shows that exercise may decrease the risk of miscarriage. Light to moderate exercise does not increase your risk nor your risk of having an early delivery or having a baby with low birth weight (ACOG) If you are high risk for miscarriage or preterm birth, follow your doctor’s advice. He/She will probably have you limit your exercise, especially heavy lifting.
Can You Work Your Core?
Absolutely. Core exercises will be modified as you progress in your pregnancy. Standing core exercises are typically okay as well as side-lying plank work. Your front planks will go from hands and feet, to hands and knees with squeezed glutes, to the quadruped position.
Can You Lift Weights Above Your Head?
Lifting weights above your head COULD cause injury IF you are letting your form go to the wayside. If you are lifting light to moderate weights, focusing on form, and doing an appropriate amount of reps that don’t jeopardize your form, lifting weights above your head is fine.
What are warning signs, or when do I need to stop and call a doctors?
This is copy & pasted from ACSM:
"Persistent excessive shortness of breath that doesn’t resolve with rest.
Severe chest pain.
Regular and painful uterine contractions.
Vaginal bleeding.
Persistent loss of fluid from the vagina.
Persistent dizziness or faintness that doesn’t resolve with rest."
Citations:
1 Clapp, J.F., 3rd, and Catherine Cram. Exercising through Your Pregnancy, Second Edition, 2012. Page 157-158
Omaha, NE: Addicus Books, Inc.
2 Barakat R , Pelaez M , Cordero Y , et al . Exercise during pregnancy protects against hypertension
and macrosomia: randomized clinical trial. Am J Obstet Gynecol 2016;214:649.e1–649.e8
.
3 Barakat R , Perales M , Cordero Y , et al . Influence of land or water exercise in pregnancy on
outcomes: a cross-sectional study. Med Sci Sports Exerc 2017;49:1397–403.
4 Graham, J.M., Jr., M.J. Edwards, and M.J. Edwards, Teratogen update: gestational effects of maternal
hyperthermia due to febrile illnesses and resultant patterns of defects in humans. Teratology, 1998.
58(5): p. 209-21
5. Cress ME, Motl RW, and Clapp JF 3rd. “Safety and Efficacy of Supervised Strength Training Adopted in Pregnancy.” Rev. of Online, by O’Connor and Poudevigne MS. Pub Med (n.d.): n. pag. Web. w(1994), qtd. in Davies et al., p. 3
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