WAVES OF WELLNESS: Guidelines for safe, smart exercise while pregnant

Most of us now know that regular exercise is important for our health, but women are often unsure of what they can and cannot do safely once they become pregnant.

It is recommended that pregnant women engage in 30 minutes or more of moderate exercise per day on most, if not all, days of the week. However, before beginning any exercise program, it is important that a woman’s overall health and obstetrical risks be evaluated by her physician.

There are some absolute contraindications to exercise in pregnancy, including preeclampsia, significant heart disease or incompetent cervix.

Most pregnant women, however, should be able to exercise routinely and derive its many benefits. Exercise will not only keep a woman fit during her pregnancy, it can also help physically and emotionally during labor and make it easier to work off the pounds once the baby is born.

Changes in the pregnant woman

There are many changes in the pregnant body that can impact how a woman exercises.

■ Joints are more mobile during pregnancy and are at more risk for injury. This is because the hormones produced in pregnancy cause a relaxation in the ligaments.

■ Most women gain 25-40 pounds in pregnancy and much of this extra weight is centered in front of a woman’s body. This shift in the center of gravity causes more strain on the lower back and pelvis. It can also cause a woman to feel less stable and lose her balance more easily.

■ Many activities will be more difficult to do as pregnancy progresses. A pregnant woman’s body will have to work harder than it normally does. Avoiding excessive heat and not overdoing it are important. If you are exercising moderately and can talk normally, then your heart rate is at a good level. Always listen to your body.

Choosing the right exercises

In general, most recreational activities appear to be safe. There are some exercises and positions, however, that can be uncomfortable or unsafe in pregnancy. Prolonged motionless standing and any exercise that requires a woman to lie flat on her back after the first trimester should be avoided.

All exercise routines should start off with a good stretch or warm-up period to prepare your muscles. And be sure to drink plenty of water.

Let’s look at some popular types of exercise:

■ Walking — This is a great form of exercise that even beginners can do. Brisk walking can give you a complete body workout. If it has been a long time since you’ve exercised, you can start by walking as little as 5 minutes a day and add 5 minutes each week until you can walk briskly for 30 minutes a day.

■ Swimming — Taking a swim is another excellent sport for a pregnant woman. Not only does it work out all your muscles, you have the added benefit of staying cool and having the water support your weight. This helps with muscle strain and a sore back.

■ Low-impact aerobics and cycling — These are other great forms of exercise, and many classes are uniquely tailored to pregnant women. The pregnant belly can affect a woman’s balance and increase the risk for falls, therefore stationary cycling is preferred later in the pregnancy.

Exercises to avoid during pregnancy

■ Contact sports that have an inherent risk for potential injury, such as basketball, soccer and hockey, should be avoided. These can result in trauma to the baby.

■ Activities that have a high risk for falling, such as gymnastics, horseback-riding and downhill skiing, should also be avoided.

■ Some racquet sports that have sudden changes in movement may have to be avoided as a woman’s balance starts to be affected in pregnancy, increasing her risk for falls.

■ Scuba diving should be avoided during pregnancy, as the baby is at risk for decompression sickness.

When to stop exercise

Exercise should be stopped and the doctor should be called if there is any vaginal bleeding, dizziness, increased shortness of breath, chest pain, calf pain, uterine contractions, decreased fetal movement or rupture of membranes.

Sayra Sievert, MD, is chairwoman of Women & Children’s Services at Baptist Medical Center — Beaches. Call her at (904) 247-5514.