The Truth About Exercise During Pregnancy: Working Hard Is OK
Sometimes it seems like the only exercise options for pregnant women are light swimming, gentle yoga, and gentle walking on the pillow field. But if you’re not happy with that, you’re in luck: many activities during pregnancy are safer than outsiders might think, or even your doctor might think.
When Calm Down Is Not Easy Advice
Well-meaning doctors, coaches, and mom friends may advise you to switch your goals from racing, games, and PR to “getting ready for childbirth,” or focus on keeping yourself and your baby healthy. If it works for you, great. This intrinsic motivation makes it easy to stick to a good habit.
But for many women who have been athletic from the start, “take it easy” is not easy advice. A quick poll of my female athlete friends included the following comments:
“I was told to relax, not skate at all, the walking was good enough. I was crazy about it. Thinking that everything I loved to do would somehow kill my unborn child. I still swam half a mile a few times a week, biked 10 miles a couple of times a week until my stomach hit my knees … but the fear did cause severe depression. I felt as if I was losing relevance while the child is healthy. ” -Carly
“Just getting ready for childbirth would be completely unmotivating for me – I needed a race [walking half marathon] to motivate me.” -Laura
“Well, random people scold me for rolling, moving chairs, bending over, doing housework. Basically doing anything other than sitting and eating was really tiring and annoying. It was almost easier to do nothing and get rid of the annoyance. Add to that a bit of severe perinatal depression, fever, and bad knees, and before I knew it I put on 70 pounds. during pregnancy, I would have lasted longer. ”—Kati
Here’s a tip for non-pregnant people too: if a pregnant woman is doing something, you usually can’t imagine what a pregnant woman is doing … relaxing.
Many times I have discussed something with my healthcare providers and received their blessing only for some well-meaning observer to lecture me while I do it – on one occasion when I was at the launch pads by the pool. (She’s heard that pregnant women shouldn’t “dive.”) So, if you’re an outside observer, remember: this crazy pregnant woman was probably thinking it over .
And if the crazy pregnant woman is you … here’s some information that might help you.
That your doctor is probably wrong
If you want to continue exercising while you are pregnant, it is important to find a doctor or midwife who can talk to you comfortably and give you informed advice. I had planned to have a no-ask / no-talk policy about my marathon training, but it turned out that my midwives were incredibly knowledgeable and supportive.
However, not everyone is that knowledgeable. Doctors still advise pregnant women (and pregnant women advise each other) to keep their heart rate below 140 during exercise. This is ridiculously outdated advice. It was made by a group of doctors who wanted to encourage pregnant women to exercise and also did some preliminary calculations to find a safe limit. They believed that too intense exercise could divert blood and oxygen from the fetus, so they recommended that the American Congress of Obstetricians and Gynecologists specify a limit of 140 beats per minute in their recommendations. Later, one of the doctors told ESPN :
[Dr. Raoul Artal of St. Louis University] said that in 1985 he and another doctor used intuition and calculation to define the 140-beat rule. Six months later, when actual testing of the women in the lab showed they were wrong, Artal said he asked for the 140 beat designation to be removed from the guidelines.
“For some reason, people are hooked on it and never let go,” he said. “Every time I was asked about it, I said to forget about it. I think this should be ignored. “
A quarter century later, a study published in the Journal of Women’s Health found that while 99% of doctors and midwives believed exercise was beneficial during pregnancy, 64% still adhered to the 140-beat rule. Most were unaware that this rule had ever been changed.
In fact, the relationship between heart rate and effort fluctuates during pregnancy: higher than usual at the beginning of pregnancy, lower than usual at the end . Therefore, even if you usually train with a heart rate monitor, it is better to give up and work with effort.
Exercise During Pregnancy is an excellent overview of medical research on exercise and pregnancy. It is written by a research professor and physiologist, but is still readable by the average Jane. In the studies described, even frequent and vigorous exercise results in healthy children. Sometimes babies have a little less fat (but are otherwise normal in size), and sometimes babies are born a little earlier (but not prematurely).
The study supports women doing the types and intensity of exercise they used before pregnancy and supports the idea that “listening to your body” (in terms of effort level, temperature, and other warning signs) is actually very good. a sensor to determine what is safe.
Actual risks (and what to do with them)
Mixing pregnancy and exercise comes with some risks, but in most cases, these risks are manageable. (As always, talk to your trusted doctor or midwife rather than blindly following advice from the Internet. This information is correct to the best of my knowledge, but not personalized to you.) Here are the factors that, in the absence of other complications, are healthy individuals doing exercise. should be considered:
- With very heavy physical exertion, blood flow to the fetus may decrease. It was the initial concern that led to the 140-hitting rule, and experts remain wary of whether or not there should be a maximum effort level. Recent studies show that blood flow in experienced athletes does not drop until it exceeds 90% of their maximum heart rate, and since blood flow returns to normal immediately, this may not even be a problem. Experts agree that moderate exercise is safe, but you can refrain from doing large work with higher levels of effort.
- High body temperature can be harmful to the fetus , but reaching dangerous levels during exercise is difficult, even in hot weather. (Fever is a more common cause of fever-related problems.) As discussed in the Exercise During Pregnancy section , pregnant women tend to dissipate heat well and voluntarily stop exercising before they overheat to dangerous levels. Make sure you moisturize well; it helps control body temperature.
- Blood sugar levels can fluctuate, and while exercising, you may develop low blood sugar levels, which can make you feel dizzy and faint . This means you might have to give extra thought to your refueling plan , perhaps stopping halfway through your workout for a snack, even if you don’t normally do it. On the other hand, exercise can help control your blood sugar levels in the long term, which is especially important if you are at risk for gestational diabetes .
- Sport with strong impacts or contact sports, as a rule, is a serious prohibition, although the baby is very well protected in the abdomen (especially in the early stages of pregnancy, when the uterus is all still inside the pelvis) and the risk of abdominal injury is very low . Even if there is no full contact in sports, in any sport there is a risk in which you can fall. Some women find it uncomfortable to ride a bike or skate because of the risk of falling. Some even avoid high heels. This is more like a judgment that I think a pregnant woman should make for herself: if you play full contact hockey, soccer, or roller derby, are you comfortable with the risk of getting hit in the stomach?
Of course, this is not a complete list of risks that your doctor (mom, friends, or bystanders) may be concerned about. Talk to your trusted supplier for the full story.
What to expect when training for two
Above all, if you are trying to stick to an exercise program, know that you will not see much improvement. When I was preparing for a marathon, it was frustrating to train harder and harder just to see my times get slower and slower. Plan your workout at the same level of effort as before, knowing that your runs will be slower and your weights will eventually need to be reduced. Drop it and drop the clock. It happens.
Why not throw away the towel completely? Keeping in shape, even if you’re slow and sluggish right now, will help you come back next season by taking a break of just a few weeks or months instead of a year or more. A year after I ran my pregnant marathon, I ran a half marathon with little or no training; I gave up the hard work I did last year. (Some experts believe that performance gains may occur several months after childbirth. This may be entirely fictional, but it’s nice to pretend you have superpowers.) Exercise also helps control blood sugar and weight gain, two things that pregnant women sometimes struggle with.
Since you may not be able to complete your workout routine, consider changing your goals to ones that are most satisfying. You may want to run longer or more consistently rather than faster, explore every mile of trails in the park, or learn a new skill. While you might not want to play a whole new sport, this is a great time to go back to an old activity you haven’t done in a long time (swim team? Archery?), Or focus on an aspect of your fitness that you sometimes neglect. … (Curl biceps? Fast leg work?)
Finding like-minded friends is an important head-saving tool. You probably already have friends who are athletes, so reach out to them and ask them if they know about communities, whether in real life or, say, on Facebook groups where pregnant women and athlete moms can compare their observations. … Try CrossfitAndPregnant.com or the women’s forum at Runner’s World.
I’ve talked about this before, but the best thing you can do for your exercise program is to find a supportive doctor or midwife that you can involve in making decisions, instead of putting up with someone you hate and ignore. In fact, there are conditions that can make exercise during pregnancy dangerous, and you should be able to trust your doctor if this ultimately applies to you.
When in doubt about your doctor, ask questions. When you get advice that you don’t like, ask:
- What exactly is risky about this activity?
- Is there a strong evidence base for understanding this level of risk? Where can I read more about this?
- If I decide to do this anyway, what can I do to reduce the risks?
Risk management is a tricky topic for everyone, and pregnancy brings with it a whole new set of risks and priorities that you may not have thought about before. Make a commitment to being well informed, listening to good advice, and making decisions based on your priorities, not others’.
Photos by Bonbon , Monts PB , Ilmicrofono Oggiono , Cris Cebrian and yonolatengo .