There is no data in humans to indicate that pregnant women should limit exercise intensity and lower target heart rates because of potential adverse effects. For women who do not have any additional risks factors for adverse maternal or perinatal outcome, the following recommendations may be made.
- During pregnancy, women can continue to exercise and derive health benefits even from mild-to-moderate exercise routines. Regular exercise (at least three times per week) is preferable to intermittent activity.
- Women should avoid exercise in the supine position after the first trimester. Such a position is associated with decreased cardiac output in most pregnant women; because the remaining cardiac output will preferentially distribute away from the splanchnic beds (including the uterus) during vigorous exercise, such regimens are best avoided during pregnancy. Prolonged periods of motionless standing should also be avoided.
- Women should be aware of the decreased oxygen available for aerobic exercise during pregnancy. They should be encouraged to modify the intensity of their exercise according to maternal symptoms. Pregnant women should stop exercising when fatigued and not exercise to exhaustion. Weight-bearing exercises may under some circumstances be continued at intensities similar to those prior to pregnancy throughout pregnancy. Non-weight-bearing exercises such as cycling or swimming will minimize the risk of injury and facilitate the continuation of exercise during pregnancy.
- Morphologic changes in pregnancy should serve as a relative contraindication to types of exercise in which loss of balance could be detrimental to maternal and fetal well-being, especially in the third trimester. Further, any type exercise involving the potential for even mild abdominal trauma should be avoided.
- Pregnancy requires an additional 300 kcal/d in order to maintain metabolic homeostasis. Thus, women who exercise during pregnancy should be particularly careful to ensure an adequate diet
- Pregnant women who exercise in the first trimester should augment heat dissipation by ensuring adequate hydration, appropriate clothing, and optimal environmental surrounding during exercise.
- Many of the physiologic and morphologic changes of pregnancy persists 4-6 weeks post partum. Thus, pre-pregnancy exercise routines should be resumed gradually based on a woman’s physical capability.
DANGER SIGNS & SIGNALS TO STOP EXERCISE
- Pain of any kind ( chest, headache, back, pubic, or hip )
- Uterine contractions ( frequent at 20 minute intervals )
- Vaginal bleeding, leaking of amniotic fluid
- Dizziness, faintness
- Shortness of breath
- Palpitation, tachycardia
- Persistent nausea and vomiting
- Difficulty walking
- Generalized edema
- Decreased fetal activity