Great Expectations: Training During Pregnancy

By Carlos Alberto Rivas, M.S., C.S.C.S.

Today, more and more pregnant women are becoming aware of the potential benefits of a properly designed exercise program. The latest studies indicate that healthy women with uncomplicated pregnancies do not need to limit their exercise for fear of adverse effects. The American College of Obstetricians and Gynecologists (ACOG) recommendS that women who currently exercise can continue their training program during pregnancy, without major modifications.

The certified personal trainers at Baptist East/Milestone Wellness Center (BEM) work with pregnant clients who exercise before, during and after pregnancy modifying intensity, duration, frequency and type of exercise. Those who plan to begin an exercise program after becoming pregnant are always advised to seek physician approval and begin exercising with low-intensity, low-impact activities, such as light weight training, walking and swimming. Most pregnant women, especially with physician approval, can gain maternal health benefits while subjecting the developing fetus to minimal risk.

THE BENEFITS

• Improved muscular strength and endurance
• Improved well-being that may help counter feelings of stress, anxiety and depression
• Less weight gain
• Greater energy
• Reduced back pain during pregnancy
• Facilitation of recovery from labor
• Establishment of permanent healthy lifestyle habits

THE ACOG RECOMMENDATIONS:

• Regular exercise at least three times a week is preferable.
• Women should avoid exercise in the supine position after the first trimester.
• Pregnancy requires an additional 300 cal/day 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 surroundings during exercise.
• Women should be encouraged to modify the intensity of their exercise program according to their symptoms. Pregnant women should stop exercising when fatigued and not exercise to exhaustion.
• Morphological changes in pregnancy should serve as a relative contraindication to types of exercise in which loss of balance could be detrimental. Further, any type of exercise involving the potential for even mild abdominal trauma should be avoided.

CONTRAINDICATIONS FOR EXERCISE DURING PREGNANCY

• Pregnancy-induced hypertension
• Pre-term rupture of membrane
• Pre-term labor during the prior or current pregnancy
• Incompetent cervix
• Persistent second to third trimester bleeding
• Intrauterine growth retardation

THE BOTTOM LINE

The ACOG guidelines recommend participation in a carefully monitored exercise program for most pregnant women. The benefits of exercise far outweigh the risks associated with participation in an exercise program. A number of professional trainers who have earned certification from the American College of Sports Medicine and the National Strength and Conditioning Association are available to help you to continue or devise a safe, effective program.

Salima Perkins, a BEM personal trainer, trains while in her third trimester with a variety of free-weight and machine exercises. With a physician's authorization, a pregnant woman can gain health benefits while subjecting the fetus to minimal risk.

Carlos Alberto Rivas, M.S., C.S.C.S., is the fitness/personal training director at the Baptist East/Milestone Wellness Center. Carlos has a master's degree in exercise physiology and has over 10,000 hours of personal training experience. He is also a member of Kentuckiana HealthFitness magazine's editorial advisory board. Carlos can be reached by phone at 502-896-3900, ext.142.