Myths About Exercising Pregnant
Recently, at a late spring Bar-B-Q, I uttered the phrase “I’m a personal trainer.” In response to this statement I often field a deluge of exercise related questions. That evening the interested party was a soft-spoken, friendly woman in her mid-30’s, a cream sweater wrapped around the seven month baby-bump of her first child. She was understandably confused about how to safely work out during her pregnancy.
Her massage therapist told her everything was fine except for deep squatting. Her acupuncturist said resistance training was okay, but she shouldn’t lift weights (given that those are synonyms, I’m not sure what he/she even meant!). Her doctor had told her not to run, but she could elliptical for no more than 30 minutes. “That’s funny,” the woman next to us chimed in, “I ran through both of my pregnancies up until I delivered.”
But my favorite part? The first OB-GYN my new pregnant pal saw told her she didn’t need to worry about Kegels until she was in labor. (She knew enough to fire this MD.) This mom-to-be was so confused and concerned she had opted to not work out until after delivery.
It doesn’t help that Googling the phrase “exercising pregnant” produces more confusion than the sex advice exchanged at a 5th grade sleepover. To make matters worse, a 2010 UNC Chapel Hill study showed only 25% of women meet the American College of Obstetricians and Gynecologists (ACOG) recommendations for exercise. Three in four women don’t get enough exercise while pregnant!
That low number is partly due to misinformed doctors: a 2005 study by the National Library of Medicine & National Institutes of Health showed over 69% of pregnant women were incorrectly being told by their doc to limit exercise. Further research showed the MDs were referencing ACOG guidelines from 1985 or earlier. When you consider the 2002—and most recent—guidelines increased the amount, duration, and intensity recommended for moms-to-be, it seems we have a problem.
What’s a Mama to do?
Today, most medical experts agree that, barring any medical or obstetric conditions, pregnant women should engage in at least 30 minutes of moderate exercise on most days. Regular exercise benefits a pregnancy by reducing back aches, constipation, nausea, and swelling; it can help prevent (and possibly treat!) gestational diabetes, improve posture, mood, and sleep, and can help ease of delivery as well as preventing conditions like incompetent cervix, which results in prolonged bed rest and is a pain in the… well… cervix.
There are, unfortunately, a few myths about exercising pregnant. Here are five of the most common and why they’re way, way off:
• Pregnant Women Shouldn’t Elevate Their Heart Rate. This myth goes back to the 1950s when it was believed that hard cardio would deprive the baby of oxygen. They thought your body would prioritize your workout over the baby’s needs. Multiple studies have shown that these previous limitations were false. In fact, every year we see women pushing new limits while pregnant. Listen to your body to be sure. If it feels good and doesn’t make you too tired, you’re likely fine.
• Pregnant Women Can’t Lie On Their Backs AT ALL. Ever lay on your arm funny and it started to tingle? It takes 2 or 3 minutes for that to happen, right? In fact, some people can lie on their arms for hours without a problem. The same idea is happening here.
Along the right side of the spine is the inferior vena cava. This vein’s primary responsibility is to return blood to the heart from the lower half of the body. After the first trimester some women may experience dizziness or nausea when the weight of the baby puts pressure on this vein, but the solution is simple: if, while lying on your back, you experience any dizziness or nausea, just roll onto your left side to release the pressure, or sit more upright.
You might be wondering about sleeping. While the 2002 ACOG guidelines say that after the first trimester “pregnant women should avoid supine positions during exercise as much as possible,” it’s generally accepted by most medical professionals that the symptoms of this state (known as supine hypotension syndrome) will cause a woman to notice, just like that horribly numb arm does, and—if asleep—to awaken. Additionally, there have been no conclusive studies linking lying on your back with fetal harm.
Though the guidelines are limiting, in April of 2013 the ACOG stated that this condition (which can also be caused by motionless standing) occurs in only 10-20% of pregnant women; some women never experience symptoms of SHS. You can decide for yourself to do your bridges on your back in that natal yoga class, or to lie on your back if it’s the most comfortable way to get sleep. If you wake up on your back, or experience symptoms of dizziness or nausea while being supine, roll to your side. You can also try using a bolster, pillows or wedge to prop up your shoulders and keep the pressure off your IVC.
• Pregnant Women Should Not Lift Weights. Lifting weights, using resistance bands, or body weight exercises are going to help you prepare to lift, rock, carry, and cuddle the new little person in your life and recover more quickly from the hard work of delivering a baby.
Still not convinced? A study in the American Journal of Obstetrics and Gynecology published in January 2004 by the University of Alberta, Canada showed that a regular strength training routine decreased the amount of insulin required by women with gestational diabetes, and a 2009 study published in the Journal of Obesity by a collaboration of universities in Europe showed no correlation between birth weight of the baby and mom’s strength routine. In short, strength training will not adversely affect your baby, but it could help you a lot.
In her book Dalai Lama, My Son, Diki Tserin (the Dalai Lama’s mother) talks about her experience working in the fields for 12 hours a day while pregnant and birthing a child in a barn alone in the dead of night. Later, after His Holiness had ascended to his current position, she didn’t do field work anymore, so she carried rocks to the roof of the palace to keep in shape while pregnant. If she can, you can. Just sayin’.
• Kegels Aren’t That Important. Yes, they are. Think of your abdomen like a basket of muscle with a figure-8 shaped drawstring at the bottom. This is your pelvic floor, and you’re filling it with a growing baby. At the bottom of that basket is the pubococcygeus (PC) muscle, wrapping around the urethra and anus. If the bottom of the basket is well cared for it will hold and stretch for 40 weeks, open wide enough to release your baby, then close back up. But what if it isn’t strong and flexible? In that case, the muscles in the pelvic floor can actually lose their elasticity. Do your Kegels prior to, and after, the birth for improved pregnancy, healthier delivery, and speedy recovery. (Learn how to Kegel here!)
• Don’t Run. This myth ties back to the outdated cardio myths detailed above and the old concerns about blood flow to the baby. Many women run while pregnant; though typically they are runners before conceiving. In 2012 Paula Radcliff made international headlines training for the Olympics by running up to 14 hours a day while pregnant with her second child.
Not a runner? There are many good cardio alternatives out there, so it’s rare for someone to pick up a running habit after conception; however, even the occasional runner can continue running while pregnant.
If you do decide to continue running, you’ll want to listen closely to your body. As your pregnancy progresses your body will change quickly, reacting day to day to the increase in weight you’re carrying and the cocktail of hormones you’re producing. Some days you’ll be tired, others sore, and towards the end the weight of the baby may put uncomfortable pressure on your joints. If running feels good, do it. When it stops feeling good, stop running. And if you show any risk factors (listed below) stop and see your doctor.
• Don’t Start a New Exercise Program After Becoming Pregnant
It’s a common held belief for new moms-to-be that “now is not the time” to begin exercising. But when you consider all the benefits of exercise, and how physically taxing delivery can be, the benefits far outweigh the perceived risk. In fact, multiple recent studies published in the journals Obstetrics & Gynecology and International Journal of Obstetrics & Gynecology have confirmed the belief that exercise, even for pregnant women who did not exercise before becoming pregnant, will not harm the fetus and will help the mother in the many ways we’ve mentioned.
You Make the Call
Fortunately, most current recommendations are common sense once you know why they’re made. Here are the 2002 guidelines from the ACOG, so you can decide for yourself where to sweat it out, and when to play it safe. In a nutshell:
• Pregnant women should get 30 minutes or more of moderate exercise most days. This includes cardio and resistance training, which can include body weight work, bands, and weights. Elite athletes can do more, but should consult their doctors.
• Avoid anything that could cause you to fall, get kicked or take a header, for obvious reasons. Examples include contact sports like skiing, rollerblading, biking, basketball, or soccer.
• Avoid being flat on your back for extended periods of time after the first trimester. Listen to your body to find what feels right for you and your baby. If you are lying on your back and get dizzy or nauseous, roll onto your left side.
• The hormone Relaxin is released during pregnancy and, among other things, causes ligaments that support your joints to relax (good name, right?) This makes your joints more mobile but increases the risk for injury. Gentle stretching, like the kind done in a prenatal yoga class, is great for the pregnant body. The key word is “gentle:” use breathing and gravity, rather than force, to stretch. Now is not the time to practice your splits.
• Be careful not to get overheated in hot or humid weather. Move into the AC, modify time and or intensity, or skip your workout that day. The pregnant body is good at dissipating heat, but extreme external temps can be problematic. For the same reason avoid saunas, steam rooms, and Bikram yoga classes.
• Drink plenty of water and eat extra calories to offset those lost during exercise.
What to Watch Out For
Exercise is not without risk for anyone, least of all a pregnant soon-to-be mom. It’s important to know what to look out for when you exercise while pregnant. Stop exercising immediately and see your doctor if you have any of the following: bleeding or spotting, dizziness or fainting, shortness of breath (other than that normal to exercise), chest pain, headache, weakness, calf pain or swelling (this could mean a blood clot), contractions, decreased fetal movement, or leaking of fluid from the vagina.
Listen to your body and adjust to what it’s telling you. Hormonally and structurally your body is changing every day during pregnancy; an exercise that felt good yesterday may not tomorrow. Keep your primary goals for exercise in mind: a healthy pregnancy, delivery, and recovery.