Exercise in your First Trimester of Pregnancy

In honor of National Women’s Health and Wellness Day!

By Kristin Anderson, PT, DPT, OCS, CLT

In honor of National Women’s Health and Wellness Day in September, we wanted to remind you of the benefits of exercise!  Health and wellness is important at every stage of life, but today we want to focus on pregnancy since this can be a time of confusion and frustration for many women. Due to the large amount of information (and not always credible information), knowing what intensity and duration of exercise to engage in during pregnancy can be overwhelming. We see graphic images of women doing high intensity work outs, while other sources may tell us to not do any activity. The American College of Obstetrics and Gynecology (ACOG) published research in 2015 on standards of exercise. Remember, these are guidelines and we want to help you walk through them. 

With all women prenatal care is vital to the health of you and your baby!  Please check with your doctor if you have any of these medical conditions so that they can help guide you with your exercise protocol.

You need to stop exercising if the following occurs:

·        Vaginal bleeding

·        Regular painful contractions

·        Amniotic fluid leakage

·        Shortness of breath before exertion

·        Dizziness

·        Headache

·        Chest pain

·        Calf pain or swelling

If any of these symptoms occur any time during your pregnancy, stop exercising and call your doctor!

Let’s first examine why you want and should exercise during your pregnancy.  As always, talk to your doctor before starting an exercise program.

Exercise during pregnancy is associated with lower risk of preeclampsia, gestational diabetes mellitus, type 2 diabetes mellitus, high blood pressure, excessive maternal weight gain, high infant birth weight, low back pain and preterm delivery and mental depression.  Improved tone of the abdominal and pelvic floor musculature and aerobic fitness may be important factors in reducing your risk of a c-section.

Next let’s examine what you CAN do!  Especially during your first trimester if you are feeling nauseous and fatigued, this can be a tough time to know where to start.  You can begin with:

·        20-30 minutes of moderate intensity exercises most days of the week

·        Mix of cardiovascular exercise and strengthening

·        Best exercise: walking/running, swimming, modified yoga and Pilates

·        LISTEN TO YOUR BODY

Moderate intensity exercise should consist of exercise where you are still able to hold a conversation. If you get too breathless to talk, you need to slow down or take a rest break!  Always listen to your body!  If a movement or sport hurts or does not feel comfortable, then do not do it!  Most women in their first trimester crave gentle exercise such as walking or swimming.  Remember your body is going through substantial changes: hormones, increased blood volume and weight distribution.  You need to listen to your body and maintain respect for what your body is telling you.

Is there a time when you should stop an exercise or not start an exercise regimen?  ACOG tells us to not exercise if you have:

·        Significant heart disease

·        Restrictive lung disease (the baby could not be getting enough oxygen)

·        Incompetent cervix (the doctor will tell you if you have this!)

·        Persistent 2nd or 3rd trimester bleeding

·        Premature labor during the current pregnancy

·        Preeclampsia

·        Severe anemia

These guidelines give you an idea of where to start. We have substantial evidence to suggest that you can start an exercise program while you are pregnant even if you have been sedentary prior to pregnancy. If you are just starting out, the recommendations are:  start at 15 minutes of exercise 3 times a week at low to moderate intensity.  Again, you should be able to hold a conversation during your work out.  If you have exercised prior to becoming pregnant, the guidelines above are for you.  

A systematic review found that during pregnancy our maximal heart rate reserve is reduced.  As a result, they tailor the target heart rates per each age decade.  For ages:

Under 20 years old            140-155

20-29 years old                   135-150

30-39 years old                   130-145

40 and older                        125-140 beats per minute

This corresponds to 60-80% of your aerobic capacity.

This is just a start to your exercise regimen during pregnancy your first trimester! We will have follow up blogs to go into more specifics as you go through your 2nd and 3rd trimesters.   Congratulations on the new addition to your family!

 

Resources:

The American College of Obstetricians and Gynecologists. Physical Activity and Exercise During Pregnancy and the Postpartum Period. Number 650, December 2015.

Hinman, S, Smith, K, Quillen, D et al. Exercise in Pregnancy: A Clinical Review. Sports Health Vol 7, no 6. 2015

Nascimento, S, Surita F, Cecatti J. Physical exercise during pregnancy: a systematic review. Women’s Health. Lippincott Williams & Wilkins. 2012