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Regular aerobic and muscle strength exercising during uncomplicated pregnancy improves cardio-respiratory function and physical fitness.  However, these activities must be modified in pregnancy to accommodate the anatomic and physiologic changes that occur in pregnant women in order to avoid adverse effects to mom and her baby.

Exercise in pregnancy has many benefits.  Exercise improves agility and coordination.  It helps minimize weight gain.  Kegels exercises strengthen the pelvic walls and reduce the risk of urinary incontinence.  Exercise reduces the risk of Gestational Diabetes and large babies.  Smaller babies also means less risk of a cesarean section.

But, exercise in pregnancy does have certain important risks.    There is always a risk of injuries and sprains while exercising.  This is more common in pregnancy because a women’s joints are more lax due to the physiologic effects of pregnancy on her joints.  Also, the increase weight especially in the belly in the second and third trimesters can cause imbalance and make a women more prone to falls.  Exercise leads to increased circulation to the muscles being used, which reduces the blood-flow to the placenta.  This ultimately decreases oxygen and nutrients supply to the baby.   Some studies have shown an increased incidence of miscarriages and Preterm labor among women who performed regular strenuous exercising in pregnancy.

The goal in pregnancy is to formulate an exercise program that increases the benefits of exercising while minimizing its risks.

Prior to initiating any exercise program, a pregnant woman should be clinically evaluated by her Obstetrician.   The Obstetrician should evaluate her exercise experience, any prior injuries, and medical problems.  Another very important consideration is high-risk conditions of the pregnancy like vaginal bleeding, placenta previa, placenta abruption, and fetal growth restriction.  All these conditions can be aggravated with exercise.

Before going on to safe exercising, I want to list those dangerous exercises that should be avoided CONTACT SPORTS LIKE BOXING, HIGH FALL RISK SPORTS LIKE SKIING, SCUBA DIVING, HOT YOGA AND PILATES.

Safe exercises include WALKING, SWIMMING, STATIONARY BIKING, YOGA, PILATES.  However in moderation.  Even these safe exercises if done in abundance can be dangerous to the mom by increasing her risk of joint injury and falls and the baby by decreasing blood-flow to it.

I encourage my patients to start with a 5-10 minute warm up.  This engages her muscles and increases blood-flow to optimize performance.  Next, I recommend a 30 min routine combining of any of the safe exercises listed above at 50-60% intensity.   Finally, she should end with a 5-10 minute cool down.  This can be repeated 3-4 times weekly.  I warn my patients to listen to their bodies and their babies.  If at any point during the exercise, a woman begins experiencing moderate difficulty or severe decreased baby movements ,she should STOP, REST and REASSESS.  If she doesn’t feel better, call me.

Also remember, DRINK, DRINK, DRINK… WATER!

TAKE CARE AND BE AWARE of your health.

By: Leonid Sorkin MD, FACOG

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