Whether you were active prior to your pregnancy or want to become more active now that you’re pregnant, you may have many questions about what’s safe to do and what’s not. That’s why we spoke with Jessica Ladd Lefterova, a Lamaze certified childbirth educator and certified prenatal yoga instructor on the staff at Texas Health Dallas, to go over safety as well as the added benefits exercising has for both your pregnancy, but also your delivery and postpartum. 

Talk it Out

First things first, if you’re starting up a workout routine or wondering if you can continue the routine you had pre-pregnancy, you should always clear it with your physician or midwife beforehand. Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery, but your physician can go over individual concerns and specifics, including your level of activity prior to conceiving and any medical conditions you might have, according to the American College of Obstetricians and Gynecologists. In fact, most prenatal-specific classes require a medical release from your physician prior to enrolling in the class, so discussing exercise with your health care team during your early prenatal visits can open the door for you to start taking these classes as soon as you’re ready.

“As soon as you’re ready” is key, Ladd Lefterova adds. 

“Some women in their first trimester don’t typically workout just because they’re nauseous, they’re throwing up, they’re fatigued, etc.,” she explains. “It’s also such a sensitive time because your first trimester is usually when you have the highest chance of miscarrying. But usually by the second trimester, that’s when moms start feeling better and will get more involved.”

If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity. That being said, women with the following conditions or pregnancy complications should not exercise during pregnancy:

• Certain types of heart and lung diseases
• Cervical insufficiency or cerclage
  
• Being pregnant with twins or triplets (or more) with risk factors for pretermlabor
  
• Placenta previa (when the placenta covers the opening in the mother’s cervix) after 26 weeks of pregnancy
  
• Preterm labor or ruptured membranes (your water has broken) 
  
• Preeclampsia or pregnancy-induced high blood pressure
  
• Severe anemia

So What Can I Do? 

After you’ve been cleared by your health care team to exercise, you’re ready to get back out there or start up your new exercise routine. The amount of exercise recommended for pregnancy does not differ from the regularly recommended amount for a healthy adult — at least 150 minutes of moderate-intensity aerobic activity every week. But the level of intensity and the types of exercises you do can differ. For women who have not worked out regularly prior to pregnancy, Ladd Lefterova says it’s recommended that you start low and slow, as in low-intensity workouts, such as walking or prenatal yoga, and pacing yourself. Begin with as little as 5 minutes a day, then add 5 minutes each week until you can stay active for 30 minutes a day. You can even divide the 150 minutes into 30-minute workouts on 5 days of the week or into smaller 10-minute workouts throughout each day.

“We really focus on not getting mom’s heart rate too high — anything over 140 BPM,” Ladd Lefterova says. “But there’s an easy way to figure out if you’re working too hard. We call it the ‘talk test.’ If you can’t hold a conversation while exercising or you’re finding it hard to catch your breath, lower the intensity. 

If you’re nervous about working out, are new to working out, or just want the added guidance, attending a prenatal fitness class can be beneficial because the class is specifically created using safe exercises for pregnant bodies. 

“A prenatal-specific class will always be a generally safe class for moms,” Ladd Lefterova explains. “Our prenatal-focused class, whether that’s yoga or fitness, is going to include warm-ups and exercises that are appropriate for the pregnant body. For instance, there are no twists involved or exercises that require you to lie on your stomach, and they’re also generally not high-impact.”

Ladd Lefterova adds that another benefit to taking a prenatal-specific class is the focus on keeping mom’s core and pelvic floor strong and healthy — safely. Many women will experience diastasis recti or abdominal separation during their pregnancy because the baby is growing outward causing the abdominal muscles to separate. But in a prenatal class, the instructors are trained to help decrease that ab separation. 

A few prenatal classes that Texas Health offers include: 

• Pregnancy Yoga – This class guides expectant mothers through safe supportive movements to help strengthen the body and mind for labor. Experienced instructors teach adapted postures, stretching, breathing and relaxation to help alleviate the discomforts of pregnancy, birth and post-delivery.  
  
• Pregnancy Cardio Fitness – This upbeat, fun and pregnancy-safe fitness class is the perfect place to get an overall high-intensity, low-impact workout.  
  
• Prenatal Water Fitness – This low-impact water class includes an aerobic segment as well as stretching and toning segments, all in an indoor heated pool.

What Should I Avoid?

While there aren’t many “off-limits” exercises, Ladd Lefterova adds that you should stay away from any deep twists or backbends, as well as any crossing over of the body or exercises that require you lie on your stomach.

If you have a class or workout program that you routinely did prior to pregnancy and you don’t want to part ways with it, she says the most important thing you can do is to learn the appropriate modifications and how to correctly engage your core, transverse abs and pelvic floor. Do some research or modified or alternative exercises for common exercises you know you will do in the class. You can even ask your instructor or trainer for advice or guidance. Also, be mindful of what your body is telling you.

“If you feel like you are getting too out of breath to hold a conversation, it may be too intense,” Ladd Lefterova explains. “If you feel any achiness in your lower back, it may not be appropriate. Any general aches and pains at all, it may not be appropriate. The same applies if you feel any kind of stretching in your abs. Also, watch how much you’re sweating and appropriately hydrate. Dehydration can cause pre-term labor and contractions. So it’s really important to stay hydrated”

She adds that there are also exercises that can exacerbate heartburn and nausea, so If you’re performing anything that is increasing nausea or heartburn, avoid those exercises for the time being.

Reaping the Benefits

Regular exercise during pregnancy benefits you and your baby in these key ways:

• Reduces back pain
  
• Eases constipation
  
• May decrease your risk of gestational diabetes and preeclampsia
  
• Promotes healthy weight gain during pregnancy
  
• Improves your overall general fitness and strengthens your heart and blood vessels
  
• Helps you to lose the baby weight after your baby is born
  

“It doesn’t get talked about as much, but it’s so good for your emotional wellbeing as well,” Ladd Lefterova adds. “It helps to decrease anxiety, depression, low energy, and promotes better sleep. Sleep disturbances and insomnia are very common in pregnancy and exercising can help reduce insomnia. 

“Research has also shown that exercising during your pregnancy can allow your labor and delivery to go smoother and faster. Usually the pushing stage is decreased due to the strength of the abs and the pelvic floor and the coordination of those muscles.” 

She adds that Lamaze training, whether taken on its own or incorporated into your prenatal fitness classes, can do wonders for your wellbeing as well as preparing you for delivery.

“Learning to breathe and then also learning to build up your endurance with exercise while utilizing breath control, is going to help you so much in your labor because labor is all about breathing,” she explains. “Our breath is tied to our emotions, feelings and resilience. It can relax the nervous system before and after labor.”  

Exercising during pregnancy can reap so many rewards for both mom and baby and can set you up for a smoother delivery and postpartum recovery. To learn more about prenatal fitness classes and register for a class near you, visit Women and Infant Services.