Practical Guide to Exercise During Pregnancy
by Lisa Stone, ACE

As long as you follow the 1994 American College of Obstetricians & Gynecologists guidelines for exercise during pregnancy, any type of exercise is fair game with a few modifications. Each month, we'll offer you several different exercises to choose from so that your pregnancy can be a fit one. Try to do the aerobic exercise and strength training exercise on alternate days, and include the flexibility training every day. As always, check with your caregiver before starting any exercise program. And be sure to drink LOTS of water before, during, and after each exercise session so that you stay hydrated and your baby stays cool.

Aerobic Exercise:

There are many types of aerobic activities to choose from during pregnancy. If you were not exercising before becoming pregnant, then walking is your best bet for beginning your fitness program. Start by walking at a brisk pace for 20 minutes three times every week. In addition, you'll want to include five minutes of warmup time (walking at a slower pace) and five minutes of cool-down time (also walking at a slower pace). As you become stronger, increase the pace of your walking, the duration of your walks, and/or the number of hills included in your route. Gradually work up to walking at a quicker pace for 30 minutes on a relatively hilly terrain.

Strength Training:

There are also many different exercises you can do to increase your muscular tone and strength during pregnancy. One muscle that you'll definitely use during your labor is your quadriceps, or front of the thigh. During the pushing phase of your labor, getting yourself into the squatting position is a wonderful way to help your baby come into the world. A great way to strengthen your quads is with squats (if you have knee problems, skip this exercise). Start in a standing position with feet a little wider than hip width and toes pointing straight ahead. Maintain good posture by pulling in your abdominal muscles (visualize pulling your belly button in toward your backbone), pulling your shoulders back and down, and opening up your chest. Take a deep breath in and slowly bend your knees, pressing your buttocks toward the back of the room as if sitting into a chair. Exhale as you squeeze your buttocks, slowly returning to a standing position. Repeat for three sets of 12 repetitions. As you become stronger, increase the number of repetitions to 15 per set.

Flexibility Training:

In addition to keeping your heart and muscles strong, you also need to maintain flexibility in your muscles and joints by doing gentle stretches after each exercise session. One word of caution, however: during pregnancy, your body secretes a hormone called Relaxin. The purpose of Relaxin is to loosen your pelvis to make room for your growing uterus and to allow your baby to fit through the birth canal. Unfortunately, Relaxin doesn't limit itself to your pelvis, and all of your joints will loosen as your pregnancy progresses. So, when you do these stretching exercises, take the stretch only to the point of feeling it and hold the position no longer than 20 seconds. Also, avoid bouncing during the stretch so that you don't overstress your loosened joints.

Since you've worked your quads with the squats described above, let's start with a nice stretch for that muscle. Lie down on one side with both knees bent and hips stacked. Reach around and grab onto your top foot, and pull the foot back toward your buttocks, keeping the knee in alignment with the hip (your thigh should be parallel to the floor). You should feel a nice stretch in the front of the thigh. Continue breathing throughout your stretch to bring oxygen to the muscle. Hold the stretch for 20 seconds and then repeat on the other side.

Installment 2

Here is Installment 2 of the Fit For 2 Practical Guide to Exercise During Pregnancy! Each month, we'll offer you several different exercises to choose from so that your pregnancy can be a fit one. Try to do the aerobic exercise and strength training exercise on alternate days, and include the flexibility training every day. These exercises are intended for healthy adult women; as always, check with your caregiver before starting this or any exercise program. And be sure to drink LOTS of water before, during, and after each exercise session so that you stay hydrated and your baby stays cool.

Aerobic Exercise:

If you were active before getting pregnant, then you have lots of aerobic exercise options available. My favorite activity while pregnant was a prenatal step aerobics class like Fit For 2. The step is an ideal apparatus for pregnant women because, depending on how you are feeling on a given day, you can adjust the height of your step to compensate. On low-energy, morning sickness days, use a 4-inch step (or maybe even do without a step that day). On high-energy, 2nd trimester days, go for that 6- or 8-inch step.

To keep your step routine pregnancy-safe, avoid any plyometric or leaping movements. Also, leave out the pivots and other quick directional changes. Be sure that the music you're using stays within the recommended 118-126 beats-per-minute range. Take frequent water breaks to keep your core temperature within a safe range, and do not workout to the point of exhaustion - 20-25 minutes of stepping is enough to reap the benefits of aerobic training without overdoing it.

Strength Training:

Abdominal strength is key during pregnancy and the postpartum period, although you'll have to modify your pre-pregnancy ab routine. After your first trimester, traditional abdominal crunches are a no-no. To effectively work the entire abdomen, start out in a quadruped (forearms and knees) position with abdominal, pelvic floor, and buttocks muscles relaxed. Exhale as you tighten the abs, pulling the belly button in toward the backbone, and inhale as you release. Concentrate on just tightening the abdominals without tightening the pelvic floor or gluteals as well. You can work your obliques (the abdominal muscles that run diagonally across your torso) by starting in a side-lying position with knees bent and at a 45 degree angle. Exhale as you lift your head and rib cage toward your hip bone, squeezing in the waist line, and inhale as you lower to the starting position.

Flexibility Training:

This month's flexibility exercise is for the lower back and abdomen. As a reminder, during pregnancy your body secretes a hormone called Relaxin which loosens all of your joints. So, when you do these stretching exercises, take the stretch only to the point of feeling it and hold the position no longer than 20 seconds. Also, avoid bouncing during the stretch so that you don't overstress your loosened joints. After you complete the abdominal workout above, get back into the quadruped position. Open up your knees wider than hip-distance and reach your arms above your head on the floor. Take a deep breath in, and as you exhale press your hips back, letting the weight of your baby come off your back and feeling the stretch through your torso. Continue breathing as you hold the stretch. Return to the starting position and take a deep breath in. As you exhale, arch your back up like a cat, tilting your pelvis forward, and feel the stretch in your lower back. Continue breathing as you hold this stretch.

Installment 3

Here is Installment 3 of the Fit For 2 Practical Guide to Exercise During Pregnancy! Each month, we'll offer you several different exercises to choose from so that your pregnancy can be a fit one. Try to do the aerobic exercise and strength training exercise on alternate days, and include the flexibility training every day. These exercises are intended for healthy adult women; as always, check with your caregiver before starting this or any exercise program. And be sure to drink LOTS of water before, during, and after each exercise session so that you stay hydrated and your baby stays cool.

Aerobic Exercise

Swimming is a wonderful way to stay in shape throughout pregnancy. Not only will you stay aerobically fit, but you'll also give your loosened joints a break by being in the water.

You can use the water in many different ways as part of your exercise program. First of all, swimming laps at a moderate pace will increase your aerobic capacity. Try to swim for at least 30 minutes, which includes 5 minutes at a slower pace to warm up and 5 minutes at a slower pace to cool down. Another option is to join an aqua aerobics class. As long as you let the instructor know that you are pregnant and modify the moves to accommodate your growing belly and breasts, you should be fine.

Let me emphasize the importance of listening to your body while in the water. The water tends to keep you cooler than when you exercise on land, so you might not notice the beginning signs of dehydration or overexertion. You still need to drink LOTS of water during your workout to keep your core temperature within a safe range. You also need to pay close attention to your exertion level - if you cannot carry on a conversation comfortably while exercising, then you're working out too hard and need to bring it down a level or two.

Strength Training

Let's focus on the upper back and chest this month. If you have a kickboard or a noodle, bring it into the pool with you. Stand with your feet a little wider than hip width, knees slightly bent, abdominals tight, in water that is about shoulder deep. Hold the kickboard or noodle in front of you at chest level underneath the water. Your elbows should be bent out to the sides (parallel with your shoulders) and your hands shoulder width apart. As you exhale, extend your arms, pushing the board or noodle straight in front of you and contracting the chest or pectoral muscles. Inhale as you pull the board or noodle back to the starting position, contracting the upper back. Try to do three sets of 8-12 repetitions, resting for 30 seconds to one minute between sets.

Flexibility Training

Now it's time for the best part of your workout - stretching! As a reminder, during pregnancy your body secretes a hormone called Relaxin which loosens all of your joints. So, when you do these stretching exercises, take the stretch only to the point of feeling it and hold the position no longer than 20 seconds. Also, avoid bouncing during the stretch so that you don't overstress your loosened joints.

After you complete your chest and back exercise, move into shallower water, approximately waist deep. To stretch your chest, clasp your hands behind your back with palms facing you. Take a deep breath in and, as you exhale, slowly lift your arms behind you. Pull your shoulder blades back and down and think about opening up your chest. Hold that position for about 20 seconds as you continue breathing. Slowly lower the arms. To stretch your upper back, inhale as you reach your arms above your head. Clasp your hands with palms facing the bottom of the pool. As you exhale, slowly round your back forward, bringing your arms in front of your chest. Let your chin drop onto your chest. Continue breathing as you hold the stretch. Slowly return to an upright position, bringing your head up last to prevent dizziness.

Installment 4

Here is the fourth and final installment of the Fit For 2 Practical Guide to Exercise During Pregnancy! For the past several months, we have offered you several different exercises to choose from so that your pregnancy can be a fit one. Try to do the aerobic exercises and strength training exercises on alternate days, and include the flexibility training every day. These exercises are intended for healthy adult women; as always, check with your caregiver before starting this or any exercise program. And be sure to drink LOTS of water before, during, and after each exercise session so that you stay hydrated and your baby stays cool.

Aerobic Exercise

Now that Autumn is almost here and the weather is cooling off, it's a great time to be outdoors. If you're in your first or second trimester, bicycling is a wonderful way to enjoy the changing of the leaves while getting an aerobic workout. If you've already entered your third trimester, try going for a power walk instead.

If you'll be bike riding, always wear a protective helmet. Also, be sure to ride with traffic and use all appropriate hand signals. If you plan to ride alone, be sure that someone knows your route, just in case. Depending on your fitness level, you can choose a flat route or one that includes some challenging hills. As always, take plenty of water with you and drink often. Start at a slower pace to warm up your body for the first 5-7 minutes, increase your pace for 20-30 minutes, and then cool down by slowing down for the last 5-7 minutes of your workout.

Strength Training

Since your lower body will get a good workout during your bike ride or power walk, our strength training segment this month will focus on the upper body, namely the biceps and triceps. If you have hand weights (no heavier than 10 pounds each), now is a good time to put them to use. If you don't have any weights, just go to your pantry and grab a couple of big cans of tomatoes or soup to use as resistance.

Start by standing with your feet a little wider than hip width apart (spread your toes out in your shoes to give yourself a wider base of support to help compensate for your changing center of gravity). Your knees should be slightly bent and your abdominals pulled in tight. Take one weight in each hand with your palms facing up. Slowly curl the weights upward toward your shoulders, squeezing your biceps at the top of the contraction. Turn your palms facing downward as you slowly lower the weights to the starting position, squeezing the backs of your arms (triceps) as you press the weights down. Turn the palms back up and repeat the entire sequence 8-12 times.

Flexibility Training

To stretch your biceps and triceps, start by clasping your hands behind your back with your palms facing in toward your body. Slowly lift your arms behind you as you pull your shoulder blades back and down, feeling the stretch in your upper arms as well as your chest. Hold for a count of 10 as you continue breathing, and then slowly lower the arms. Next, inhale as you lift both arms above your head. Exhale as you bend the right elbow, reaching your right hand behind you toward your left shoulder blade. You can support your right elbow with your left hand if that's more comfortable. Hold the stretch for a count of 10 and then repeat with the left arm.

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