Are There Risks to Working Out During Pregnancy?

Some research shows that standing for a long time or lifting heavy objects is associated with pregnancy complications (such as preterm birth), but exercise is more of a protective factor for women during pregnancy. If you’re in good health with no pregnancy complications, the American Congress of Obstetrics and Gynecologists (ACOG) approves a “regular, moderate intensity” exercise program for all fitness levels, even for previously inactive women.

weights, weight lifting, exercise, exercise and pregnancy, fit and healthy pregnancyYou can continue activity as long as your pregnancy stays healthy and you feel good doing it, but it’s important to regularly discuss the type and intensity of your workouts with your health care provider. Be willing to make adjustments in response to changes in how you feel over time.

Despite the misperception that exercise during pregnancy is risky for women and their babies, studies consistently show that those who work out when they’re expecting tend to have better health outcomes during pregnancy and delivery.

So are there any cautions besides not pushing yourself too far?

Anecdotal evidence suggests that women already at risk for preterm labor might trigger labor with exercise, but those moms didn’t experience the healthy, typical pregnancy that we’re primarily focused on here. Exercise does not increase your risk for preterm labor, and additional research finds that women who are considered “heavy” exercisers actually show lower rates of preterm birth than do women who exercise less often or with lower intensity. After 37 weeks, active women deliver 6 days earlier, on average, but these deliveries are not considered preterm.

More intense exercise is associated with an increase in blood glucose in pregnant women, but there isn’t a known impact on insulin level. It’s thought that the glucose is produced in response to the need for it as a result of intense exercise, so there isn’t likely to be a surplus that would cause a risk to you.

runner, woman running, running and pregnancy, working out and pregnancy, fit and healthy pregnancyExercising during pregnancy does seem to make a difference, with the best outcomes reported for women who maintain a consistent workout practice from early pregnancy through the third trimester, even if they adjust the intensity and type of exercise as they near delivery.

For example, overall discomfort in late pregnancy appears to be lower in women who exercise more during the first trimester, and researchers have found that women with a history of vigorous workouts who continue to be highly active in pregnancy have lower resting heart rates and a better maximal oxygen consumption (VO2max) throughout pregnancy than do moderate and nonexercisers.

There’s a slight increase in VO2max postpartum even among recreational athletes if they maintain just a moderate level of exercise throughout pregnancy. However, while you can maintain (or even improve) your VO2max, your anaerobic working capacity may be reduced in late pregnancy even if you’ve stayed active.

Still, the takeaway message is that maintaining a consistent, moderate fitness program throughout pregnancy is good for you, your athletic body, and your baby’s healthy development.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

How to Keep Cycling Safely and Comfortably during Pregnancy

bike, bicycle, cycling, cycling during pregnancy, cycling and pregnancy, pregnancy, fit and healthy pregnancyPregnant? Don’t throw your bike into that shed yet! Just because you’re pregnant doesn’t mean you have to stop being active, and it doesn’t mean you have quit cycling either.

If you’re an active woman or even an athlete, there’s no reason you can’t keep your active lifestyle as long as you aren’t experiencing any complications and you’re listening to your body’s cues to know when to stop. However, if you haven’t been active prior to getting pregnant, now may not be the time to start a rigorous workout routine. (If you want more advice on starting a fitness routine during pregnancy, check one of our posts on the topic.)

A Safe Way to Cycle While Pregnant

So how do you safely and comfortably keep cycling during pregnancy? One way is to do what Olympian and triathlete Sarah Haskins did: she rode on a CompuTrainer.

Like many women, Hadownhill, fast hill descent, descent, cycling, mountain biking, cycling during pregnancy, fit and healthy pregnancyskins was nervous about cycling on the roads when she found out she was pregnant because she feared falling and harming her baby. This is a legitimate concern, and precautions should be taken to prevent falling and crashes like avoiding group rides, pacelines, fast hill descents, racing, gravelly and slippery roads, and busy intersections.

A Shift in Gravity

However, it is safe to ride your bike for the first 12 weeks of your pregnancy because your pelvis encases and protects the uterus during the first trimester. During your second trimester is when your balance and center of gravity begin to change, and your pelvis no longer protects your uterus. And when that third trimester rolls around, your balance will only have gotten worse, so that may be the time to switch to a stationary bike or an indoor bike that’s on a trainer, if you haven’t done so already.

Although there are no hard-and-fast obstetric rules that prohibit a woman from riding when she’s expecting as long as it’s a normal pregnancy without complications, you and your doctor will have to decide what’s right for you. And keep in mind that deciding not to ride on the roads doesn’t make you any less of an athlete.

Regardless of your choice though, you shouldn’t start an outdoor cycling routine after the first trimester because your balance is now comprised, and getting on (and staying on) a bike could be difficult if you haven’t been doing it regularly.

Monitor Your Efforts and Make Room for Comfort

If you continue cycling, remember to keep your efforts at 14-16 RPE after the first trimester, with recovery intervals at 10-12 RPE. And don’t forget to monitor your core body temperature when cycling or doing workouts of any during your pregnancy. You might even want to carry a basal thermometer with you to make sure your core body temperature is in the safe zone.

saddle, bike saddle, cycling, cycling and pregnancy, fit and healthy pregnancy You’ll also want to adjust your bike fit to your changes in posture and weight distribution for a more comfortable ride. A wider saddle might also lend more comfort, and getting a hydration pack that you wear on your back will keep you from shifting your balance to reach for your water bottle.

The Upside of Staying Stationary

Spinning, Stationary bikes, CompuTrainers, and even recumbent bikes are safe alternatives for those looking for peace of mind and assurance that they won’t fall. You can even find a CompuTrainer center where you bring your own bike and a coach sets you up at a designated wattage for your individual level. Be sure to tell the coach that you’re pregnant!

A CompuTrainer center also lets you ride on a stable bike in a temperature-regulated space, with a skilled cycling expert to adjust your level of difficulty and bike fit. It’s a great option for athletes of all levels—novice to competitive—and lets you ride with stability while watching a simulated outdoor course.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

Why Prenatal Yoga Is So Popular with Celebrities

red carpetDrew Barrymore, Gisele Bundchen, Jessica Alba, Gwyneth Paltrow, Mila Kunis. Why did I just list off a bunch of female celebrities? Well they’re not just female celebrities; they’re all moms or soon-to-be moms. Whats my point? Well these women have something else in common too: they’ve all engaged in prenatal yoga—an exercise the new book Fit and Healthy Pregnancy recommends.

Just last week, popular mommy-to-be, Mila Kunis, was spotted coming out of a prenatal yoga class on her birthday. So what’s so great about prenatal yoga that so many women, celebrity or otherwise, have turned to it?

First off, exercise in general during pregnancy is as important as your pregnancy multivitamin. (You can read about the importance of exercise during pregnancy in one of our other posts such as: “The Benefits of Exercise During Pregnancy” and “Is Exercise Good for Babies?”) But yoga might be of particular benefit to expectant mothers for a number of reasons, especially during the second trimester.

The second trimester is the best trimester for working our. For many women, it can feel like the midpoint in a race when all systems are go and you’re fired up with zest and strength. In fact, women often experience the expectant woman’s equivalent of a runner’s high. So this is the time to take advantage of your energy and positive outlook and to empower your health with activity oriented toward strength and wellness for you and your baby.

Not only is this an energized time during pregnancy, it’s also a time when women begin experiencing more physical discomforts such as lower back pain, postural changes, abdominal muscle separation, and leg cramps. So what can you do to combat those unfortunate changes or least make your situation more comfortable?prenatal yoga, yoga, celebrities and yoga

Do what the celebs do: prenatal yoga. Strength work during pregnancy will help your back before, during, and after delivery, making labor easier, (as many celebrity moms have reported). Plank and side-plank yoga poses will fortify your core and back and help prevent pain from motor weakness, muscle contraction, and posture changes.

You can also develop excellent ab and back strength with standing core exercises that can be performed comfortably into the seventh month of pregnancy. Just remember to avoid lying flat on your back when exercising during the second trimester because the weight of the uterus on the big vessels that bring blood back to the heart will decrease blood flow.

Remember to always listen to your body when working out during pregnancy, whether you’re doing yoga, cycling, swimming or any other exercise. If you’re looking for an example of a good yoga pose to test out, follow the training tip below, one of many detailed in Fit and Healthy Pregnancy:

To strengthen those back and abdominal muscles, do plank poses every day. Start with two sets of 20 to 30 seconds each for the basic plank and side plank on both sides, working your way to 2 to 3 sets of 60 to 90 seconds for reach position. Keep your spine as straight as possible; resist the urge to push your rear out and back. If necessary, make the planks easier to adapt to your changing weight by lying on your side and keeping your lower knee on the mat, with that leg bent behind you. To make a basic plank easier, put your weight on your knees instead of your feet or open your legs wider and hold yourself up on your palms instead of your forearms.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

The Benefits of Exercising During Pregnancy

running, exercise, fitness, fit and healthy pregnancyDespite the misperception that exercise during pregnancy is risky for women and their babies, studies consistently show that those who work out when they’re expecting tend to have better health outcomes during pregnancy and delivery.

Here are some of the benefits of exercising while you are pregnant:

  • yoga, exercise, fitness, woman doing yoga, exercise and pregnancy, fit and healthy pregnancyBetter cardiovascular function
  • Less weight gain
  • Lower musculoskeletal discomfort, especially in the lower back
  • Better posture
  • Fewer muscle cramps
  • Better mood and self-esteem
  • Lower risk of gestational diabetes
  • Fewer instances of hypertension
  • Better circulation throughout the body and to the placenta
  • Less constipation and bloating
  • Improved muscle support for the pelvis
  • Lower rates of incontinence
  • Stronger muscles, bones, and ligaments for labor and delivery
  • More energy and better sleep

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

Fueling Your First Trimester: Tackling Myths, How Much to Eat, and What to Eat

Myth busting

salmon, fish, eating fish, eating fish during pregnancyThere are lot of myths out there in terms of how much diet and nutrition during pregnancy. One recent controversy is the FDA’s recommendation of pregnant women eating more fish. Fish is your friend; you just need to watch how much and what kind of fish you eat to avoid the intake of too much mercury. Steer clear of shark, swordfish, king mackerel, or tilefish during pregnancy, but you can eat halibut, rainbow trout, wild shrimp, salmon, canned light tuna, and catfish, all of which have low mercury content.

At this point, you might be asking yourself what other lies have I been told about what and how much I can eat during pregnancy? What about the “eating for two” myth. Contrary to stereotypes about expectant women, pregnancy—particularly the first trimester—isn’t best served by a caloric free-for-all. U.S. News and World Report recently came out with a great article entitled: “The Best and Worst Foods to Eat During Pregnancy” The first point the article makes is “eating for two” can lead to overeating.

How much should I eat?

While cravings come along with the territory, overeating can put you at risk for complications during pregnancy. Physiologically, your body has no need for extra calories during those first 12 weeks. However, women active in endurance sports (or other activities) need sufficient caloric replacement for what they’re burning. Remember to talk to your doctor about your specific training and eating additional calories when you’re using energy through exercise.

In terms of how much to eat, aim for small meals every few hours during the day to avoid a drop in blood sugar, which is a risk in early pregnancy because of the major metabolic changes happening. Eating small, frequent meals also helps prevent nausea and dizziness, particularly an hour or so before a workout and right after you finish, when your blood sugar is likely low.

What should I eat?

beans, complex carbohydrates, carbs, carbohydrates, carbs during pregnancyGoing back to the U.S. News and World Report article, they say, “carbohydrates are a pregnant woman’s best friend.” Indeed! They’re essential to fueling your performance as an active woman, and they help fuel the workout happening inside of you. Your body is using more carbohydrates while you’re pregnant, which can lead to low blood sugar when exercising, so replacing carbs immediately after a workout is essential.

In terms of what kinds of carbs, you’ll want to focus on replenishing your calories in the form of complex carbs such as whole-grain pastas, quinoa, nuts, beans, and brown rice, because complex carbs offer more fiber that slows digestion. (Not to mention that high-fiber can help alleviate the oh-so-unwelcome constipation and nausea that comes along with the first trimester).

On top of complex carbs, you’ll want sufficient protein from meat and/or legumes to build muscle and promote healthy growth. Hydration is also one of the most important factors throughout a fit pregnancy, but it’s especially critical in early pregnancy. Dehydration can prompt uterine contractions, so it’s extremely important to stay hydrated when exercising—make sure your urine is clear! And ask any woman who’s been pregnant, and she’ll probably tell you that prenatal vitamins are like a gift from the gods. Your prenatal vitamins will give you the extra iron and folic acid you need because of increased blood volume and an increase in red blood cells.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

Is Exercise Good for Babies?

Research shows that exercise, and even vigorous training, are safe for you throughout pregnancy. So go ahead, exhale.

Not only is a fitness practice safe, but also it will improve your health during and after pregnancy. Even better, research shows that your fitness routine or training is both safe and healthy for your growing baby. Here’s your next one-liner comeback for the doubters: “Fit mama, fit baby.” Let those words help guide your 40 weeks, not to mention the postpartum family life you’re going to build.

baby, boy, curious,

The research on the effects of exercise on fetal development has kept pace with studies of the impact of exercise on women’s bodies during pregnancy, and results show that your activity brings benefit to the baby in utero. Babies of women who were active during pregnancy tend to be leaner at birth and exhibit somewhat better neurobehavioral maturation. These babies also have lower rates of long-term weight issues at age 5 as well as slightly higher brain function during childhood.

From early pregnancy through the third trimester, a fetus can tolerate your exercise very well because a woman’s body adapts to pregnancy in a way that regulates the impact of her activity on the growing baby. For instance, your body has an improved ability to regulate your core body temperature by cooling itself through sweat and heat dispensation from your skin. Similarly, fetal heart rate can increase when you exercise, but it returns to normal after you finish working out. This and other fetal responses to your activity are temporary and have no permanent effects on the baby’s development. Regular and sustained workouts can increase the placenta’s volume in early and mid-pregnancy but have no adverse effects on any pregnancy outcomes.

Fetus, sonogram, baby, pregnancy, pregnant, ultrasound

What about intensity? Well, maintaining a fantastically sweaty and vigorous level of exercise does not carry any negative health consequences for your growing baby, either, as long as that level of exercise is familiar to you and your body. There are no significant differences in the fetal heart rate (FHR), Doppler health, birth weight, and Apgar scores among babies of vigorous versus moderate exercisers.

The upshot is that training is good for your pregnancy health, and it actually benefits your baby as well. The base you’re building for a fit pregnancy is achieved by the concept of wellness: doing what feels good to the body for the sake of mom-baby health. It’s safe and healthy to train and work out, but scale it back if you experience any of the adverse symptoms listed earlier or if you feel depleted and stressed by it to the point that it fails to enhance your general wellness. As athletes, we feel empowered by our agency over our bodies in the world, and pregnancy is no time to lose that self-possession.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MDFit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD.

Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.

Kristina’s Story: Exercise Makes Being a Mom Better

Kristina Pinto, EdDAs a developmental psychologist, mom, running coach, and marathoner for more than a decade, I have seen and heard countless stories of the power of sport in mothers’ lives. Through my blogs, Marathon Mama and Mother Running Rampant, I discovered the legions of mother-runners on the roads and on the trails, many of whom were forging online connections with other moms, cultivating a social movement in sneakers. And with the uptick in the popularity of triathlon, you can now find more and more moms celebrating their love of fitness and sport on wheels and in the water. What I’ve learned from these women is that while being an athlete empowers each of us differently, we are unified by our need for sport and fitness, and we’ve become more committed to keeping that power in our lives as we have babies and grow our families.

The confluence of running, motherhood, and women’s identity is an area about which I write with both respect and a good dose of irreverence. These are my passions and the source of much laughter as I coach other women in running. I teach the joy of getting out of your comfort zone to find the rewards of striving for goals many women never knew they could accomplish, whether it’s completing a 5K or qualifying for Boston. Admittedly, my coaching has even included advice on how to spit while racing and how to paint toes with no nails. runner, woman running, athletic womenWhen I had my baby, I didn’t think I could manage training and motherhood and frankly couldn’t imagine how any woman did. I’d exercised throughout my pregnancy by running, walking, swimming, and using the elliptical at the gym, and when I developed preeclampsia in my 40th week of pregnancy, I was quickly induced. As childbirth goes, I had an “easy” labor and vaginal delivery, due in no small part to a fit pregnancy, according to my doctor. My smooth birth experience gave way to a mentally tough postpartum transition, even with the joys of my new baby, who was born in Boston during the same October week that the Red Sox broke the curse to win the World Series. In a city full of exuberance, a crippling mix of fatigue and insomnia besieged my baby’s first few weeks of life, and I developed clinical postpartum depression. My body and mind had been thrown for a loop, and I felt guilty that I couldn’t find the bliss new moms were supposed to have. Before he was born, life had been only about my needs and goals, and I felt shell-shocked by life as a mother.

A typically frigid New England winter put us under house arrest in a small apartment, where I edited my dissertation and took care of a tiny baby who needed me in order to survive. I didn’t want to go outside on the icy sidewalks with the stroller, and running felt crazy when I was so tired. I couldn’t see straight to run and didn’t know any women with new babies who did run. No one told me that mothers can run, and—more to the point—that sport actually helps motherhood. Far beyond that, it never occurred to me that running can feel as much a part of motherhood as the primal drive to protect our young. It was the end of 2004, and I had no clue that a mother, Catherine Ndereba, had won the world’s most prestigious marathon that year. In my mind, motherhood entailed surviving the day with an infant who subjected me to intervals of crying with 90-second recovery periods of sleep. mother and baby, new mother, mother kissing baby,

It took six months to motivate myself to start running at all and a year to run a slow but liberating 10K. I hadn’t realized that forcing myself out the door for short distances or locating a group of running mothers would relieve my depression and insomnia. I had no clue that even a daily mile alone might give me more strength to care for a baby who I swore was saying I was not his first choice. It was no fluke that my slow return to running coincided with greater adoration of my baby and a new love for being his mother. On spring and summer and then fall mornings, we would run to the Charles River together, his voice undulating in the jogging stroller as we bounced across cracks in the sidewalk. Occasionally I would run alone while he played with his dad, and on those runs I felt like Winged Victory, but with my head firmly— finally—restored. I shed all of the trappings of motherhood with every step. My new-mom body was completely free, bouncing loosely like clothes in the dryer as I jogged slowly. Everything about my body was slack, as my bladder liked to remind me.

But I was running, so I didn’t much care.

Fit and Healthy Pregnancy by Dr. Kristina Pinto and Rachel Kramer, MD Fit & Healthy Pregnancy is a friendly, comprehensive guide to exercising during pregnancy from athlete-moms Kristina Pinto and Rachel Kramer, MD. Find Fit and Healthy Pregnancy in your local bookstore or online and learn safe ways to exercise for two!

Please consult your doctor before embarking on an exercise program during pregnancy.