Trained fitness professionals should consider their work with pregnant/postpartum women the same way as a health care provider, that is, a continuum of care should be provided. Certified fitness professionals have the knowledge and practical experience to counsel a woman throughout all stages of her pregnancy experience. Knowledge of the woman’s exercise history, goals, and potential barriers to performance will help ensure that the relationship between the fitness professional and pregnant/postpartum client is maximized.

Recommendations for exercise during pregnancy have significantly changed during the past 20 years. Women are now encouraged to perform some sort of physical activity or exercise on most, if not all, days of the week during a normal pregnancy and soon after delivery. Women can perform a variety of activities for cardiovascular fitness, muscular strength and endurance, and flexibility (Tables 1 through 4 below). Modifications can and should be made according to a woman’s goals and her maternal symptoms. Despite the liberalization of recommendations, a woman should still be concerned with safety issues, temperature regulation, and proper nutrition to complement her exercise program. The health care provider should be included in exercise discussions from the very beginning of a woman’s pregnancy to ensure appropriate prenatal care.

Warning Signs To Terminate Exercise During Pregnancy

  • Vaginal bleeding
  • Cramping
  • Frequent lightheadedness/Dizziness
  • Significant nausea
  • Headaches
  • Shortness of breath before exercise
  • Chest pain
  • Decreased fetal movement
  • Amniotic fluid leakage
  • Preterm labor

Common Exercise Risks During Pregnancy and Suggested Modifications

Exercise Risk Suggested Modification
Falling caused by changing center of gravity Use a treadmill or track with a smooth surface for walking/jogging; switch to non-weight bearing aerobic activities
Fetal harm/premature labor because of blunt trauma to the abdomen Avoid certain activities such as water skiing and contact sports
Overheating of the fetus during intense or prolonged exercise Exercise in climate-controlled environments; use a fan or stationary equipment
Reduced maternal blood return to the heart during exercise in the supine position Avoid exercises laying on the back; perform crunches on an inclined bench with the head starting higher than the feet

Institute of Medicine- Recommended Pregnancy Weight Gain by Prepregnancy Weight Status

Prepregnancy BMI Categories, KG-M2 Recommended Weight Gain
Underweight (<18.5) 28-40 lbs
Normal weight (18.5-24.9) 25-35 lbs
Overweight (25.0-29.9) 15-25 lbs
Obese (>30.0) 15 lbs

Recommendations For Strength Training During Pregnancy

  • Avoid breath holding/Valsalva maneuvers
  • Use weight machines and/or resistance bands in place of free weights to reduce risk of injuries caused by changing center of balance
  • Decrease resistance, increase repetitions, and use shorter sets
  • Avoid power-lifting activities
  • Concentrate on maintaining proper form during lifts

Pivarnik, James M., and Lanay Mudd. “Oh Baby! Exercise During Pregnancy and the Postpartum Period.”
ACSM’s Health & Fitness Journal 13.3 May (2009): 8-13. Print.

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