Pregnancy, Exercise, and Eating

Photo: Takis Markopoulos

You may be tempted to decrease or stop exercising while pregnant. Or you may be tempted to eat whatever you crave--no matter how unhealthy. But doctors recommend you continue to exercise throughout any normal pregnancy. And, of course, eating right is more important now than ever, both for your health and your baby's.

Pregnancy and Exercise:
If you normally exercise at very high intensity, you will need to decrease to moderate intensity during pregnancy. Your guideline is to keep your heart rate below 140 beats per minute. So if you usually run at 6.5 or 7.0 miles per hour, you will likely decrease your pace to 4-5 miles per hour now. This is difficult for women like me who like hard and sweat-pouring workouts. But you can still do most of your usual workout activities as long as you slow them down or modify them.

Exercise Appropriate During Pregnancy:
Treadmill or walking/light jogging
Elliptical machine
Stair Climber
Stationary bike
Swimming
Yoga/Pilates
Weight training

Exercise Not Recommended During Pregnancy:
Fast Jogging/Running
High Intensity Cardio
Plyometrics
High Impact Aerobics

Pregnancy and Eating:
In the past 9 years I have been pregnant five times, so I understand cravings of all sorts: potato chips, chicken soup, fudge, popcorn, chocolate frosties, and even cheese grits. Most foods can be eaten in moderation during pregnancy. But here is a brief list of unsafe foods: fish high in mercury (including tuna), cold cuts, caffeine, alcohol, unpasteurized cheese, raw sprouts, raw sushi, smoked fish, raw or rare meat, foods prepared with raw eggs. Some of these are allowed in small amounts, such a serving of tuna per week. The book referenced below is very comprehensive about all types of foods and the recommended amounts during pregnancy. Generally, try to eat a wide variety of nutritious foods. Find foods full of iron and folic acid. Eat a lot of fruits and veggies! Drink a ton of water! All of these are great habits to start now and should continue when you are breastfeeding.

References: Murkoff, Heidi and Mazel, Sharon. Eating Well When You're Expecting. Chapter 7: "Eating Safely When You're Expecting."

Pregnancy, Exercise and Weight Gain

What Exercises Are Safe During Pregnancy?

The ideal form of pregnancy exercise for you depends on your exercise routines beforehand. In general, cardio is important to continue. Arm/leg strengthening is beneficial. Core strengthening, with some modifications, can remain part of your routine. Prenatal yoga/pilates are ideal forms of exercise to do at least 1-2x/week, in combination with cardio and strength training. The biggest guideline is your heart rate; keep it around or below 140 beats per minute. So if you used to do sprinting intervals, you will have to give those up, at least for these 9 months. Jogging is typically not recommended unless you jogged consistently prior and can slow down your pace appropriately now. Seated exercise of almost all types is appropriate (including leg and arm strengthening with machine weights or free weights). Lying on your side is ok, which may be a position you can do in yoga/pilates or with core strengthening instead of lying on your back or tummy. Standing exercise is good, including leg/arm strength training with free weights. Swimming is ideal, especially if you are having joint pain or discomfort. Most gym cardio equipment is appropriate during pregnancy. Walking is one of the easiest and safest forms of exercise you can do.

Exercise Guidelines based on Prior Fitness Level:

1. If you were minimally exercising prior to pregnancy, then stick to low-level choices such as walking, water aerobics or prenatal yoga/pilates.

2. If you were exercising 1-3x/week consistently prior, then continue the same type of exercise (such as stationary bike, elliptical machine, aerobics class, etc). However, be sure to modify the intensity to keep your heart rate below 140 beats per minute.

3. If you were consistently working out 4-5x/week at a moderate-high intensity prior, then you should be able to continue similar forms of exercise but with modifications. Decrease the intensity/speed in order to keep your heart rate at 140 beats per minute. Remove all plyometrics (jumping) exercise from your routines. Eliminate supine (lying on back) and prone (lying face-down) exercises.

4. If you were an exercise-aholic prior, you obviously will not let pregnancy keep you out of the gym. Let the heart rate of 140 beats per minute be your guide. As long as you are not having morning sickness or joint pain, you should be able to exercise most days per week for an hour or even more, depending on the type of exercise. For example, if you are doing a 1-hour yoga class, you should be able to do 30 minutes of cardio on the same day. Your body/baby will tell you if you are overdoing it. It is urgent to drink more water than you think you need. Do not worry too much about your weight gain; let your OB monitor it and give any needed advice in this area. Most likely, if you love to exercise, you will easily lose all your baby weight after he/she is born.

What Exercises Should Be Avoided During Pregnancy?

You should not lie flat on your back, which eliminates some upper body exercises, core exercises and yoga positions. You should not lie on your stomach, which eliminates some core exercises and yoga positions. Avoid plyometrics or jumping drills. Avoid dangerous exercises/sports that would put you at fall risk. Avoid exercise at high intensities (such as high-intensity interval training). Avoid exercise that causes back pain or joint pain. Do not exercise outside in hot weather. Avoid sit-ups and abdominal crunches. 

How Do I Maintain My Fitness Level During Pregnancy?

You will likely lose some of your cardiovascular endurance and muscle strength/power during pregnancy if you abide by the recommended guidelines because it is not safe to exercise in the pre-baby intensity and manner. However, consistent exercise 3-6x/week at a low-moderate intensity has countless benefits. It will keep you moderately fit, prepare you for childbirth, help to limit your weight gain, and prevent some prenatal medical problems. The most important thing to remember is the safety of your baby, which matters more than how much weight you put on. 25-35 lbs of weight gain is the usual recommended amount, but your doctor's orders may vary depending on your pre-pregnancy weight and other factors.

How Do I Avoid Excessive Weight Gain During Pregnancy?

First, avoid overeating! You only need ~300 extra calories per day during pregnancy. Try to make healthy food choices that are filled with nutrients for you and your baby. Next, stay active! Do not put yourself on bedrest unless your physician does. Do not become a lazy glutton simply because you are pregnant and have people willing to do whatever you ask. Try to continue working or doing your usual daily activities throughout these 9 months. Lastly, exercise regularly! Do so several times per week, as much as possible throughout your pregnancy.