Pregnancy Exercise: All You Need to Know Before You Start

Pregnancy, especially the first one, brings up a lot of questions. And while exercise is generally advisable for pregnant women, it can be hard to figure out what exactly to do.

You’ll find everything you need to know here:

• Answers to the most common questions regarding safe pregnancy exercise
• Specific trimester tips and other tips for prenatal workouts
• Training plan examples
• Prenatal home workouts in the adidas Training app

1. Who should not exercise during pregnancy?

In uncomplicated pregnancies, exercise is highly encouraged (see Pregnancy exercise benefits). However, there are certain conditions in which exercise is not permitted (absolute contraindications) or allowed only under special supervision (relative contraindications).⁽¹⁾

Keep in mind: You should always get approval from your doctor before starting any exercise during pregnancy.

Absolute contraindications

• Multiple pregnancies at risk of premature labor 
• Persistent 2nd trimester or 3rd trimester bleeding
• Placenta previa after 26 weeks of gestation 
• Premature labor during current pregnancy
• Ruptured chorioamniotic membranes 
• Preeclampsia or pregnancy-induced hypertension 
• Severe anemia 
• Certain types of heart and lung disease 
• Incompetent cervix or cerclage

Relative contraindications: 

• Anemia
• Chronic bronchitis
• Poorly controlled type 1 diabetes, hypertension, hyperthyroidism, or seizure disorder
• Extreme obesity or underweight
• History of extremely sedentary lifestyle
• Intrauterine growth restriction in current pregnancy
• Unevaluated maternal cardiac arrhythmia 
• Orthopedic limitations
• Heavy smoker

Before you begin exercising, make sure to also check the warning signs to know when you should stop exercising.

2. What kind of exercise is safe? 

Even though the doctor has cleared you for exercise, the changes you experience during pregnancy might still make you wonder what kind of exercise is safe. 

Unsafe sports during pregnancy⁽²⁾

• Sports with a high risk of falling or injury (i.e. skiing, climbing, horseback riding, martial arts, diving, surfing, etc.)
• Contact sports like soccer, handball, and basketball
• Lifting weights heavier than you are used to and need to strain to lift
• Competitive sports and races, unless you are an athlete supervised by coach and doctor
• Activities at high altitudes (> 2500 m/8,200 ft) and high temperatures (hot yoga)
• Scuba diving
  

Most other sports activities are generally safe, but you still need to consider your individual experience and skill level. 

If you were…

Active before pregnancy – can you keep doing what you were doing?

If you were active before pregnancy, you can consider continuing with the same or similar activities, unless they’re on the above-mentioned list of unsafe sports. You need to consider your physical changes (see Exercise Tips and Adjusting to Your Trimester) that may require necessary modifications and adjust the intensity (see How intensely can you exercise while pregnant).

Not active before pregnancy – can you start exercising?

Yes, but you need to do it gradually. Start at a low intensity (where you can normally keep a conversation while active), working out continuously for 10 minutes. You can start with 10-minute walks, too.

Over the next 2-4 weeks, aim to increase the duration of the workout (or walk) to 30 to 45 minutes and the intensity to a moderate level (see How intensely can you exercise while pregnant). This will entirely depend on how your body responds to the exercise and how your pregnancy evolves.⁽³⁾

Prenatal workouts such as Short Seated Stretching and Yoga Inspired Mobility in the adidas Training app can be a great start. 

Pregnancy is unpredictable. So instead of setting expectations, aim to be content with knowing that you are doing the best you can, while at the same time honoring your current situation, whatever that is.

Make sure to check the warning signs to know if you should stop exercising.

3. How to choose the best pregnancy workout

Pregnancy is a unique opportunity to learn what it really means to “listen to your body”. 

Choosing the best activity depends not only on your previous experience and preference, you should also consider the current state of your body (and mind). 

Golden rule: The best pregnancy workout is the one that makes you feel better – more energized or relaxed – than when you started (and not more tired or nervous). 

Physical changes from pregnancy that may affect exercise^(4,5,6)

• Abdominal muscles get stretched, the core is less efficient in handling loads and pressure 
• Changes in postural balance make pregnant women more likely to sustain a fall
• Hormonal changes causing increased breast size, relaxed ligaments, swelling, fatigue all directly affect how you feel before, during, and after exercise.
• Oxygen requirements increase, making it harder to sustain longer or intense exercise
• It gets harder to stay hydrated. Drink more water and watch out for signs of dehydration
• Postural changes such as changes in the curvature of the lower spine and rounding of the shoulders affect movement 
• The expansion of the belly changes the rib and diaphragm position, affecting breathing.

Considerations for different types of activities

Strength Training

• Recommended to support muscle function, improve posture, and metabolism. There is no need to completely avoid resistance training in pregnancy; it can be adapted.
• Can be done with weights or just using your body weight. 
• There are no specific weight limitations. It depends on your fitness routine and experience before pregnancy. Do not lift anything that requires you to strain or hold your breath. This might be a loaded barbell for some, while dumbbells may be too much for others. 
• A general rule to follow is: never “max out” and stick to higher rep ranges, ending the set when you feel like you could still do some reps. 
• Try the 25-Minute Full-Body Pump and Full-Body Strength prenatal workouts in the adidas Training app.

Stretching & Pregnancy Yoga

• Make sure not to overstretch; only stretch as far as is comfortable. 
• Consider avoiding any poses that include backbends, strong and rapid contractions of the abdominal muscles, holding your breath, deep twists, inversions… 
• Try the Yoga Inspired Mobility and Short Seated Stretching workouts in the adidas Training app. For more advanced workouts, qualified supervision is advised (instructor or coach with certification for prenatal workouts).

Cardio

• Stick to moderate intensities (check out How intensely can you exercise while pregnant?)
• Avoid any jumping, high-impact, or bouncing movements. 
• The Low-Impact Cardio workout from the adidas Training app was created especially for pregnancy cardio at home.
• You can keep running during pregnancy if you were running before, as long as you keep the intensity moderate and stop the instant anything begins to feel “off” (pelvic floor heaviness or any other symptom). If you were not running before, stick to walking workouts during pregnancy.
• Other cardio ideas: swimming, stationary cycling…

What’s best? Staying active by combining different types of workouts will bring the best results. For example, a combination of strength and cardio will have a greater effect on reducing the risk for gestational diabetes.⁽⁷⁾ 

4. Pregnancy Training Plan

When it comes to prenatal workouts, the most important thing is to listen to your body, not follow a set schedule. That’s why you can find examples of two completely different training plan weeks for pregnancy. These are suggestions only; they show you how much a training plan can depend on our energy levels and current state. 

You can get all workouts in the adidas Training app and use them according to what feels best!

Download

5. How intensely can you exercise while pregnant?

The easiest way to measure intensity is the talk test:⁽⁸⁾

Can you still hold a conversation while exercising, even though it might be a bit harder? If you have to stop to finish a sentence or pause to be able to breathe normally, the workout is too intense.

When it comes to prenatal exercise, it’s essential to keep the intensity moderate. What this means, however, can be different for each person and can also be measured differently.⁽⁹⁾

What does moderate intensity feel like? You could continue the activity for a longer period, even though your breathing is getting slightly heavier. It might be more difficult to sustain a conversation, but still possible. Singing would not be an option. You start sweating but are not yet on the verge of feeling uncomfortable.

Use a measurement scale: On a scale of 1 to 10, your effort should not feel like more than 6; ideally, it would be between 4 and 6.

Doctors and coaches can advise more experienced athletes on how to train at higher intensities.

What should my heart rate be during pregnancy exercise?

The 140 bpm limit for pregnancy exercise is outdated. Published expert guidelines around the world do not agree on a single number that applies to all pregnant women.⁽¹⁰⁾ A better approach is to modify the intensity based on your perceived effort as explained above.

6. Warning signs – when to stop exercising

If you notice these warning signs at any point during the workout, stop the workout and consult your doctor:⁽¹¹⁾

• Dizziness or feeling faint
• Vaginal bleeding 
• Shortness of breath before starting to exercise
• Chest pain or abdominal pain
• Headache
• Muscle weakness affecting balance
• Calf pain or swelling
• Regular, painful uterine contractions 
• Fluid gushing or leaking from your vagina

7. How often should you work out during pregnancy? 

20-30 minutes of moderate-intensity exercise per day on most or all days of the week is considered ideal.⁽¹²⁾ However, the ideal fitness routine is not always realistic. Pregnancy is a time when you need to honor the current state of your body. Some days you can do more, others less, or you might even need to just take a day off to rest.

Can you work out every day if you feel good? It is best to take rest days from working out (at a moderate intensity), but stay active (with low-intensity activities). You should definitely, as much as your energy allows, be active every day. Movement is healthy and it doesn’t always have to be exercise!

Check out the weekly training plan suggestions to get an idea of how to adjust workouts to your energy levels.

8. Exercise tips – pelvic floor, breathing, posture

Even if you have always exercised regularly, your body will change during pregnancy. It’s important to consider these educational tips when working out.

Your Pelvic Floor and Kegel Exercises

What is the pelvic floor? The pelvic floor is a group of muscles that support the bladder, bowel, and uterus. These are located inside the pelvis. Among other things, they are important for sexual function, stabilization of your core during movement, and preventing incontinence. 

Why is the pelvic floor important for pregnancy exercise? Pregnancy affects the pelvic floor, mostly by increasing the pressure on it. It can lead to complications such as prolapse or incontinence. You need to watch out for symptoms such as a feeling of heaviness, the sense that something is “falling out of your vagina”, or pain in the pelvic area. This helps you react early enough, modify activities, and avoid further complications. 

Should you be doing special exercises for the pelvic floor (Kegels)?

Doing Kegel exercises can help you get familiar with your pelvic floor muscles and learn how to contract and relax them (both are equally important!). That is crucial for your pelvic health, also later in the postpartum period. However, more is not always better. The pelvic floor works also when you just walk or do other types of work, so don’t overdo it. 

Based on current research, specific pelvic floor training during pregnancy can decrease the risk for urinary incontinence and may reduce the symptoms of existing urinary incontinence in pregnant women^(13,14). If you had a high BMI (>30) before pregnancy, are over 35 years old, experience coughing, or have a family history of incontinence, it is worth considering adding specific pelvic floor muscle training during pregnancy. A general approach is to do 3 sets of 8 repetitions of Kegels, 2 times a day. Pelvic floor muscle training can also be part of your existing workout, like in some of the prenatal workouts in the adidas Training app.

Breathing During Pregnancy Exercise

Breathing is an important part of core stabilization, as it regulates the pressure inside your abdomen. This is even more important during pregnancy, as the growing belly presents an even bigger challenge. It pushes up your diaphragm and restricts its movement. 

What to focus on during pregnancy breathing exercises 

• Work on rib cage mobility and diaphragm expansion to practice the 360 breathing pattern, where the whole torso expands in all directions, instead of directing the breath only to the upper chest or pushing the belly out. Pregnancy yoga is a great way to get in touch with your breathing. Try the Yoga Inspired Mobility workout or practice for a few minutes every day using exercises such as Side Lying Breathing, Kneeling 360 Breathing, all available in the adidas Training app.
• Inhale: feel the side and back ribs expand (instead of inhaling into the upper chest and shoulders), relax the pelvic floor and let it “fill with air”.
• Exhale: feel the pelvic floor move back up and in as the abdomen and rib cage deflate
• Match the exhale phase to higher efforts during exercise; avoid holding your breath!
• Start to practice engaging your deep core muscles (especially m. transversus abdominis), for a couple of minutes each day. This will be especially useful to rebuild core strength postpartum. By adding a pelvic floor contraction to your exhale, you can try to feel your lower abs gently pulling in. If you stand in front of a mirror you should see your belly pull in, while the belly button should ideally not move up. Make sure to relax and inhale fully (releasing the pelvic floor) before each repetition. 
• Try to let the pelvic floor relax naturally as you inhale, and then feel it contract, activate and lift back up as you exhale. Contracting the muscles with more intensity is not better; this is an exercise in awareness.

Posture and Alignment

The weight of your growing belly pulls you forward, which you adapt to and compensate for with your posture. Working on body awareness can help you notice and improve your posture in exercise and in daily life. That way you can build muscles for better alignment, enabling you to distribute the load more equally. It’s also more comfortable in the long term.

Posture tips for exercise and daily life

• When getting up from a lying position or relaxed sitting on a couch, always roll to your side first and then get up by supporting yourself with your arm.
• During exercise, keep your chin tucked and ribs aligned over your hips.
• Check your alignment as often as you can, try to align your ribs over hips, pull your chin back, and use your glutes for support instead of locking your knees.

9. Adjust the Workouts to Your Trimester

Can you lie on your back to exercise while pregnant? 

Lying on your back for longer periods of time carries some risk, once the weight of the belly is heavy enough to press down on the venous system/blood flow. Exercise promotes blood flow, which is why supine exercise is different from just lying down; it is still safe in most cases. Check with your doctor or midwife if you are unsure. Monitor for dizziness or other uncomfortable feelings. Using pillows under your back to lift up your upper body (at least 15 degrees) will reduce any risks.⁽¹⁵⁾

Can you do Squats?

If you don’t have any heaviness or feeling of bearing down in the pelvic floor, you can keep doing squats throughout your pregnancy. Adjust the depth and width of your stance for your comfort. Make sure not to hold your breath. 

What about abdominal muscle exercises? 

Exercises that place extra load on the front abs, such as Planks, Sit Ups, Push Ups, Mountain Climbers, Leg Raises will become uncomfortable at some point during your pregnancy. That’s when it’s time to work your core in other ways, especially through breathing and stabilization. Monitor your body for any signs of bulging/doming on the midline of your abs and modify the exercise or skip it. See more under 2nd-trimester tips.

First Trimester

• Fatigue and nausea might increase. Adjust the workout volume, and accept that you have to cut down for now to avoid pushing yourself.
• Your weight might quickly start to change and you might get hungrier. Pay attention to whether you are experiencing uncomfortable feelings of guilt related to food and trying to compensate with exercise. If this persists, consider working on mindfulness in your relationship with food and your body, seeking help if needed.
• When tired and in doubt, sleep instead of working out. In most cases, you’ll have more energy during the 2nd trimester.
• Practicing breathing and connecting the breath to the pelvic floor will pay off in the future, especially during postpartum recovery (see Exercise Tips above). 
• Consider focusing more on the upper body and glute strength to support the upcoming postural changes and loads (growing belly and breast size). You can find lots of prenatal exercise ideas in the adidas Training app. 

Second Trimester

• As your belly starts to grow, it’s time to watch out for bearing down. This is the sensation of pushing down on your pelvic floor when you need extra support (similar to how you might strain when having a bowel movement). It can be a compensatory strategy to handle the additional pressure. When you engage your abs, the belly should slightly draw in, without a sensation of pushing down on the pelvic floor. If not, modify and/or stop the exercise. Look for a coach or physical therapist who can teach you better strategies to handle the load in person.
• Are you starting to feel a pulling sensation when tightening your abs? Does the midline on your abs start to come up under effort, creating a doming/bulging look? The diastasis rectus abdominis, a separation of the abdominal muscles, occurs naturally as the belly grows. Most exercises that work the front abs might become uncomfortable in the late second and third trimesters. That’s when they should be replaced with an easier version (that you can still control without bearing down or holding your breath) or avoided entirely.
• Practice engaging deep core muscles instead with exercises such as Breathing Leg Pointers, Quadruped Tuck, Heel Slides, and many more you can find in the adidas Training app. The home prenatal workouts featured in the app are designed to minimize the front loading.

Third Trimester

• Posture and movement strategies keep changing as the belly grows and might aggravate existing pain points or create new pain. Common problems in pregnancy are pubic symphysis pain, located on your pubic bone; a feeling of heaviness in the pelvic floor; lower or upper back pain. Monitor yourself for changes and types of pain and consult your doctor. Modify and adjust exercises accordingly. For pubic bone pain avoid single-leg exercises (and other asymmetric exercises) and narrow your squat stance. When it comes to heaviness in the pelvic floor, scale down the movements (avoid weights, adjust depth and stance for lower body exercises) and intensity. For chronic lower and upper back pain, try mobility flows such as Yoga Inspired Mobility in the adidas Training app. Remember to consult your doctor before starting a pregnancy exercise program, especially when feeling pain or discomfort.
• Stability starts to be affected, so make sure you find your balance before starting any exercise move; this is especially important as the belly gets bigger.
• Breathing gets harder each day – work on rib mobility and maintaining a full, 360-degree breathing pattern, with side and back expansion of the ribs and the connection to the pelvic floor. You can include an exercise such as Kneeling 360 Breathing from the adidas Training app to your daily routine, if even for just 5 minutes.
• Pay special attention to signs of pelvic floor dysfunction such as baby feeling very low, difficulty starting urination, evacuating bowels, urine leakage during exercise, or – check with a pelvic floor physiotherapist and modify your workouts to avoid anything that causes symptoms.
• Reduce walking times if long walks start to cause discomfort, primarily in the pelvic or lower back area. Plan some rest after workouts whenever possible.
• When strength exercises feel uncomfortable, opt for more seated and side-lying exercises, such as the Short Seated Stretching and the Yoga Inspired Mobility in the adidas Training app.
• It gets harder to stay hydrated; make sure you drink water throughout the day, especially when you work out outdoors or sweat.

Pregnancy Exercise Benefits

Research has shown that regular exercise is not only good for the expectant mother but the child as a fetus and into childhood, too.⁽¹⁶⁾ 

If you need some extra motivation to start, here are the key benefits of prenatal exercise.

Exercise in pregnancy…

• eases common pregnancy-related problems like backache, posture issues, and constipation
• reduces your risk of gestational diabetes
• increases the supply of oxygen for you and your child
• strengthens your cardiovascular system, making you feel fitter and more resilient, which might also help you handle the strain of giving birth
• might help prevent blood clots and varicose veins
• could improve the quality of your sleep
• enhances your general sense of well-being and helps with mood swings and stress

Takeaway

At first it may seem at first like exercising during the prenatal period is really complicated. However, your body will tell you a lot of important information to guide you.

Pregnancy is an opportunity to learn what it really means to “listen to your body”. You might encounter roadblocks, but if you don’t give up, you will also discover new strategies for self-care and awareness, which will also be useful postpartum.

Remember, staying active throughout your pregnancy benefits both you and the baby.

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Source: Fitness - runtastic.com