By Marge Dwyer

BIDMC Correspondent


It’s easy for Dr. Hope A. Ricciotti to tell which of her pregnant patients are staying physically active. “They look more fit, feel better during their pregnancy, have more stamina during labor and delivery, and recover more quickly,” she says.


In decades past, doctors often placed limits on exercise for pregnant women. Today the women are encouraged to be active, as long as they first check with their doctor or midwife and follow certain guidelines.


“Today we want women to be vibrant and fit during pregnancy—not hiding in their homes because they are pregnant. They are not fragile flowers,” says Dr. Ricciotti, Active Chair of the Department of Obstetrics at Beth Israel Deaconess Medical Center in Boston and Director of Obstetrics and Gynecology at The Dimock Center.


Studies have shown that pregnant women who are active have fewer problems like backaches, constipation, mood swings, bloating as well as trouble sleeping and controlling weight gain. They also have a lower risk of developing a form of diabetes during pregnancy called gestational diabetes because physical activity helps the body makes better use of blood glucose.


The American College of Obstetricians and Gynecologists (ACOG) recommends pregnant women who are able to exercise do 30 minutes a day of walking or some other moderate physical activity.


“You don’t have to have special equipment or go to the gym. It can be as simple as parking further away from the mall or taking the stairs at work instead of the elevator,” Dr. Ricciotti says.


“Moderation is the key,” she adds. That’s one reason walking is one of the best ways for pregnant women – and the rest of us – to stay active. “It’s something many of the women already are doing. They can continue walking from the start of the pregnancy to the finish.”


Even women who have a cesarean delivery (C-section) generally can safely resume walking after the surgery. In fact, it’s often recommended to help prevent blood clots and speed recovery.


Pregnant women need not be limited to walking. Other possible activities include mild aerobics, bicycling on a stationary bike, yoga, and certain types of weight training. “Swimming is a great exercise, especially in the third trimester,” she adds. “Even women who have some aches and pains can feel comfortable swimming.”


Forget the Contact Sports


It’s important with any physical activity to avoid anything that would cause trauma to the abdomen, Dr. Ricciotti says. Sports like roller blading, downhill skiing, scuba diving (due to water pressure) and contact sports should be avoided during pregnancy. Some activities like gymnastics and horseback riding should be avoided because of the risk of falling.


There are some women who should not exercise. According to ACOG, these include:


  • Women at risk for having pre-term labor
  • Women experiencing vaginal bleeding
  • Women whose membranes (amniotic sack) breaks prematurely


Women with high blood pressure and other medical conditions should check with their doctors to see when exercise is appropriate.


While it’s not unusual for a pregnant woman to have difficulty catching her breath due to changes in the body, if you really have trouble breathing, you should stop exercising and contact your doctor or midwife. Other reasons to stop physical activity and contact your healthcare team include:


  • Feeling dizzy or faint
  • Experiencing vaginal fluid leaks
  • Having chest pain, muscle weakness, calf pain or headache
  • Noticing decreased fetal movement



Tips for physical activity when you are pregnant:


Wear comfortable, stable shoes. You may need to buy a new pair before you start walking because your shoe size may have changed during your pregnancy. “Your shoe size can change one-half to a whole size from beginning to end of the pregnancy,” Dr. Ricciotti says. It’s important to make sure the shoes are comfortable and stable to prevent falls. “This is not the time to wear your stiletto heels.”


Stay hydrated:  When walking in warm weather, be sure to dress comfortably and bring along plenty of water to stay hydrated. Dehydration can cause contractions, says Dr. Ricciotti. The amount of water needed will vary by individual; some people eat a lot of fruit like strawberries and melon that contain a lot of water and may not need to drink as much. “The best gauge is the color of your urine. If it’s dark yellow or orange, you should drink more water. If the urine is light yellow or clear, then you have good hydration.”


Bring along the sunscreen. Sunscreen is safe for pregnant women to use.


Keep your calorie intake up: If you burn extra calories with physical activity, make sure you eat enough calories. “We don’t want to see women lose weight during pregnancy,” she says.


Don’t let fatigue keep you on the couch. A lot of women experience fatigue when they are pregnant, especially in the late stages. But if you can push yourself to do a little activity like walking, you will feel better and have more energy.


Stay out of hot tubs and saunas. They may be tempting but you don’t want to raise your core body temperature if you are pregnant.


Watch your form while exercising: While obviously you want to avoid lying on your stomach after the first trimester, it’s also important not to lay flat on your back later in pregnancy as you might normally do in yoga or weight training. This could put too much weight on arteries leading into the abdomen. Also, ACOG advises avoiding standing still in one place for a long period of time. Watch your balance as your center of gravity may have shifted. Hormone changes may make your joints more susceptible to injury so avoid bouncy, high-impact movements.


Don’t overdo it:  Ease into your routine. Begin and end with 5-10 minute warm-up and cool down periods. Avoid getting tired too quickly. Make sure you can carry on a conversation while exercising to help gauge your pace. You may need to shorten your workouts as your pregnancy advances.



To schedule a consultation with the experts at the Department of Obstetrics and Gynecology at Beth Israel Deaconess Medical Center, call 1-617-667-4600.


Above content provided by Beth Israel Deaconess Medical Center.

For advice about your medical care, consult your doctor.