USC Health Now

Maintaining or even starting a physical fitness routine can help pregnant women prepare for labor by increasing strength and stamina. In honor of Mother’s Day, a USC expert explains how to stay in shape safely when expecting.

May 5, 2008
by Katie Neith

Getting ready for baby is an exciting, busy and frequently draining time. But taking a few minutes each day to exercise is important for pregnant women and can reap many healthful benefits.

According to Yogi Matharu, DPT, OCS, assistant professor of clinical physical therapy in Biokinesiology and Physical Therapy, a division at the USC School of Dentistry, exercise can help prevent pain and complications, improve posture and balance, and decrease risk of falls. It can also improve or maintain fitness and flexibility, make it easier for you to stay functional throughout the pregnancy, and decrease risk of gestational diabetes.

In fact, the American College of Obstetrics and Gynecology recommends 30 minutes of moderate daily exercise during pregnancy in the absence of medical complications. However, you should speak to your obstetrician before starting any exercise program to ensure that you do not have any complications that would make exercise unsafe. Examples of risk factors are bleeding, threatened or recurrent miscarriage, history of early labor, heart disease, asthma, diabetes and hypertension.

First trimester

During the first trimester, you can generally continue low to moderate intensity exercises that you performed before pregnancy, says Matharu. “You should keep your heart rate under 130 bpm and avoid jarring and high impact activities,” he says. “If you are not exercising [before pregnancy], it is usually considered safe to start a walking program. Swimming or walking in the water is also an excellent exercise.”

Matharu points out that this is also a good time to prepare for the changes in your body that will occur during pregnancy. He says to focus on strengthening exercises of the hamstrings, gluteals (buttocks) and trunk muscles.

A good example is bridges: lie flat on your back and lift your buttocks from the floor while contracting your abdominals, gluteals and thigh muscles (quadriceps). Another good exercise is squats: put feet shoulder width apart and bend knees to about 90 degrees use small weights in your hands if you need more resistance.

“This will prepare your body for the increased weight you will be carrying.” Matharu says.

To strengthen upper body, perform bicep curls: stand with feet shoulder width apart and bend elbows. Use a small weight when you can. Also, overhead press: stand with feet shoulder width apart and raise arms to ceiling. Add small weights when you are able.

To increase cardiovascular fitness, start by walking at a slow easy pace for 10 minutes. Slowly increase the time that you walk to 20 or 30 minutes. After you have increased the time, slowly increase the speed of the walk.

Balance is also key. Matharu suggests standing on one leg in front of a counter, using your hands on the counter as necessary. Slowly decrease use of hands and increase the time on one leg. The goal is 60 seconds. This will help decrease your risk of falls as your center of gravity changes during the pregnancy weight gain, he says.

Second trimester

You can continue exercise during this phase of pregnancy as long as you keep your heart rate below 130 and are not feeling any discomfort or having any signs of complications.

“Continue to discuss your exercise program with your obstetrician,” says Matharu. “It is also important to avoid lying on your side or back for more than three to five minutes as the pressure of the baby can decrease blood flow and increase risk of clots.”

He also suggests avoiding activities that require a lot of change of direction and being cautious of activities that could cause falls by challenging your balance.

Third trimester

For some women, it is more difficult to exercise in this trimester as they may be having more difficulty breathing as the baby gets larger. Also, as you are carrying more weight, you are working harder to move around, says Matharu.

Safety is the key during this portion of pregnancy, he says, and depending on your condition, walking or a pool program may be your best option.

Proceed with care

If you are unsure of how to begin a program, consult a physical therapist to prescribe an individualized program for you. In addition, avoid exercising in hot/humid areas and drink plenty of water before, during and after exercise.

Stop exercise and contact your physician if you develop high blood pressure, difficulty breathing, chest pain, swelling in your legs, spotting or bleeding, cramping, or dizziness. Also avoid holding your breath during activity and avoid aggressive stretching as hormones will cause your ligaments to become more lax.

“Each person’s pregnancy is different as is each person’s fitness level,” concludes Matharu. “Regular communication with your physician is important while developing an exercise program.”