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Safe Exercise During Pregnancy: ACOG Backed Guidelines
Safe Pregnancy Exercise | Image Courtesy of Lucas Favre via Unsplash

Dr. Debbie Dy, PT, DPT

Orthopedic Clinical Specialist/Pelvic Health Physical Therapist 

Once the exciting news of a new pregnancy is shared, it is common to get flooded with misinformation and “advice” from concerned family members regarding the safety of exercise during their pregnancy. Historically, it is common for people to be told to “take it easy” during their pregnancy or spend more time in bed. What we know is that exercise during pregnancy is safe and beneficial for both birthing parent and baby. 

ACOG Updated Guidelines on Exercise During Pregnancy

The American College of Obstetrics and Gynecology (ACOG) in 2020 released updated guidelines regarding exercise in pregnancy which states that “exercise is both safe and desirable for birthing people in the absence of obstetric or medical complications or contraindications.” Not only is regular exercise safe for most pregnancies, exercising has immense physical and mental health benefits for not only the birthing person, but for the growing fetus as well. Birthing people who engage in regular exercise during their pregnancies have been shown to have decreased rates of gestational diabetes, hypertension, cesarean births, operative vaginal births and postpartum recovery time. It can also be preventative for the development of depressive disorders in the postpartum period.

ACOG recommended program for exercise during pregnancy

ACOG currently recommends an exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20–30 minutes per day on most or all days of the week. For moderate-intensity exercise, ratings of perceived exertion should rate between 13-15 or “somewhat hard” on Borg Ratings of Perceived Exertion scale. A simple Talk Test can be used as well: as long as one can carry on a conversation while performing exercise, they are likely not overexerting themselves. Pregnant people who were more sedentary prior to pregnancy should take a more gradual progression towards these exercise recommendations. Outside of these measures, other signs you may be overdoing it with exercise intensity include vaginal bleeding, abdominal pain, painful contractions, calf pain or swelling, dizziness, headaches and chest pain. 

Something else to consider is the climate in which you are exercising. Pregnant people should perform exercises in a thermoregulated environment to avoid prolonged heat exposure. So save your hot yoga for the postpartum period! Other types of exercise that should be generally avoided include contact sports, activities associated with increased risk of falling ie. gymnastics, downhill skiing, surfing and horseback riding.

Pregnancy and motherhood itself are extreme sports and it is important that you plan accordingly! All of our therapists at Femina Physical Therapy are well versed in providing fitness programs that are tailored to your needs during pregnancy. If you are interested in learning safe and effective ways to exercise during pregnancy to keep your body strong and flexible throughout your pregnancy from a licensed physical therapist and Pilates instructor, give us a call to schedule today! 

References: 

  1. Barakat, R., Refoyo, I., Coteron, J., & Franco, E. (2018). Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Brazilian Journal of Physical Therapy. doi:10.1016/j.bjpt.2018.11.005
  2. Berghella V, Saccone G. Exercise in pregnancy, Am J Obstet Gynecol 2017;216:335–7.
  3. McMurray RG , Mottola MF , Wolfe LA , Artal R , Millar L , Pivarnik JM . Recent advances in understanding maternal and fetal responses to exercise . Med Sci Sports Exerc 1993 ; 25 : 1305 – 21 
  4. Soultanakis HN , Artal R , Wiswell RA. Prolonged exercise in pregnancy: glucose homeostasis, ventilatory and cardiovascular responses. Semin Perinatol 1996 ; 20 : 315 – 27 .

What Our Patients Have to Say

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Testimonial by M.M.

My husband and I were married for 5 years and unable to have intercourse, but I never knew why. After numerous awful experiences at doctor’s offices (where many doctors told me I “just needed to relax”), a surgery that didn’t fix the problem, and a year of owning dilators that didn’t get me anywhere, someone finally referred me to Heather for Physical Therapy. I finally had answers and information from someone who knew exactly what I was dealing with!

Read more: Testimonial by M.M.

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

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