Cedars-Sinai Blog
Why Should You Exercise During Pregnancy?
One in five pregnant patients is told to restrict their activity, even though exercise has been shown to be safe and healthy during most pregnancies. Guidelines recommend pregnant and postpartum women aim for 150 minutes of moderate-intensity exercise weekly.
Though some clinicians continue to prescribe bedrest, evidence shows that exercise in pregnancy is usually the best choice, said Gabriela Dellapiana, MD, a maternal-fetal medicine physician who cares for women with high-risk pregnancies. Here, Dellapiana outlines reasons to stay active during and after pregnancy, how to get motivated to move, and when to ease off the workouts and consult with your doctor.
"There’s so much misinformation, but the bottom line is that exercise is safe for most people throughout pregnancy," she said.
"Exercise is safe for most pregnant people, including groups who were traditionally recommended bedrest, such as people pregnant with twins."
What are the benefits of exercise during pregnancy?
Exercise during pregnancy is beneficial for you and your baby: People who are more physically active have better birth outcomes, said Dellapiana. Regular exercise helps to reduce the risk of developing gestational diabetes, high blood pressure (preeclampsia) and postpartum depression.
Staying fit can also lower the chance of a cesarean delivery and perineal tears, and can help shorten recovery time after birth. For patients who were overweight or obese before pregnancy, an increase in exercise reduces preterm delivery.
What types of exercise can pregnant women do?
Most forms of exercise are safe during pregnancy, as long as your heart rate remains in the moderate-intensity range. For most people, this is below 140. A smartwatch can monitor your heart rate, but if you don’t have one, practice the talk test: Exert yourself enough so that you can carry on a conversation but couldn’t sing.
Brisk walking, jogging and running, stationary cycling, swimming, light weightlifting, stretching and pelvic floor exercise are all great options, Dellapiana said.
"If you were active before your pregnancy, you can generally continue what you were doing," she said. "Listen to your body’s cues, and pivot as necessary."
Dellapiana cautions that pregnant exercisers should avoid overheating—stay hydrated, wear loose clothing and avoid "hot" variations of classes such as yoga and Pilates. Steer clear of activities that put you at risk of falling or sustaining trauma to the abdomen, such as contact sports, horseback riding, downhill skiing and surfing.
After 20 weeks, avoid exercise that involves lying flat on your back for prolonged periods of time. During pregnancy, your joints are looser, so be mindful not to overstretch. If you ever experience vaginal bleeding, leaking of amniotic fluid, painful contractions, or shortness of breath, stop exercising and talk to your doctor.
When should a woman avoid physical activity during pregnancy?
Some complications during pregnancy could call for activity restriction—a certain number of hours of rest and limits on household chores determined by a doctor. Women with high blood pressure, those at risk of preterm delivery or whose baby is small in utero should talk with their physicians before starting any exercise.
Pregnant women with significant heart disease or severe lung disease, those whose bag of water is protruding into the vagina and patients with persistent vaginal bleeding should also consult their physicians before they exercise.
There is no evidence that bedrest prevents preterm delivery, which most providers know, Dellapiana said. In a 2009 study of 800 maternal fetal medicine physicians across the country, more than 80% said they would prescribe bedrest for at-risk patients, even though 70% of those surveyed acknowledged there’s no data to support bedrest. Dellapiana offers one theory for the persistent practice.
"Preterm delivery has significant, lifelong implications for the child and the family, and providers and patients want to feel like they’re doing something—anything—to protect the baby," she said.
In most cases, staying sedentary actually carries far more risks than benefits.
"Guidelines from the Society for Maternal and Fetal Medicine specifically recommend against activity restriction, since there is little evidence that it helps and has even shown to be harmful," Dellapiana said. "Bedrest deconditions you quickly. Within just a few days of immobility, there are body-wide changes to cardiovascular stamina, breathing and bone mineral density."
Bedrest can lead to poor weight gain for mom and baby, as well as insulin resistance, which increases the likelihood of developing gestational diabetes. Also, just three days of bedrest puts pregnant patients at higher risk of blood clots.
There are psychological risks as well—people put on bedrest have more stress, anxiety and depression, Dellapiana said.
"Exercise is safe for most pregnant people, including groups who were traditionally recommended bedrest, such as people pregnant with twins," she said.
Gabriela Dellapiana, MD
Gabriela Dellapiana, MD
How can women get and stay active during pregnancy?
It’s never too late to get active, and even minimal movement can help improve mental and physical health during pregnancy, Dellapiana said.
If you’re not a regular exerciser, find what interests you. Set small goals and recruit your loved ones to join. Exercising with friends or family is a good way to create a routine and remain consistent.
"If you weren’t active before your pregnancy, start with walking—that counts, and it’s great exercise," she said. "It’s an easy thing to do socially, and if you have kids, they can join, too."
