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Exercise in Pregnancy
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Exercise in Pregnancy
, Sports Participation in Pregnancy, Lifting Restrictions in Pregnancy
See Also
Pregnancy Education in the First Trimester
Nutrition in Pregnancy
Physiology
Exercise
benefits in pregnancy
Improves mood and fitness during pregnancy
Decreases postpartum pregnancy
Decreases risk of
Gestational Diabetes
Decreases excessive
Weight Gain in Pregnancy
Decreases operative delivery and cesarean delivery risk
Decreases
Preeclampsia
risk
Precautions
Activities to avoid
Avoid more than light weight lifting
Avoid hyperextension activities (e.g. gymnastics)
Avoid raising
Body Temperature
>30 minutes (avoid
Exercise
in excessive heat and humidity)
Avoid hot yoga or hot pilates
Exercise
in loose fitting clothing and in comfortable
Temperature
s
Avoid excessive hot tub exposure
Increased risk of
Neural Tube Defect
s, esophageal atresia,
Omphalocele
Avoid starting strenuous Exercise in Pregnancy
Avoid
Scuba Diving
Avoid travel to altitude >13,000 feet or 4000 meters (esp. for those living at low altitude)
Avoid activities at high risk of injury
Avoid
Contact Sport
s (e.g. ice hockey, soccer, volleyball, basketball, martial arts, boxing)
Avoid sports with high risk of fall (e.g.
Downhill Skiing
or snow boarding, water
Skiing
, mountain biking, gymnastics)
Precautions
Contraindications to strenuous
Exercise
Pregnancy-related factors
History of 3 or more
Spontaneous Abortion
s
History of
Premature Rupture of Membranes
(
PROM
)
History of premature labor
Multiple Gestation
at risk for
Preterm Labor
(e.g. triplets, monoamniotic monochorionic twins)
History of cervical incompetence
History of
Placenta Previa
>26 to 28 weeks
History of
Intrauterine Growth Retardation
(
IUGR
)
Serious comorbidity
Hemodynamically significant heart disease
Restrictive Lung Disease
Severe
Anemia
Uncontrolled Hypertension
Uncontrolled
Type 1 Diabetes Mellitus
Uncontrolled
Thyroid
disease
Precautions
Lifting Restrictions in Pregnancy
Very Frequent Lifting (>3 times per minute)
Individualize restrictions and consider occupational health or obstetrics
Consultation
Repetitive Long Duration Lifting (>1 continuous hour of lifting more than once every 5 minutes)
Lifting height from floor >52" (4' 4") or 132 cm (1.3 M) or above
Shoulder
height
15 lb (7 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
10 lb (5 kg) if Lifting distance from body 20" or 51 cm
9 Lb (4 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >28" (2' 4") or 71 cm (0.7 M) or above knuckle height
18 lb (8 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
13 lb (6 kg) if Lifting distance from body 20" or 51 cm
10 Lb (5 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >17" (1' 5") or 43 cm (0.4 M) or above Tibia height
16 lb (7 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
11 lb (5 kg) if Lifting distance from body 20" or 51 cm
9 Lb (4 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor <17" (1' 5") or 43 cm (0.4 M) or below Tibia height
Lifting from this low height is not recommended
Repetitive Short Duration Lifting (<1 continuous hour of lifting more than once every 5 minutes)
Lifting height from floor >52" (4' 4") or 132 cm (1.3 M) or above
Shoulder
height
25 lb (11 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
18 lb (8 kg) if Lifting distance from body 20" or 51 cm
14 Lb (6 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >28" (2' 4") or 71 cm (0.7 M) or above knuckle height
30 lb (14 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
22 lb (10 kg) if Lifting distance from body 20" or 51 cm
17 Lb (8 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >17" (1' 5") or 43 cm (0.4 M) or above Tibia height
27 lb (12 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
20 lb (9 kg) if Lifting distance from body 20" or 51 cm
16 Lb (7 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor <17" (1' 5") or 43 cm (0.4 M) or below Tibia height
Lifting from this low height is not recommended
Infrequent Lifting (less than once every 5 minutes)
Lifting height from floor >52" (4' 4") or 132 cm (1.3 M) or above
Shoulder
height
30 lb (14 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
21 lb (10 kg) if Lifting distance from body 20" or 51 cm
17 Lb (8 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >28" (2' 4") or 71 cm (0.7 M) or above knuckle height
36 lb (16 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
26 lb (12 kg) if Lifting distance from body 20" or 51 cm
20 Lb (9 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor >17" (1' 5") or 43 cm (0.4 M) or above Tibia height
32 lb (15 kg) if Lifting distance from body 15" or 38 cm (<20 weeks gestation)
23 lb (10 kg) if Lifting distance from body 20" or 51 cm
18 Lb (8 kg) if Lifting distance from body 25" or 64 cm
Lifting height from floor <17" (1' 5") or 43 cm (0.4 M) or below Tibia height
Lifting from this low height is not recommended
References
MacDonald (2013) AJOG
https://www.ajog.org/action/showPdf?pii=S0002-9378%2813%2900242-1
Management
Gene
ral Recommendations
Continue a regular
Exercise
program in pregnancy
Maintain adequate hydration and
Nutrition in Pregnancy
to support activity
Competitive athletes performing strenuous Exercise in Pregnancy should specifically discuss with provider
Avoid Bed rest in pregnancy
Does not reduce premature contractions
Increased risk of DVT
Lactation
Breast
feed before strenuous
Exercise
to reduce discomfort from
Breast
engorgement
Moderate
Exercise
does not affect quantity or composition of
Breast Milk
Aerobic
Exercise
Perform for 20-30 minutes per day on most days of the week (150 minutes/week)
Previously physically active women may continue their pre-pregnancy activity level
Previously inactive women are encouraged to gradually increase activity to reach goals
Expect maximum
Heart Rate
to be lower during pregnancy
Avoid using
Heart Rate
in pregnancy to guide exertion level
Swimming is an optimal Exercise in Pregnancy (however, unknown effect of pool chemicals on pregnancy)
Running
,
Jogging
or Walking
Low-impact aerobics
Racquet Sports
Resistance Training
Limit to lighter weights
Avoid heavy lifting in pregnancy (see above)
Stretching
and Strengthening
Exercise
s
Yoga or Pilates (not hot yoga or hot pilates)
Yoga improves well-being in second and third trimesters
Holden (2019) Glob Adv Health Med +PMID: 31489259 [PubMed]
Back
While sitting, alternate straight and curved back
Exercise
s for back pain in pregnancy (YouTube Bob and Brad)
https://www.youtube.com/watch?v=ixJOwV1DijA
Abdomen
Alternate leg raises tones abdominal
Muscle
s
Isometric abdominal contraction
Plank
Exercise
s
Posterior Pelvic Tilt
Exercise
s
Diaphragmatic Breathing
Pelvic Floor Exercise
s
Hip bridges (with and without resistance bands, or with weighted pullovers)
Kegel Exercise
s
Also perform with toe taps and squats
References
(2015) Obstet Gynecol 126(6):e135-42 [PubMed]
Caro (2020) Am Fam Physician 102(7): 420-6 [PubMed]
Wojnowich (2022) Am Fam Physician 106(1): 52-60 [PubMed]
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