Warning Signs
While there are not many reasons that exercise would be contraindicated during pregnancy, it is important to know what to look for in terms of protecting yourself. In general, here are some problems that you may experience that would signal you to stop exercise during portions or all of your pregnancy.
Bleeding
About 30 to 40 percent of women will experience some form of bleeding during pregnancy. The majority of these women, more than 60 percent, will go on to carry a healthy baby to the end of pregnancy. However, it is wise to find out the source of the bleeding, which will determine whether or not you can exercise.
For example, the cervix region becomes much more vascular during pregnancy. Sometimes something as simple as a vaginal exam or sexual intercourse can cause the cervix to bleed slightly. While this is definitely scary, it does not necessarily mean an impending miscarriage or other problems with the pregnancy.
However, bleeding from the uterus, like under the placenta, also called a partial abruption, would be a reason not to exercise during this pregnancy until the issues were resolved and your doctor or midwife gave you the go-ahead.
Placenta previa is a condition in which part of or the entire placenta covers the opening of the uterus, the cervix. This can lead to bleeding, with or without pain, as well as pregnancy loss and other trauma to the pregnancy. There may not be an opportunity for you to exercise during this type of pregnancy because of the inherent risks.
Ask your provider about how this will affect your pregnancy and birth. You might also ask how often and how they intend to monitor the location of the placenta. Many times this condition will spontaneously resolve itself during the second trimester as the body of the uterus grows, helping to move the placenta away from the cervix.
Fact
Placenta previa, detected via ultrasound prior to 20 weeks of gestation, often does not wind up interfering with the birth process. As you enter the second trimester, the body of the uterus begins a major growth spurt, often helping the placenta to move from the cervical region in 95 percent of the women. If the placenta does not move far enough away, your baby will be born via a cesarean surgery.
History of Preterm Labor
If you have previously given birth to a baby before 37 weeks, you will want to talk to your practitioner about exercise. In certain cases, your previous birth may have had a non-repeating factor that caused you to have your baby early. This means that this particular pregnancy is not at a higher risk for preterm birth. Some practitioners, however, will advise that exercise for the first portion of pregnancy is best avoided to confirm the fact that it was a non-repeating factor. And then again, they may advise taking it easy during the later portion of pregnancy.
Contractions
The rhythmic tightening of the uterus that leads to cervical changes is not good; if you feel it, you should discontinue exercising immediately. These contractions are an indicator of preterm labor, even if they are not painful or even noticeable. Any regularly occurring contractions you feel prior to 37 weeks of pregnancy should be immediately reported to your doctor or midwife.
Incompetent Cervix
Incompetent cervix is a condition in which your cervix dilates prior to being full term. This can happen with or without noticeable contractions. You may have been previously diagnosed an incompetent cervix in this or a previous pregnancy, in which case you will probably be treated with a cervical cerclage, a stitch placed in the cervix to attempt to delay labor. Exercise is usually contraindicated because of the risk of preterm labor.
Alert
Timing contractions is very simple. Using a watch with a second hand, make a note of when a contraction begins. When the contraction ends, make note of that time as well. The third number to write down will be when the next contraction starts. The period from the beginning of the first contraction to the beginning of the second contraction is how far apart your contractions are. How long they last is from the beginning of one contraction until it ends.
Membrane Ruptures
If your water breaks you will likely be confined to bed rest for the remainder of your pregnancy in an attempt to prevent the preterm birth of your baby. While on bed rest, there may be opportunities to do certain types of physical therapy to help prevent muscle loss. Talk to your medical team about utilizing these services. Regular exercise is simply not possible.
It can be perfectly normal to have slight contractions for about 20 to 30 minutes after exercising. However, the contractions that do not stop after this short period of time or those that become very painful or intense need to be reported to your practitioner. Drinking water and lying on your left side should also help contractions decrease in frequency.
Pregnancy Induced Hypertension (PIH)
When your blood pressure is elevated in pregnancy, one must worry about the effects on mom and baby. Overall, exercise will tend to lower blood pressure, but during the actual exercise it does raise your blood pressure. Some practitioners advise that you avoid all exercise if you experience any episode of high blood pressure. Other practitioners take a wait-and-see approach, often depending on the severity of your symptoms and the timing of the onset of the symptoms.
Multiple Gestation
When you are carrying more than one baby, it is simply not well studied as to whether or not exercise is acceptable or beneficial. The general consensus is that with twins, moderate exercise in the beginning of pregnancy is acceptable. Since you will be more closely monitored during the second half of pregnancy, you can look for signs of impending preterm birth, like a shortening cervix. This will alert you and your provider to what changes you need to make in your physical activity levels.
Are there exercises I should avoid during pregnancy?
Absolutely! A few sports are considered inappropriate during any phase of pregnancy. Mostly these sports are dangerous for reasons related to balance and risk of physical blows. It is not recommended that pregnant women ride horses, scuba dive, downhill ski, play rugby, or engage in other contact sports.
In the later portion of pregnancy, exercise will have to be considered on a case-by-case basis. For those women carrying more than two babies, higher order multiples (HOM), greater restrictions on exercise during pregnancy will exist. However, physical therapy and some forms of stretching may be perfectly acceptable. Again, working with your practitioner is the best option.
Some of these conditions might not make exercise impossible for you, though you may wish to consider modifying your program. It's very important to discuss your current fitness status with your doctor or midwife.
