Pregnancy
• Healthy, pregnant women without exercise contraindications are encouraged to exercise throughout pregnancy.
• Regular exercise during pregnancy provides health benefits and reduces the risks associates with
sedentary behavior.
Pregnancy - Exercise Testing
• Maximal exercise testing should not be performed on women who are pregnant unless medically
necessary.
Pregnancy - Exercise Testing (cont.)
• The acute physiologic responses to exercise are generally increased during pregnancy compared with nonpregnancy.
• Because of the physiological changes that accompany pregnancy,
assumptions of submaximal protocols in predicting maximal aerobic capacity may be compromised and are therefore most appropriately used in determining the effectiveness of training rather than
Pregnancy - Exercise Prescription
• In the absence of obstetric or medical complications, the
exercise recommendations during pregnancy are consistent with recommendations for healthy adults
• The recommended Ex Rx for women who are pregnant should be modified according to the woman’s symptoms, discomforts, and abilities during pregnancy.
• The Physical Activity Readiness Medical Examination for Pregnancy (PARmed-X for Pregnancy) or the electronic
Physical Activity Readiness Medical Examination
(ePARmed-X+) should be used for the health screening of pregnant
Pregnancy - Exercise Prescription
• Research on the effects of resistance exercise during pregnancy is limited, but show that compared to sedentary controls, resistance training either:
• has no effect (e.g., no difference in gestational age, preterm labor, or caesarian delivery; delivery of normal birth weight infants at term)
Pregnancy - Exercise Training
Considerations
• While there is no ideal number of days, exercise frequency during pregnancy should be regular, occurring throughout the week, and adjusted based on total exercise.
• Heart rate ranges corresponding to moderate intensity exercise have been developed, however due to heart rate variability,
RPE may also be used to monitor exercise intensity during pregnancy.
• Exercise may be accumulated in shorter bouts (e.g., 15
minutes) or performed continuously. A 10–15 min warm-up and a 10–15 min cool-down of light-intensity PA are suggested
Pregnancy - Exercise Training
Considerations
• Previously inactive women should progress from 15 min∙d−1 (~3
d∙wk−1) at the appropriate RPE or target HR to approximately 30
min∙d−1 on most days of the week
• Women who habitually participate in resistance training should continue during pregnancy and should discuss how to adjust their routine with their health care provider.
Pregnancy - Special Considerations
• PA in the supine position should be avoided or modified after 16 wk of pregnancy.
• Women who are pregnant should avoid exercising in a hot humid environment, be well hydrated, and dressed
appropriately to avoid heat stress.
• During pregnancy, the metabolic demand increases by ~300 kcal∙d−1. Women should increase caloric intake to meet the
caloric costs of pregnancy and exercise.
Pregnancy - Special Considerations
• Women who are pregnant and severely obese and/or have gestational diabetes mellitus or hypertension
should consult their physician before beginning an
exercise program and have their Ex Rx adjusted to their
medical condition, symptoms, and physical fitness level. • Women who are pregnant should avoid contact sports
and sports/activities that may cause loss of balance or trauma to the mother or fetus.
Pregnancy - Special Considerations
• PA can be resumed after pregnancy, but should bedone so gradually because of normal deconditioning in the initial postpartum period.
• Generally, gradual exercise may begin ~4–6 wk after a normal vaginal delivery or about 8–10 wk (with medical clearance)
after a cesarean section delivery
• Women with higher CRF levels and more rigorous exercise routines prior to and during pregnancy may be able to resume exercise sooner.
