 
Physician Offers Advice for Pregnant Women Who Exercise
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Pregnant women who exercise have better pregnancies and outcomes than their sedentary counterparts, according to a recent study conducted by Raul Artal, M.D., professor and chairman of the department of obstetrics and gynecology. Fit women appear to cope better with labor, too.
"The ideal exercise program for pregnant women should offer a variety of options such as walking, swimming, stationary cycling, strength training or calisthenics," Artal said. "But all should be individually tailored by a certified exercise trainer and approved by the woman's physician to ensure the program maximizes safety."
Artal offers his advice on which types of exercise are best for pregnant women and which should be avoided.
Jogging. Artal said if a woman didn't jog before she was pregnant, she shouldn't start now. The risk of injury increases. If a pregnant woman is a jogger, she shouldn't run more than two miles a day. Pay special attention to terrain and running surfaces because of connective tissue changes associated with pregnancy. And be sure to wear running shoes with proper support.
Walking. Should a pregnant woman be unable to jog, she could engage in a brisk walking program. This could include a four-to-six-mile walk, depending on terrain and climactic conditions. Avoid exercise during times of high temperatures and humidity. These adverse conditions may cause fetal loss.
Aerobics. There has been a sharp increase in the number of aerobics classes specifically for pregnant women. When selecting one, make sure the class is led by a qualified exercise leader who is aware of the basic physiology of pregnancy and has formal training in physical education. And because aerobics is a weight-bearing exercise, the risk increases for potential joint and ligament injuries and unrecognized fetal distress. Avoid exercises that involve overextension or anything performed while lying on your back.
Bicycling. In a nutshell, stationary bikes are the way to go. Exercising on a stationary bike (with a fan) is non-weight-bearing and can be started during pregnancy. It is preferred to standard bicycling because of weight and balance changes. Bicycling should be avoided outdoors during high temperatures and high pollution levels.
Swimming. Artal said swimming might be the most adequate aerobic exercise for pregnant women. Lap swimming, water calisthenics and wading programs are all non-weight-bearing. Women should avoid water that is too cold or too hot and should stay away from a Jacuzzi if the temperature exceeds 38.5 degrees Celsius. Respiratory changes also may make swimming difficult in late pregnancy.
Scuba Diving. The Undersea Medical Society said there could be grave risks to the fetus when a pregnant woman scuba dives. For example, the oxygen tension of inspired gas could increase, which might asphyxiate the fetus. Artal said women who are or may become pregnant should not dive.
Strength Training (Weight Lifting). Training with light weights can be cautiously continued through pregnancy. Heavy resistance on weight machines should be avoided, as should the use of free weights. Artal also said proper breathing techniques are important. Remember to exhale while lifting and inhale when returning the weight load to its original position.
"No single exercise or exercise program will be able to meet the needs of all women," Artal said. "Just make it safe and fun to do." The information provided also will be included in an upcoming book co-authored by Artal.
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