Despite competent national and international associations and specialist physicians in the field of Women's Health, Pregnancy and Birth stating and even especially recommending that it is safe, it is known that women reduce even their normal daily activities during pregnancy, avoid sports and physical activity due to the concern that it may cause miscarriage, and even rest much more than their usual routine.
However, the potential benefits of moderate exercise and adequate physical activity during pregnancy are significant;
- Prevention of excessive weight gain during pregnancy
- Prevention of gestational diabetes or easier and smoother management if it has already developed
- Prevention or reduction of high blood pressure and related problems during pregnancy
- Reduction in the birth of overweight babies (4500 grams) and ensuring birth weight appropriate for gestational age
- Reduction of lower back, back, groin, and other joint pains, especially in the last 3 months of pregnancy
- Preparation of the pelvic floor, especially for pushing strength during labor
- Balancing weight after delivery and facilitating return to ideal pre-pregnancy weight
- Prevention of pelvic floor dysfunctions such as urinary incontinence that may develop due to the load and changes caused by pregnancy
Although movement, exercise, and sports are recommended for all pregnant women, this need is much more important in women with a high body mass index. In pregnant women with a body mass index of 25 and above, the need for and benefits of exercise become even more significant.
The three most important risks to consider during exercise in pregnancy are;
- Trauma to the mother (falls, impacts, and joint injuries) and the possible effects on the baby
- Fever, meaning a significant increase in body temperature
During exercise in pregnancy, body temperature should not be allowed to rise to 39 degrees or above. This can easily be prevented by wearing comfortable clothing appropriate for the season and weather, avoiding fleece or synthetic sportswear that prevents sweating, ensuring adequate fluid intake to prevent dehydration, and limiting exercise duration to no more than 30 minutes.
Although caution is required, knowing that risky body temperatures cannot be reached during normal exercise helps reduce concerns. For example, even 60 minutes of moderate cycling effort increases body temperature by only about 1 degree.
- Exercise and sports are not recommended in pregnancies where there is restricted growth and development of the baby. Because physical activity may redirect blood flow to muscles and other organ systems, uterine blood flow may decrease to critical levels. Since every pregnancy is different, it is essential to consult your obstetrician for advice on exercising.
I have had a miscarriage before, is exercise prohibited in this pregnancy?
Should I spend this pregnancy resting?
It is known that light and moderate sports, movement, and exercise do not increase the risk of miscarriage. Unless your doctor explicitly advises otherwise, there is no need for continuous bed rest. You can continue your normal daily activities and moderate exercises.
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Type of exercise | Duration | How will it be monitored? | What should be avoided? |
Low-intensity aerobic exercise
Walking Pedaling on a stationary bicycle Swimming | 3 or 5 days a week 20-30 minutes per day | Can be monitored with devices that measure heart rate and pulse (*should not reach 80% of the maximum allowed heart rate) or Can be controlled by stopping before feeling fatigue | *Exceeding 80% of the maximum allowed heart rate Long-distance running Exercises with risk of falling or impact Running or walking uphill or against resistance Jumping movements All diving activities
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Pelvic floor muscle exercises
Kegel exercises | 3 or 5 days a week 10-15 minutes per day | Should not exceed 100 repetitions |
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*The upper limit of heart rate varies by age (220-Age = safe maximum heart rate) For example, in a 20-year-old pregnant woman, 220-20=200. 80% of this should not be exceeded. That means 80% of 200 is 160 beats/minute. Therefore, during exercise, the pulse (heart rate) of a 20-year-old pregnant woman should not exceed 160 beats per minute. For a 30-year-old pregnant woman, this number is lower. 220-30=190 and 80% of 190 is 152. Therefore, during exercise, the pulse should not exceed 150.
It is even safer to be more cautious and keep the heart rate below 120 beats/minute, which corresponds to the level where palpitations are felt.
Pregnant women who experience severe fatigue or palpitations even with simple movements or climbing 1-2 flights of stairs should definitely consult a cardiologist. | |||
Which exercises should I avoid? Which types of exercise are not recommended for pregnant women?
- Activities with risk of falling, impact, or sprain
- Jumping movements
- Sudden changes in direction
- Heavy weights (1-2 kg may be acceptable depending on muscle strength, but 5-10 kg and above are risky)
- Hot yoga and excessive stretching without supervision
- Exercises requiring lying on the back for long periods (may reduce blood return to the heart by compressing major vessels, causing dizziness, low blood pressure, or fainting)
- All diving activities are prohibited during pregnancy
- Prolonged exercise (over 30-45 minutes) and exercises that cause excessive sweating
Which pregnant women should not exercise and should postpone it until consulting a physician?
- Any type of bleeding (including spotting and brown discharge)
- Abdominal pain with or without nausea
- Regular uterine contractions
- Amniotic fluid leakage or suspicion of it
- Fatigue and drowsiness
- Headache
- Inner ear problems affecting balance or muscle weakness
- Calf pain and recurrent cramps
When can I return to recreational or professional sports after delivery?
Normal and cesarean deliveries require different recovery periods.
It takes approximately 6 to 8 weeks for the cardiovascular, circulatory, respiratory, and musculoskeletal systems to return to their pre-pregnancy state.
After cesarean delivery, abdominal exercises such as sit-ups should be postponed for up to 90 days. Because full healing of the fascia layer over the muscle tissue may take up to 3 months. Strong contractions of the abdominal muscles before this period may lead to hernias.
I do not have a habit of exercising. I am not overweight either. What is the minimum level of activity I should do?
Walking at least 2-3 rounds per day in sessions of at least 10 minutes is necessary for blood circulation, metabolism, and blood sugar control. Being unable to perform even this level of activity is defined as a sedentary lifestyle.
At least 150 minutes of exercise per week is recommended by many national and international authoritative organizations.
Climbing 1 or 2 flights of stairs in apartment buildings is considered normal. There is no need to use an elevator.
Kegel exercises (contraction of the muscle used to hold urine) are recommended to be performed daily after using the toilet for a total of 5-10 minutes. Video training materials can be accessed online to learn Kegel exercises.
Assoc. Prof. Dr. Semir Köse
Obstetrics, Gynecology and Perinatology Specialist