Basics of Training

Your most common exercise questions answered, plus a great prenatal workout.

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You probably already know that it's better to stay active during pregnancy than to sit on the sidelines.

Studies show that women who exercise while pregnant not only have smoother pregnancies than their sedentary counterparts, but they may also have easier labors and feel better about themselves after delivery.

But if you're like most expectant moms, you have specific questions about how much exercise is safe, how you should do it and at what intensities. Here is the nitty-gritty on the most common concerns about exercise during pregnancy. Now that I'm pregnant, I want to start exercising. Do I need my doctor's approval before I begin? You'll be seeing your doctor for prenatal visits anyway, so why not mention that you hope to begin an exercise regimen? Chances are you'll get a green light and lots of encouragement.

Walking and low-impact prenatal aerobics are excellent choices for beginners. Just make sure that you start out at a low or moderate level; aim to work up to 20- to 30-minute sessions, three times a week.

Can pregnant women lift weights? Absolutely — and pay special attention to your upper-body work, since you're going to need extra strength to carry your baby once she is born. If you're new to strength training, start slowly. "For women who have never weight-trained, I recommend beginning with light free weights," advises James F. Clapp III, M.D., in Exercising Through Your Pregnancy (Human Kinetics, 1998). If you already strength-train, don't increase weight loads, repetitions or sets until after 10 or 12 weeks. The main caveats: Avoid holding your breath while lifting, since that can impede blood flow to the fetus; and don't lift weights while lying on your back.

I'm worried that my workouts might trigger a miscarriage. Is there any risk? As long as you don't overdo it, no. In fact, a recent study of more than 300 women by the Columbia University School of Public Health in New York found that women who engaged in aerobic exercise during their pregnancies were less likely to experience miscarriages early in pregnancy. "We don't understand why or how exercise may be protective, but one theory is that it blunts [or lessens] hormonal changes that can trigger uterine contractions and miscarriage," says Maureen Hatch, Ph.D., associate professor at the Mount Sinai School of Medicine in New York City.

I have to interrupt my exercising all the time to urinate. I sometimes leak a little, too. Should I reduce my water intake?

Don't cut back on fluids. The urge to urinate more often is one of those facts of pregnancy you can't do much about; it's caused by your expanding uterus putting pressure on your bladder.

Still, you need a minimum of six to eight glasses of water a day because of your increased blood volume in the early months of pregnancy; in the later months, dehydration could trigger premature labor.

But you can do something about pesky urine leakage: Tone your pelvic-floor muscles, which control the flow of urine. In a University of Michigan, Ann Arbor, study of more than 83 women with pregnancy-related urinary incontinence, the group who learned how to do Kegel exercises reported significantly diminished symptoms, both during late pregnancy and postpartum.

Here's how to do a Kegel: Contract your pelvic-floor muscles (the ones you use to stop the flow of urine) for a count of three; then release for a count of three. Repeat twice a day for a total of five minutes. Build up to 10 reps of 10-second holds.

How intense can my cardio workout be and still be safe? Sorry — there's no easy answer to this. Although no adverse effects of heavy workouts have been documented, many doctors contend that not enough is known about the effects of severe-intensity exercise to say it's safe. Other experts are more liberal in their prescriptions.

So what to do? If you want to be squarely in the safe zone, monitor your efforts by using the "talk test": If you can easily carry on a conversation while exercising, you're working out at a level that all experts consider safe.

If you want to maintain a rigorous training regimen, follow these three rules: 1) find a care provider with whom you can work closely to ensure that your intense training isn't harming the pregnancy; 2) be extremely attentive to eating, staying hydrated and resting properly; and 3) be ready to quickly lower your goals if training leads to excessive fatigue or other problems.

Also make sure to take some safety precautions: See guidelines from the American College of Obstetricians and Gynecologists on page 128; don't exercise flat on your back, especially after the first trimester; don't exercise to exhaustion; make sure to drink water before, during and after exercise; and stop exercising immediately if you feel dizzy or experience pain or bleeding.

Will chlorine in the pool harm my unborn baby? To the contrary — chlorine helps protect you and your baby-to-be from disease-causing bacteria and other harmful organisms. Another plus for the pool: Swimming is an ideal form of exercise during pregnancy. Many women find that working out in the water, which helps support their added weight and takes the stress off swollen legs and stressed backs, is far more comfortable than exercising on land. In fact, in a study of pregnant recreational athletes conducted by researchers from the Kaiser Permanente Medical Care Program of Northern California, the percentages of women participating in swimming increased from 9.8 percent prepregnancy to 16 percent, 19.6 percent and 25 percent, respectively, in the first, second and third trimesters.

What's more, there are a minimum of precautions when it comes to water exercise, according to aquatics expert Jane Katz, Ed.D., who gives this advice in Water Fitness During Your Pregnancy (Human Kinetics, 1995): Don't jump, dive or do strenuous wall push-offs, because the impact could cause uterine trauma; make sure the body of water you're swimming in is clean; and don't swim in overly warm or cold waters.

Can I play tennis throughout my pregnancy? "There is no official recommendation that specifically addresses racket sports, partly because there have been no good studies," notes Thomas W. Wang, M.D., director of Primary Care Sports Medicine at MacNeal Hospital in Berwyn, Ill. "Besides the risk of abdominal trauma — if you charge the net and fall, for example — the main problem might be that it becomes difficult to twist at your hips and waist as you enter your third trimester." To keep your game safe, consider playing less aggressively and playing half-court or doubles.

My biggest fear is that my baby will be born prematurely. Won't exercising in the last trimester increase the risk? "Vigorous exercise has not been shown to be a risk factor for preterm delivery," says Hatch. In fact, there's some evidence that it reduces, rather than raises, the risk of preterm birth: In a study of 557 women conducted by Hatch, the women who exercised for three to five hours weekly had almost half the risk of preterm delivery as non-exercisers and a significantly lower risk of delivery after their due dates. And in a University of Northern Colorado study of 2,314 women, the group who exercised moderately (up to three times a week for 43 minutes per session at a heart rate of 144 beats per minute) was found to be at no greater risk for preterm labor than the group who was sedentary.

The Workout

Lisa Simonsen, a personal trainer and owner of Simonsen Says Inc. in New York City, has trained women before and after their pregnancies. She designed the following workout, which emphasizes the butt, arms and legs to keep them fit and shapely for your pregnancy and beyond.

Weights & reps Upper body. Weights: Use 2- to 6-pound dumbbells. Sets: Do 2–3 sets of 12–15 reps for each exercise listed, resting 30–60 seconds between sets. (Kegels: During your upper-body rest periods, do 10 sets of Kegels, holding each one for 10 seconds.) Lower body. Weights: Use 1- to 3-pound ankle weights for Exercises #4 and #5 and 5- to 8-pound dumbbells in each hand for Exercise #6. Sets: Do 2–3 sets of 20–25 reps for each exercise listed. Alternate legs for each set, resting in between to switch legs and weight.

1. SHOULDER STRENGTHENER Stand with your feet hip-width apart, legs straight but not locked. Hold a dumbbell in each hand with arms hanging by your sides, palms facing in, tailbone pointing down so your spine is in a neutral position. Squeeze shoulder blades down and together, then lift arms up and forward to chest height [A]. Open arms wide, using upper-back muscles to open arms out to the sides [B]. Turn palms down, lift slightly upward [C]; then lower arms to your sides. Continue to alternate these movements (1 rep equals the full movement). Note: As pregnancy progresses, sit on the edge of a chair, then all the way back if necessary. Strengthens shoulders, rotator-cuff muscles and upper-back muscles.

2. TRICEPS OVERHEAD EXTENSION Lie face-up on the floor with head propped higher than your belly, knees bent and feet on the floor. Hold a dumbbell in each hand, palms facing in with arms straight and in line with your shoulders [A]. Keeping back against support, bend both elbows, lowering dumbbells on both sides of your head [B]. Slowly straighten arms to starting position and repeat. Strengthens triceps.

3. BICEPS CURLS Stand with feet hip-width apart, legs straight but not locked. Hold a dumbbell in each hand, arms hanging at your sides, palms facing forward. Bend both elbows, keeping them in line with your shoulders, bringing dumbbells up to shoulders [A]. Lower dumbbells until elbows are bent to a 90-degree angle [B]. Complete reps without stopping. Note: As pregnancy progresses, sit on the edge of a chair. Strengthens biceps.

4. LEG-LIFT COMBO Attach an ankle weight to your right ankle; then stand with your left side to the back of a chair, holding the top for support. Place right hand on right hip and slightly bend left knee. Contract your abs to drop your tailbone down; then lift your right leg up and out as high as you can, keeping your balance and hips square [A]. Lower right leg; then lift it up and behind you, pointing your toes, hips square [B]. Lower leg and repeat. Switch legs and ankle weights; repeat. Strengthens upper hip, buttocks and hamstrings.

5. PRESSBACKS Standing in the same position as in Exercise #4, bend your right knee to a 90-degree angle so your knee and tailbone point down toward the floor [A]. Maintain this position without arching your back and press your right foot straight backward, contracting your buttocks [B]. Return to starting position and repeat. Then switch legs and ankle weights and do the same exercise with your left leg. Strengthens buttocks and hamstrings.

6. SPLIT LUNGE Stand with your right foot in front of your left in a lunge position, left heel lifted. Hold a dumbbell in each hand, arms hanging straight by your sides. Keep your torso straight and balanced between both legs, chest lifted and shoulders relaxed [A]. (If you have trouble balancing, hold onto a chair for support and place your other hand on your hip.) Bend both knees, keeping your right knee aligned with your right ankle as your back knee approaches the floor [B]. Straighten both legs to starting position, repeat for reps; then switch legs. Strengthens buttocks, quadriceps, hamstrings and calves.

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