Exercise Guidelines

Essential exercise information and weight-gain guidance for pregnant women.

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The following is a summary of the American College of Obstetricians and Gynecologists' guidelines for exercising while pregnant:

1. In the absence of contraindications (see below), pregnant women are encouraged to engage in 30 minutes or more of moderate exercise a day on most, if not all, days of the week. (See "Don't Exercise If ..." below.) As always, check with your doctor before beginning an exercise program.

2. During the second and third trimesters, pregnant women should avoid standing motionless for too long and exercising while lying on their backs.

3. A wide range of recreational activities appears to be safe. However, activities with a high risk of falling or abdominal trauma should be avoided; these include basketball, soccer, in-line skating, downhill skiing, horseback riding, ice hockey, gymnastics and vigorous racquet sports.

4. Scuba diving is not safe at any time during pregnancy.

5. Exertion at altitudes of up to 6,000 feet appears safe. However, engaging in physical activities at higher altitudes carries various risks and should be avoided.

Don't exercise if...

Aerobic exercise during pregnancy is not safe if you have any of these medical conditions:

■ Significant heart or lung disease

■ An incompetent cervix or cerclage

■ You are carrying more than one baby and are at risk for premature labor

■ Persistent second- or third- trimester bleeding

Placenta previa past 26 weeks of pregnancy

■ Premature labor during your current pregnancy

■ Ruptured membranes

Preeclampsia (pregnancy-induced hypertension)

Warning Signs to Stop Exercising and Call Your Doctor

■ Vaginal bleeding

■ Dyspnea (difficult or labored breathing) prior to exertion

■ Dizziness

■ Headache

■ Chest pain

■ Muscle weakness

■ Calf pain or swelling

■ Preterm labor

■ Decreased fetal movement

■ Amniotic fluid leakage

How much weight should you gain?

The Institute of Medicine recommends that women who start out at a healthy weight gain 25 to 35 pounds during pregnancy; underweight women, 28 to 40 pounds; overweight women, 15 to 25 pounds; and obese women, 11 to 20 pounds. (Some experts disagree with the recommendation for obese women.)

Try out our online tool to calculate your pre-pregnancy BMI. This will give you a starting point for recommended weight gain.

If possible, also pay attention to your weight before becoming pregnant. Women who are very overweight when they conceive have an increased risk of delivering babies with birth defects, including spina bifida, according to the Centers for Disease Control and Prevention.

Top 5 Nutrients

Include these in your daily diet:

■ CALCIUM>1,000 mg

Where to get it: Dairy foods, dark leafy greens, calcium-fortified foods.

■ FOLATE>600 mcg

Where to get it: Legumes, broccoli, asparagus, oranges. (Folic acid is the synthetic form, available in supplements.)

■ IRON>27 mg

Where to get it: Dry beans, liver, meat, oatmeal, tofu.

■ PROTEIN>70 g

Where to get it: Meat, poultry, seafood, milk and other dairy foods, beans.

■ VITAMIN C>85 mg

Where to get it: Citrus fruits and juices, strawberries, dark leafy greens.

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