The Pregnant Woman’s Guide to the Gym

An hour of cardio usually flies by for me at the gym, thanks to my secret motivational strategy: watching “Law & Order” reruns on the club’s TV. I hop on the elliptical machine as the opening credits roll, and before I know it, Sam Waterston is finishing his closing argument to the jury.

At least, that was the case before I got pregnant. In my first trimester, some days, to my amazement, I’d poop out 10 minutes into the show—before the detectives even identified the body.

“Many active women are surprised at how pregnancy affects their workouts,” says Renee M. Jeffreys, M.Sc., a prenatal-fitness consultant in Milford, Conn., and co-author of Fit to Deliver (Hartley & Marks). “But remember that these are normal, short-term changes.”

So should you dial down your cardio? Are certain machines off-limits? Can you still do Pilates? The answers depend largely on what your fitness level is, which trimester you’re in and how you’re feeling, Jeffreys says. But this much is certain: The gym is a great place to be pregnant. If one cardio machine or strength exercise isn’t comfortable, there’s always another one to try.

Getting yourself to the gym may take an extra dose of motivation, but the payoff is huge. Consistent exercise during pregnancy can minimize aches and constipation, help you sleep better, and lower your risk of gestational diabetes and depression. You may even end up having a shorter, less complicated labor. Developing good workout habits during pregnancy will help you get your body back faster after delivery too.

Though my first trimester was rough going, my second was a breeze, and my third wasn’t half bad, either. With my stamina back, I’d usually make it all the way through “Law & Order” at the gym—except, I’d spend the commercial breaks in the bathroom.

Whether you take classes, work out in the cardio room or

lift weights, everything changes when you’re pregnant.

Here’s how to adapt.

Class Action

If you have access to prenatal exercise classes, sign up. Not only are the workouts modified for pregnancy, but you also get to bond with your fellow moms-to-be over charming symptoms such as heartburn, swollen feet and hemorrhoids. You might even get labor tips.

If your favorite classes don’t come in the prenatal variety, it’s fine to keep going, as long as you pay attention to how your body feels, limit your intensity and stay within the normal range of motion. Just make sure the instructor knows you’re pregnant and is knowledgeable about modifications you can make, Jeffreys advises. If your instructor hasn’t worked with pregnant women, find one who has. Keep in mind that highly choreographed classes like Step aren’t the best choices for expectant women since they require quick direction changes and a heightened sense of balance. Hereare the most common classes you’ll find at the gym and what you need to know about benefitting from them whilepregnant.

Pilates Pilates helps maintain your abdominal muscle tone, which will support your growing belly, minimize back pain and give you more oomph for pushing during labor. But mat classes can be problematic after the first trimester because so much work is done lying on your back. Either opt out of these exercises or use an angled foam spine support (found in most Pilates studios but not many gyms); this will keep your head higher than your belly. You can still do the side-lying leg work, upper-body exercises and stretches.

Yoga Yoga not only strengthens your core and improves flexibility, but with its gentle movements and emphasis on breathing and meditation, it also fosters a sense of calm. In the second half of your pregnancy, avoid exaggerated twists and movements that tug on your belly, moves that require you to lie on your back or belly for prolonged periods, and inversions like headstands and shoulder stands.

Water aerobics Ah … relief. You can’t trip and fall; you won’t overheat; and for once you won’t feel like a big clod. No wonder water aerobics is a third-trimester favorite. Your joints will thank you! Wear aqua shoes so you don’t slip on the bottom of the pool.

Safe, Effective Cardio

When it comes to cardio exercise, Fit to Deliver co-authors Karen Nordahl, M.D., an OB-GYN in Vancouver, British Columbia, and Renee Jeffreys have a rule of thumb: “If you were really active before pregnancy, stay really active. If you weren’t, now is a good time to become active.” For beginners, Nordahl recommends 30 minutes of walking three days a week.

During pregnancy you’ll need to scale back on the intensity. Gauge your intensity using the Rate of Perceived Exertion (RPE) scale from 0 to 10: Aim for an intensity between 3 and 5 (you should be able to talk but not belt out show tunes). Ignore heart-rate readouts on the cardio machines; since your blood volume increases during pregnancy, and your resting heart rate is considerably higher than normal, heart rate isn’t an accurate gauge of intensity.

Which cardio machine is best during pregnancy? Try them all. That way, if one becomes uncomfortable, your body will already be accustomed to the alternatives.

Treadmill Walking on the treadmill is ideal since you can control the terrain. Add moderate hills when you’re up to it; go flat when you’re not or if hills trigger calf cramps. If you’re a runner, let your body tell you when it’s time to switch to walking; nearly everyone does.

Elliptical The elliptical trainer places little stress on your joints. However, the motion may feel uncomfortable if you’re experiencing symphysis pubic dysfunction (SPD), apain in the front of your crotch.

Stationary bike The recumbent and upright bikes are both good options. Many women like the back support the recumbent offers, though in the third trimester your belly might get in the way of your knees.

The Right Weight Routine

Strength training is safe and one of the best ways to minimize aches and pains. Weight machines are ideal, especially for gym newbies, because they control your range of motion. “During pregnancy, your joints get looser, and it’s easy to move outside of your normal range,” says Jeffreys. However, if you’re accustomed to doing free-weight exercises, you can continue.

Steer clear of any machine with a pad that presses against your belly, such as the seated row machine or abdominal machines. In addition, forgo any overhead lift, since this kind of motion can increase the curve in your lower spine (aka hyperlordosis).

The strength routine below targets the muscles that are key to reducing discomfort during pregnancy. Do 1 or 2 sets of 8 to 12 reps for each except the Plank. Choose a weight that allows you to perform the repetitions properly and comfortably. And after the first trimester, avoid any exercise done while lying on your back.

Upper/Middle Back
Best Machines: Seated cable row, lat pulldown
Pregnancy Benefit: As your breasts get bigger, your shoulders round forward. Strengthening the muscles between your shoulder blades helps counteract the slump.

Chest
Best Machine: Seated chest-press
Pregnancy Benefit: It’s important to create muscle balance in your upper body by working your pecs.

Arms/Shoulders
Best Machines: Biceps and triceps
Pregnancy Benefit: Strong arms. Soon you’ll be schlepping a baby, a diaper bag—and the groceries.

Lower body
Best Machines: Leg extension and seated leg-curl
Pregnancy Benefit: Your quadriceps and hamstrings bear the weight of your pregnancy as your belly grows.

Core
Best Exercise: Plank
Pregnancy Benefit: Keeping your abs strong will help prevent pregnancy-induced back pain.
How to: Lower onto all fours so your wrists are directly under your shoulders. Lift your knees off the floor (don’t arch your back) so your body forms a straight line. Hold for 1 to 2 breaths, working up to 5 breaths.

Mind and Body Fitness for Lifelong Good Health

Mind and body fitness? Many people who want to get into shape don’t realize there is more to fitness than well-toned muscles. There’s no shortage of exercise regimes that just promote the perfection of the body, or the idea of fitness as a part of a weight loss plan.

Centuries ago, Western culture lost its focus on the interconnectedness between the body and the mind or spirit, and how each has the power to affect the other. Cultivating a love of movement can help you get beyond the concept of physical fitness as separate from mental fitness – and toward a lifelong program of good health through mind and body fitness.

Whether you choose yoga or another form of movement for exercise, remember that our bodies are made to move to feel good. So when you incorporate regular activity in your life, you’re moving closer to overall mind and body fitness. But if you are overweight, this can be more difficult. You can improve your mind-body connection for better mind and body fitness – it’s just important to choose realistic fitness options.

You might consider redefining exercise as any activity that unites your mind and body and reduces your stress level. In fact, high levels of stress have been linked to weight gain, and certainly can lead to emotional eating. Finding activities that are both enjoyable and easy to do is important when developing any type of exercise plan.

It’s important to be realistic about what we expect from ourselves. Consider your goals. Is 30 to 60 minutes on a treadmill a reasonable time frame at this point in your life? Are you setting yourself up for failure or success when you create this expectation for yourself? Would it be more enjoyable to you to do some stretching and a shorter period of time on the treadmill?

Developing an exercise plan that fits your lifestyle and your desires is critical. Surprisingly, long-term weight loss is linked more closely to whether a person sticks to their fitness routine than to what that routine actually consists of. A routine that is gentle and pleasurable is more likely to lead to the long-term gains you are seeking.

All-or-nothing thinking about exercise leads us to first bite off more than we can chew and then give up all together. Just walk into a gym in the month of January and try to get on a Stairmaster. There’s a good chance you’ll have to wait in line. But by March or April, there are usually plenty of free machines.

It is also important to tailor your fitness goals to your preferences. Some people like the idea of getting out of the house in the evening and going to the gym. Others prefer staying home and doing a quieter exercise routine after the demands of a stressful day. Either approach, or a combination of the two, can result in improved mind and body fitness.

What is critical is for you to come to know yourself and to take yourself seriously. If you like to be home in the evenings, find things to do in your home or consider an occasional walk with friends or family. If you crave the company of others, head for the gym. Think about what would please you most, and follow your inner voice.

Many people who are preoccupied with food and body issues tend to pay too much attention to the needs of others, while paying too little attention to their own needs. While you may intend to benefit your children with their countless activities, the added stress can cause an imbalance within your family. Can you take a look at your schedule (or your family’s) and reschedule some time for yourself? What would it be like to say no?

Long-term weight loss can take time. And we can get demoralized when we don’t see immediate results. But remember that maintaining an exercise routine is associated with physical as well as mental well-being. Where has our focus on the numbers on our scale gotten us? Some would say it has taken us to more harsh thoughts, more bingeing and grazing on food, and, ironically, less fitness rather than more.

It may be that the best exercise you can do right now is to throw your scale into the garbage. Focus on how you’re feeling with your exercise routine. Is it something you enjoy and can maintain? Is it reducing your stress level and allowing a connection between your mind and body? If so, you’ll probably keep it up, and fitness of mind and body and spirit will be yours.

Don’t forget how important it is to see your physician before starting any type of exercise routine, and to following his or her recommendations. So try to be gentle with yourself and realistic about how to proceed.

There is tremendous confusion in our society about how to approach health and fitness. You may have tried losing weight before and failed. But consider the possibility that we as a society have not failed at dieting and weight loss. Rather, dieting has failed us as an effective tool for fitness.

Remember that fitness of mind and body belong together, and that exercise is very narrowly defined in our society. So redefine exercise as any activity that reduces stress and connects your mind and body. You’ll be more likely to continue your exercise plan and achieve the outcome you’re looking for.

Guide to Physical Activity

An increase in physical activity is an important part of your weight management program. Most weight loss occurs because of decreased caloric intake. Sustained physical activity is most helpful in the prevention of weight regain. In addition, exercise has a benefit of reducing risks of cardiovascular disease and diabetes, beyond that produced by weight reduction alone. Start exercising slowly, and gradually increase the intensity. Trying too hard at first can lead to injury.

Examples of moderate amounts of physical activity
Common Chores	Sporting Activities
Washing and waxing a car for 45-60 minutes	Playing volleyball for 45-60 minutes
Washing windows or floors for 45-60 minutes	Playing touch football for 45 minutes
Gardening for 30-45 minutes	Walking 1.75 miles in 35 minute (20min/mile)
Wheeling self in wheelchair 30-40 minutes	Basketball (shooting baskets) 30 minutes
Pushing a stroller 1.5 miles in 30 minutes	Bicycling 5 miles in 30 minutes
Raking leaves for 30 minutes	Dancing fast (social) for 30 minutes
Walking 2 miles in 30 minutes (15 min/mile)	Water aerobics for 30 minutes
Shoveling snow for 15 minutes	Swimming Laps for 20 minutes
Stairwalking for 15 minutes	Basketball (playing game) for 15-20 minutes
	Bicycling 4 miles in 15 minutes
	Jumping rope for 15 minutes
	Running 1.5 miles in 15 min. (10min/mile)

Your exercise can be done all at one time, or intermittently over the day. Initial activities may be walking or swimming at a slow pace. You can start out by walking 30 minutes for three days a week and can build to 45 minutes of more intense walking, at least five days a week. With this regimen, you can burn 100 to 200 calories more per day. All adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. This regimen can be adapted to other forms of physical activity, but walking is particularly attractive because of its safety and accessibility. Also, try to increase “every day” activity such as taking the stairs instead of the elevator. Reducing sedentary time is a good strategy to increase activity by undertaking frequent, less strenuous activities. With time, you may be able to engage in more strenuous activities. Competitive sports, such as tennis and volleyball, can provide an enjoyable form of exercise for many, but care must be taken to avoid injury.

Activity Progression

For the beginner, activity level can begin at very light and would include an increase in standing activities, special chores like room painting, pushing a wheelchair, yard work, ironing, cooking, and playing a musical instrument.

The next level would be light activity such as slow walking of 24 min/mile, garage work, carpentry, house cleaning, child care, golf, sailing, and recreational table tennis.

The next level would be moderate activity such as walking 15 minute/mile, weeding and hoeing a garden, carrying a load, cycling, skiing, tennis, and dancing.

High activity would include walking 10 minute/mile or walking with load uphill, tree felling, heavy manual digging, basketball, climbing, or soccer/kick ball.

You may also want to try:

• flexibility exercise to attain full range of joint motion
• strength or resistance exercise
• aerobic conditioning

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Kick It Up With Cardio Exercise

Before you jump on that Stairmaster or start pounding the pavement, make sure you have a cardio exercise plan that will give you the most bang for your muscle burn.

Whether it’s pounding the pavement, logging miles on the bike, or climbing those stairs that seem to go nowhere, it’s all about cardio exercise. But other than a sweaty t-shirt, what do you have to show for your workout? A slimmer stomach? Killer quads? Are you exercising for the right amount of time to reap the full health benefits of cardiovascular fitness, or often enough?

Exercise experts, including fitness maven Denise Austin, answer cardio questions for WebMD, so you can make the most of your muscle burn.

Cardio Exercise: The Heart of the Matter

“Cardiovascular exercise is any type of exercise that increases the work of the heart and lungs,” says Tommy Boone, PhD, a founding member of the American Society of Exercise Physiologists. “Walking, jogging, and running are common forms of cardiovascular, or aerobic, exercise.”

From running and walking, to swimming, elliptical cross-training, biking, Stairmaster, and rowing — to name a few — the physical benefits of cardio exercise abound, explains says Len Kravitz, PhD, senior exercise physiologist for IDEA Health and Fitness Association. They include:

Reduced risk of heart disease

• Improved blood cholesterol and triglyceride levels
• Improved heart function
• Reduced risk of osteoporosis
• Improved muscle mass

“The American College of Sports Medicine and the CDC recommend, for health, that adults should accumulate 30 minutes of moderate-intensity physical activity on most days of the week,” says Kravitz, who is also a coordinator of exercise science at the University of New Mexico. “And to improve cardiovascular endurance, they recommend 20 to 60 minutes on three to five days per week.”

Now that you know the benefits of cardio exercise, where should your heart-pumping fitness plan begin?

Getting Into the Zone

To help you make the most of your cardio exercise workout — help your heart, increase muscle, and lose fat — Denise Austin, fitness expert, author of seven books, including Shrink Your Female Fat Zones, and star of 50 fitness videos, gives WebMD some tips.

“To reap all the benefits of a cardio workout, you should sustain your workout for 20 minutes or more — I do 30 minutes myself — on a schedule of about three to four times per week,” says Austin.

Not only that, but you need to get in the zone, which calculates into burning calories and fat.

“The best way to find out if you are burning fat is to take your pulse halfway into your cardio workout for six seconds, then add a zero to that number,” Austin tells WebMD.

This number is your heart rate per minute.

Next, calculate your zone.

“Take the number 220, then minus your age, then calculate 70% of that number for your target beats per minute,” says Austin, and that’s your zone. “If your heart rate halfway through your workout is over that 70% mark take it down a level, and if under, pick up the pace.”

Not a math wiz? There are easier ways to figure it out.

“Another great way to find out your zone is to get a pulse monitor, which takes the math out of it,” says Austin. “Or very simply, take the talk test: while you are doing aerobics, talk a sentence. If you are too winded to finish the sentence, you are overdoing it, or if it’s too easy to say, kick it up a notch!”

Getting Cut With Cardio

If you’re looking for ripped abs and toned arms, interval training will help get you there — especially if you throw in some weights.

“I love interval training because it consistently jump-starts your metabolism,” says Austin. “Let’s say you are walking — you could power-walk really fast for three minutes to get the burst of calorie burn, and then walk calmly and slowly for one minute, which offers recovery. By switching back and forth, you push the muscle and let it relax over and over and this gives you maximum results.” You can do interval training on any type of cardio exercise machine — alternating a high intensity with a more moderate level.

Austin suggests doing weights during your recovery time, such as bicep curls or tricep toners, to reap the benefits of both cardio exercise and weight training, and along with interval training, add dedicated weight sessions to your regimen to burn fat and sculpt muscle at the same time.

“Do cardio four days a week for 30 minutes, and add a weight-training workout at least two times a week at 20-minute sessions,” says Austin. “Cardio will burn the fat, and it’s the weight training that gives you the toned sculpted look that will have you bikini ready.”

Cardio’s Best Fat Burner

So you want the bottom line: Which cardio exercise will fat-bust the best?

“Running is the best option for calorie burning, in my opinion,” says Niki Kimbrough, personal fitness expert with Bally Total Fitness. “Whether it’s outside or on a treadmill, it’s the best exercise because you’re burning calories and you’re strengthening your legs and heart — it’ll get you nice and lean.”

Beginners should start with 20 minutes, explains Kimbrough, and work their way up.

“It takes about 20 minutes for your body to get going, and then your body starts to kick it to another level,” says Kimbrough. “Ideally, you want to run for about 30 or 45 minutes.”

For those with bad knees, Kimbrough recommends the elliptical machine as a good second choice.

In case running isn’t your game, Kravitz takes another track.

“I really feel the most important message is to chose a cardio modality or modalities that you like,” says Kravitz. “Because in the final outcome, if a person enjoys a mode of exercise, that is what all research shows they will choose.”

Splitting It Up

While it may not be the fastest way to a body built for the beach, splitting up your cardio exercise still has its benefits.

“In order to achieve the best results, and also in order to maintain a healthy heart, it is best to not split up your cardio workouts,” says Austin. “You need the consistency of 20 minutes or more of an elevated pulse to ensure great results. However, something is better than nothing.  If all the time you have is 10 minutes or even five minutes, it is better than sitting still; you will still be garnished benefits and lose weight.”

Kick Up Your Cardio

Let’s be honest — cardio exercise can get boring after awhile. How can you jazz it up and make it interesting again? The experts recommend never letting it get stale in the first place.

“I believe you should do different types of cardio exercises during the course of a week, if possible,” says Austin. “The thing to remember is that too much repetition will fatiguemuscles and you will plateau, which will slow your results down.  By adding variety to your workouts you give muscle groups a chance to recover on their days off and you can maintain a steady progress.”

Kravitz agrees with adding options to cardio exercise.

“Vary the mode, vary the place you train, vary the workout, vary the time of day, vary the intensity of the workout, vary the duration — vary, vary, vary,” says Kravitz. “That is what I have found to work the best for exercise compliance.”

Before starting a new exercise program, it is important to have a discussion with your doctor about types and levels of activity. Your doctor can advise on any limitations or restrictions you may have.