Guide 7: Working Out While Pregnant

By Catherine CHUA Bee Hong Senior Principal Physiotherapist, Elizabeth CHAN Jiahui Principal Physiotherapist, KK Women’s and Children’s Hospital

While exercise and working out is beneficial throughout pregnancy, there are certain exercises you should avoid, particularly in the first and third trimesters. Here’s a guide to keeping in tip-top shape at every stage.

Related: Pregnancy Exercises

Trimester 1

Benefits of Exercising

Besides better weight control, staying active reduces the risk of developing pregnancy-induced diabetes and hypertension. Studies have also shown that staying fit helps mums-to-be regulate their mental and physical stress. This may help to reduce the likelihood of their babies developing colic. Exercise does not increase your risk of miscarriage or induce preterm labour. However, please seek medical advice before starting any exercise programme.

Recommended Exercises

If you were generally inactive or sedentary before your pregnancy, it’s best to start with 15 minutes of exercise and gradually increase that to 30 minutes a day, five to seven days a week. If you’ve always been active, go ahead and continue with your current exercise programme. Don’t take part in contact sports, competitive sports, and activities that involve jumping, jarring motions or rapid changes of direction like tennis or squash. You should also stay away from high-impact exercises that might cause joint pain, such as Zumba and running. Also, avoid standing for long periods of time.

How to Prepare Yourself for Exercise

You should drink plenty of water before, during and after exercise to prevent dehydration and overheating. Avoid exercising in the sun, and remember to warm up and cool down to prepare the muscles and joints. Do also maintain good posture during exercising to avoid straining the joints. On top of all that, make sure you’re eating enough and getting adequate calories to support your baby’s growth and development.

Stop all exercises immediately and seek medical help if you experience symptoms like vaginal bleeding, nausea, vomiting, feeling light-headed, strong pain (especially in the back or pelvis), reduced baby movement, chest pain or amniotic fluid leakage.

These are some of the exercises that are ideal for Trimester 1:

• Walking on the spot
• Ankle pumps
• Wrist extension stretch
• Pelvic tilt — standing
• Half squat

Walking on the Spot

Lift one knee up until your calf and thigh forms a right angle. Lower that leg and repeat with the other leg. Do 10 repetitions of the above steps. If you’re unable to raise your leg as high, just raise it to a level you’re comfortable with.

Ankle Pumps

Begin with elevating your legs — a good way is to lie on the sofa with your legs on the armrests.

In a long sitting position (to sit straight with your legs stretched out in front of you), bend an ankle upwards, as if you’re pulling your toes towards you. Relax that foot and repeat with the other foot. Repeat this exercise 10 times on each foot.

Wrist Extension Stretch

Extend your elbow to hold your arm straight in front of you. Stretch your wrist backwards and press the fingers and palm towards you with your other hand. Hold the stretch for 20 seconds and change to the other arm. Do 10 repetitions of this exercise on both arms.

Pelvic Tilt — Standing

Stand upright with your feet shoulder-width apart, ensuring not to lock your knees in extension. Tilt your pelvis backwards to flatten your back, you should feel your abdominal and buttock muscles tighten when you do so. Hold this position for 5 seconds and revert to standing normally.

Do not hold your breath when doing this exercise, and repeat steps 10 times.

Half Squat

Stand upright with feet shoulder-width apart. Do not lock your knees in extension and raise your arms forward throughout this exercise. Bracing your tummy muscles, gently squat as though you’re lowering yourself to sit in a chair. Hold your lowered pose for 5 seconds, and straighten back up to a standing position. Follow the steps to do 10 squats.

Do not hold your breath in this exercise, and make sure your knees do not move forward beyond your toes.

Trimester 2

Benefits of Exercising

You’re likely to feel full of energy in your second trimester, a time of pregnancy when many women feel healthier than they’ve ever felt before.

Recommended Exercises

Similar to the advice given in trimester one, if you haven’t been exercising regularly before pregnancy, it’s recommended that you start with 15 minutes of exercise a day and gradually increase up to 30 minutes a day, five to seven days a week. These exercises can include walking, stair climbing or light aerobics.

These are some of the exercises that are ideal for Trimester 2:

• Pelvic tilt in four-point kneeling
• Pelvic tilt — standing
• Pelvic rocking
• Half Squat
• Side-lying clams

Pelvic Tilt in Four-point Kneeling

You need to get down on your hands and knees on a mat for this pose. To ensure good posture, check that your shoulders are above your hands and that your hips are above your knees.

Relax your abdomen and take a breath in. While breathing out, suck your belly in, imagining pulling your belly button up towards the spine. Tilt your pelvis backwards to flatten your back further and hold this position for 5 seconds. Repeat the steps 10 times.

Make sure your lower back is not arched throughout the exercise and do not hold your breath. A great way to check your posture is to practice with a mirror on your side.

Pelvic Tilt — Standing: See Trimester 1

Pelvic Rocking

Begin by standing with your feet shoulder-width apart, and rock your pelvis to your left and to your right. Repeat this 10 times.

Make sure that as you rock your pelvis, your upper body is upright and not swaying.

Half Squat: See Trimester 1

If you’ve always been active, it’s safe to continue with your current exercise programme. But, as you become heavier as your pregnancy progresses, you may need to reduce the intensity of your exercises.

Pelvic floor exercises are also important to maintain the strength of pelvic floor muscles to prevent stress urinary incontinence and in future, organ prolapse.

Side-lying Clams

Lie on your side and support your head with one hand. Keep your knees bent and tighten your tummy muscles. Slowly raise your top knee by a few inches and lower it slowly. Do this 10 times, then lie on your other side and repeat 10 times.

Do not roll your pelvis forward or backward, keep your back straight and do not hold your breath as you do this exercise.

Related: Exercising Safely in Trimester 2

Trimester 3

Benefits of Exercising

Welcome to your last trimester, when your tummy is growing ever larger and you’re carrying a baby that gets heavier by the week. Hormonal changes have also increased the likelihood of water retention, so you may notice your arms and legs swell.

Exercising in the third trimester will help you to prepare to meet the physical demands of labour and birth. Plus, there’s nothing as energising (yet relaxing) as a good workout. Exercise also helps control your blood glucose levels and blood pressure. Just to be safe though, please seek medical advice from your obstetrician before starting any exercise programme.

As in previous trimesters, if you haven’t been exercising regularly before pregnancy, start with an easy 15 minutes of activity a day. Then gradually increase that to 30 minutes a day, five to seven days a week.

These are some of the exercises that are ideal for Trimester 3:

• Calf stretch
• Walking on the spot
• Low impact aerobics
• Pelvic tilt in four-point kneeling

Calf Stretch

You begin by sitting on a mat or a firm surface, keeping one leg bent with the foot flat on the floor and pointing forward. Loop a towel around the foot of the straight leg and slowly pull the foot to point towards you. Hold the position for 20 seconds and slowly release the towel. Repeat this exercise 10 times on each leg.

Walking on the Spot: see Trimester 1

Pelvic Tilt in Four-point Kneeling: see Trimester 2

Pelvic floor exercises are also a great way to maintain the strength of pelvic floor muscles to prevent stress urinary incontinence and in future, organ prolapse.

Here’s how you do it:

Imagine that you’re trying to stop yourself from passing wind and trying to stop your flow of urine mid-stream at the same time. The feeling is one of “squeeze and lift”, closing and drawing up the front and back passages. Hold this position for a few seconds, then release. Do this six to eight times.

Hormonal and postural changes may cause you to develop back pain during this trimester. Back exercises like pelvic tilts can help to alleviate the discomfort.

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