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SUMMARY
RECOMMENDATIONS ON EXERCISING DURING PREGNANCY AND POSTPARTUM HAVE EVOLVED OVER THE PAST DECADES. THIS ARTICLE PROVIDES CURRENT GUIDELINES FOR EXERCISING DURING PREGNANCY AND POSTPARTUM. BACKGROUND INFORMATION ON THE PHYSIOLOGICAL CHANGES DURING PREGNANCY IS COVERED, AND THE BENEFITS, CONTRAINDICATIONS, AND BARRIERS TO EXERCISE FOR THIS SPECIAL POPULATION ARE HIGHLIGHTED. FURTHERMORE, RELEVANT RESEARCH PERTAINING TO THE IMPORTANCE OF EXERCISE DURING THIS STAGE OF A WOMAN'S LIFE WILL BE EXAMINED. IT IS IMPORTANT TO NOTE THAT EVERY PREGNANT WOMAN BE MEDICALLY PRESCREENED FOR CONTRAINDICATIONS TO EXERCISE AND SHOULD SPEAK TO HER HEALTHCARE PROVIDER BEFORE STARTING OR CONTINUING AN EXERCISE PROGRAM DURING PREGNANCY.
KEY WORDS:
exercise; physical activity; pregnancy; postpartum
BACKGROUND AND CURRENT GUIDELINES ON EXERCISE DURING PREGNANCY
Exercise recommendations during pregnancy and postpartum continually evolve. Based on concern for the developing fetus, before 1985, pregnant women were told by their healthcare providers to rest and not to engage in physical activity (17). More recently, in 2002, the American College of Obstetricians and Gynecologists (ACOG) announced that moderate exercise for 30 minutes or more per day, on most if not all days of the week, was recommended for women with low-risk pregnancies. Also, it was considered safe for sedentary women to start a new exercise program during pregnancy (2).
Currently, the ACOG's recommendations for pregnancy and postpartum, in the absence of medical/obstetrical complications, include regular exercise at least 3 times per week for 30-40 minutes (continuous activity being preferable to intermittent activity). It is recommended that pregnant women avoid exercise in the supine position after the first trimester, and caution is needed during exercise where there could be a loss of balance, especially in the third trimester. Pregnant women who exercise should augment heat dissipation by adequately hydrating, wearing appropriate clothing, and exercising in optimal environmental surroundings. Because many of the physiological and morphological changes of pregnancy persist 4-6 weeks postpartum, these recommendations should also be followed after delivery. These guidelines reflect our current understanding of the many changes that occur to the body during pregnancy (2,13).
PHYSIOLOGICAL CHANGES DURING PREGNANCY
A normal gestation period is approximately 240 days divided into trimesters. During this time, the most apparent change that occurs is an increase in body weight. In 2009, the Institute of Medicine released new guidelines for...