Extreme Exercise During Pregnancy: How Much Is Too Much?

pregnant woman doing headstand during yoga YouTube

Recommendations for exercise during pregnancy are vague, and generally quite conservative so as to prevent any undue stress on the pregnancy or the expectant mom. Official medical position on the subject has been revised in recent years, however, to encourage more activity during pregnancy. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that, in the absence of contraindications, pregnant women engage in “moderate to intense physical activity for 30 minutes most if not all days of the week.” But how much is too much?

The general “rule,” if there is such a thing, is that women should not begin a new activity during pregnancy, but that it’s safe to continue most activities while pregnant as long as the body was accustomed to that activity on a regular basis pre-pregnancy. Some exceptions to that are high-impact activities that have a high risk of fall or injury, like horseback riding or downhill skiing, or contact sports like soccer. This “rule” can be applied to most moms in most situations. But there are the outliers: those who do everything a little more to the extreme. What about those moms-to-be — the marathon runners, the power yogis, the competitive cyclists? For many women who are accustomed to advanced physical exercise pre-pregnancy, there is little in the way of studies or official recommendations to guide them on how much is too much.

In those cases, as in most, I defer to the sensibilities of the individual woman. One of my most frequent phrases is “Listen to your body.” A marathon runner can usually keep training well into pregnancy, sometimes until the last days, but she also usually has to adapt her routine throughout the pregnancy in order to continue without discomfort or injury, slowing the pace, cutting the distance, alternating walking and running, and adding an under-belly support to lighten the strain of the weight of the bump as it grows. When will she know to make these changes? When her body tells her so! It’s important to be attentive to the subtle signs: shortness of breath earlier in the run than usual, joint or pelvic pain and overall discomfort.

In other cases, it may not be so clear. The power yogi who is ultra flexible and accustomed to twisting into pretzel shapes, back bends and headstands can keep up her yoga practice throughout pregnancy, but again, with modifications so that she doesn’t over-stretch the ligaments that are already lax with the hormonal changes of pregnancy. While it’s important for these moms-to-be to listen to their bodies and not go so deep into Warrior 2 that they feel pelvic pain, it is also important that they know the risks of some positions or poses. Accordingly, then need to then take precautions to minimize risk of injury, such as using a prop for balance for all standing balance poses, and avoiding extreme extension of the spine to protect the vulnerable lower back and prevent separation of the abdominal muscles.

Of course, you should always consult your doctor before starting any exercise routine during pregnancy. And when you do, be sure to let your doctor know what you were doing for exercise before pregnancy so that the recommendations will be more tailored to your situation. For those who are looking for a good exercise to get and to stay in shape, my favorites that are safe for nearly any health mom-to-be are walking, swimming (or any kind of aquatic exercise), and prenatal core exercises to target the muscles weakened the most during pregnancy.