“Exercise in Pregnancy: Yes!” – with Dr. Stephanie Melka
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In this episode, Drs. Fox and Melka discuss their recommendations for exercise during pregnancy. Dr. Melka says that she talks about pregnancy “at least several times a day” with her patients, and that she always brings it up in the first visit. Dr. Fox agrees that it’s a frequent topic of discussion, because “there’s definitely a lot of myths about exercise during pregnancy.” Patients frequently hear conflicting information or advice from their friends or online, and then have questions for their OB/GYN. Dr. Fox says that “often, the advice that they’re give is directly opposed to what’s healthy.”
There are many benefits to exercising during pregnancy, which include maintaining a healthy weight, improving and maintaining cardiovascular function, and maintaining mental health. Drs. Fox and Melka also explain that exercise is an important way to avoid disease or complications, such as gestational hypertension or diabetes, and that it can help keep a baby from growing too big. Some evidence also suggests that exercise lowers the risk of a preterm birth.
Contrary to popular belief, the biggest risks of exercise during pregnancy are to the mother, not the baby. The major risk is injury, which is why activities like skiing are recommended against. While the activity itself doesn’t pose a risk to the baby, the danger of having an injury such as a bone fracture is higher for the mother.
Dr. Melka says that beyond avoiding these dangerous activities, she doesn’t put a limit on her patients’ exercise. She notes that “this is probably not the time to train for a marathon,” but that patients are free to keep up their exercise routines as normal. There is a myth that women should avoid getting their heart rate up above 140, but this doesn’t present a real risk. Instead, Dr. Melka says that “it comes down to someone’s baseline of fitness.” Dr. Fox explains that he advises patients that “if you can sing, it’s too light, but if you can’t talk it’s too hard.”
It’s recommended that patients exercise for 20-30 minutes a day on most days of the week. Most types of exercise are safe and encouraged, including yoga, running or jogging, swimming, or studio classes such as spinning, HIIT, Orange Theory, barre, or Pilates. There are some modifications that pregnant women can make, however. For example, Dr. Fox recommends against hot yoga due to a risk of overstretching or dehydration, and Dr. Melka recommends against biking due to a risk of falling or getting into an accident on the road.
Dr. Fox warns that women should be careful while exercising because it’s common to become clumsier during pregnancy due to a changing center of gravity. He also recommends that women focus on core strength to alleviate back pain, which commonly occurs as ligaments loosen.
Some conditions, however, require that women rest or avoid exercise altogether. For example. Those with placenta previa, cerclage, or who are carrying multiples may be advised not to exercise. Dr. Fox says that he typically wouldn’t restrict women with twins, unless they had certain symptoms or had contractions while exercising. He explains that “common sense has to be used.”
Dr. Stephanie Melka is an OB/GYN at Maternal Fetal Medicine Associates in New York City. Dr. Melka studied at SUNY Downstate in Brooklyn and completed a residency at Mount Sinai Hospital. Learn more about Dr. Melka in this episode of Healthful Woman.