Editor’s note: Pregnancy experience varies from woman to woman; as a result, this story is not meant as medical or safety advice. Please consult your physician to talk about what is right for you.
I had just returned from a trail run with my husband and I was feeling funny. It was mid-May and I was excited for the months of good weather ahead. But I was also exhausted—so much so that I decided to take a rare midafternoon nap. Puzzled, I finally took a pregnancy test. It was positive.
After learning I’d be having a baby boy in January 2020, I happily made plans for an active pregnancy. I would continue running, I figured, at least until the middle of my pregnancy. I had friends who’d done it! And I’d keep hiking, too. For my 29th year, I’d planned to tackle 29 peaks and challenging hikes. That should still be possible, I thought. After all, hiking involved mostly walking. I wanted to make my way through the next nine months focused on feeling physically strong.
Then the nausea hit. From week six onward, I threw up multiple times per day. I’d never felt so exhausted, and I often slept 14 hours at night. A 7-mile hike with 1,000 feet of elevation gain during month four of my pregnancy put me on the couch for two days. As the months went by, even hiking on easy trails made my body shake with exhaustion.two se
Running, too, became a challenge. I jogged often at first, even clocking a respectable time in a local 5-mile race, but it wasn’t comfortable. I felt like I was sucking air from the moment I stepped out the door. The fetus bounced against my bladder and my joints felt bizarre, like they were coming apart. Eventually, after a few months, I abandoned that pastime, too.
I was able to maintain some activity like yoga, despite the nausea, exhaustion and joint pain. Still, I struggled mentally with losing the hardcore outdoor routine, which felt like a part of my identity. My physical therapist reminded me, month after month, that my body was doing something much harder than usual. I needed to cut it some slack. But the immediate shift away from my norm felt like the end of something I had once loved.
As I started to research the topic of the outdoors and pregnancy, I discovered a few things: First, I wasn’t alone. Maintaining a high-intensity workout routine while pregnant isn’t possible for many women, despite our expectations. Second, many women experience anxiety when they can’t do their usual activities, especially athletes. And third, it’s still a good idea to try to get outdoors, even if the activity doesn’t look quite like it used to.
The research behind exercise during pregnancy
Recommendations about exercising during pregnancy have shifted dramatically in the past 10 years. After it had been recommending for years that pregnant women engage in limited exercise, in 2015, the American College of Obstetricians and Gynecologists (ACOG) released a groundbreaking report revealing the benefits of exercise during pregnancy. Study author Dr. Raul Artal wrote: “Pregnancy should not be looked at as a state of confinement. In fact, it is an ideal time for lifestyle modification. That is because more than any other time in her life, a pregnant woman has the most available access to medical care and supervision.”
This year, ACOG took things a step further when it released a new set of recommendations suggesting that women can even begin an exercise routine while pregnant. “Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery,” the report said, noting that every woman should discuss exercise with her care provider prior to getting started. Some conditions, such as heart and lung disease, placenta previa, being pregnant with multiples, anemia and preeclampsia might make exercise more dangerous. Your health care provider should be able to help you make decisions about what’s best for you and your baby.
Experts are coming around to the idea that exercise can be helpful for pregnant women, especially when it comes to combating uncomfortable or risky pregnancy symptoms like back pain, constipation, gestational diabetes, excessive or limited weight gain and more.
“If you think about blood flow and oxygenation in general, more exercise helps you get more blood flow to the baby,” Heather Ranney, a certified nurse midwife at the University of Washington, says. “Exercising is not drawing support away from the baby. Actually, a strong and healthy body has more endurance and is better prepared for pregnancy.”
A 2019 report from the British Journal of Sports Medicine even noted that “prenatal physical activity should be considered a front-line therapy for reducing the risk of pregnancy complications and enhancing maternal physical and mental health.”
What kinds of exercise are best?
According to ACOG, pregnant women should aim for 150 minutes of moderate-intensity aerobic activity every week. That means you’re moving the large muscles of your body just enough to get your heart rate up. Women who exercised before pregnancy are generally encouraged to continue their routines if they feel good; women who didn’t exercise before pregnancy should start slow.
“In general, most of the time, we say that what you have done prior to pregnancy, you can do during pregnancy,” Ranney says. “But you do need to increase water ... You also have to be really aware of snacks, especially eating protein-based snacks, because your blood sugar is more sensitive and you’ll get dips where you haven’t before.”
As for more intense exercise like high-altitude hiking or competitive running, the research remains inconclusive. A few studies have shown that traveling to high elevations and staying active in outdoor sports won’t necessarily put women at greater risk, however, the findings acknowledge that further research is necessary. Ranney says it really depends on the individual person and what her body can tolerate.
Some activities are truly off limits for most pregnant women—especially those that could cause impact trauma. According to ACOG, that list includes:
- Contact sports where you could get hit or fall on your abdomen (think: ice hockey, boxing, soccer and basketball)
- Activities that have a very high fall risk (like downhill skiing, bouldering and climbing, water skiing, off-road cycling, gymnastics and horseback riding)
- Scuba diving
When and how to modify your exercise routine
Have an initial conversation with your doctor about what’s right for you, and then check in with your body week to week, Ranney says. “There are women who do Crossfit and hot yoga, and I think it works for them and their bodies adjust,” she adds, “but it may also be that when you get to 20 weeks, you don’t feel quite as proficient and you decide to shift to another activity.”
Hike It Baby founder Shanti Hodges remembers feeling completely uncomfortable while trying to casually ride a bike around town while she was pregnant. “I remember saying to my husband: Something is wrong down there!” she says. “That’s the thing: Just because your best friend can run a 50K while pregnant, doesn’t mean you can. Your body will react how it reacts. You can be incredibly fit, but your body might not like certain activities.”
When you need modifications, Ranney suggests looking for an activity that you can do proficiently but with less impact. For outdoor enthusiast and small-business owner Cassie Abel, that meant walking her dog instead of running or mountain biking. For me, it meant turning to activities like yoga and swimming, where I still felt strong.
Ranney suggests cyclists consider riding the stationary bike. Yogis need to avoid upside-down postures and should stay away from deep twists after 20 weeks.
Then there’s hiking, which Ranney says is a solid way to stay moving during pregnancy. Though you might not be able to do trails of the same difficulty level or altitude increases as you used to, there are still many benefits to tackling shorter hikes or walking in a nearby park.
“We know that being outside is very settling for us,” Ranney says. “It’s healing, it’s distracting and it smells good. For pregnant women, being outdoors is phenomenal.”
To keep hiking comfortable, Ranney recommends using trekking poles (as your balance can shift drastically during the second and third trimesters) and a waist belt, which supports and holds up your belly.
The bottom line
The most important—and sometimes the hardest—advice I received about staying active during pregnancy was about adjusting my expectations. “You have to understand that things are changing,” Swedish Medical Center perinatal psychiatrist Catherine Davies told me. She counsels her patients to approach their new, modified routines with a curious mindset. “Say: I’ll see how this goes and look for support as things develop. [Pregnancy] is a profound experience and I think we forget that.”
Hodges has a version of the same: “I encourage women to not be hard on themselves,” she says. “The thing you used to be able to do might not be easy anymore, but you’ll get back to it. The way pregnancy progresses, your body can be unpredictable. There’s no training yourself out of it.”
Give yourself grace when you can’t do what you’re used to doing, and be patient. Once your baby is born, you’ll benefit from that mindset as it can take a while to get back to the routine you once had—and that’s OK.
As for me, I’ll be practicing prenatal yoga, taking long walks, swimming and sleeping as much as possible. All the while, I’ll remind myself that this, too, shall pass, and soon I’ll be back outdoors—with my son. That adventure is more exciting than anything else I can imagine.