All pregnant women, without medical contraindications, should be physically active. Physical exercise during pregnancy has numerous benefits, such as increased stamina and energy, promotion of better body awareness, reduction of physical discomforts, strengthening of essential muscles for pregnancy and childbirth, and weight gain control. In addition to these benefits, there are also clinically significant reductions in the likelihood of developing gestational diabetes mellitus, preeclampsia, gestational hypertension, and depressive symptoms.

There are, however, some contraindications and, for this reason, all women should have a previous evaluation with the obstetrician accompanying the pregnancy before starting/maintaining the practice of physical exercise.

For those to whom exercise is recommended, they should preferably be accompanied by a professional trained in the area and follow the international recommendations (Figure 1. ITF Model).

The ITF model must be individually tailored to meet the needs and goals of each woman. To help, there are some fundamental questions to answer:

Were you physically active before your pregnancy? 

It is important to understand a woman's fitness for exercise in order to best adapt the ITF model to her current condition. If she was already physically active, she is more likely to be able to better adapt to the demands placed on her cardiovascular and respiratory systems, as well as the increased load on her joints, pelvic floor, abdominals, and breasts.

2.   Do you feel any discomfort/pain?

Pregnancy is a period of constant adaptation of a woman's body, and some musculoskeletal conditions common in pregnancy may arise and worsen during exercise, such as lower back/pelvic pain. It is important to see a physical therapist to help you with these types of conditions and possibly adapt your exercises.

3.   Do you have any symptoms of pelvic floor dysfunction?

The pelvic floor acts as the floor of our pelvis and is responsible for supporting the pelvic organs, including the uterus, bladder, and rectum. The weight that the uterus is exerting on this structure and all the hormonal changes resulting from pregnancy can lead to the appearance of some symptoms, such as urine leakage and vaginal heaviness. It is important that in this type of situation you seek a physical therapist with expertise in pelvic rehabilitation.

If your doctor has authorized you to run and you feel no pain/discomfort, don't be afraid to exercise. However, there are a few things to pay attention to:

1.     Feeling comfortable - wearing good sneakers and a good bra to support the weight of the breasts, paying attention to hydration, and avoiding exercise during hot periods are fundamental.

2.     Monitoring the intensity of effort - you can monitor the intensity by heart rate - up to 146 bpm (beats per minute) for women aged 30 years - or by a scale of perceived exertion - imagine you have a scale with a range of 0-10, where 0 is rest and 10 is maximum effort, effort should not exceed 6 (moderate effort).

3.     Stop/adjust the training if you experience any of the following symptoms:

      - Pain (lower back, pelvis, knees)*

      - Urinary and/or fecal incontinence*

      - bulging or tension along the linea alba (connective tissue connecting the two sides of the rectus abdominis muscles)*

      - Excessive shortness of breath**

      - Severe chest pain**

      - Regular and painful uterine contractions**

      - Vaginal bleeding**

      - Persistent vaginal fluid loss**

      - Persistent dizziness**

*requires evaluation by the doctor and/or physical therapist

**requires immediate medical evaluation

Every woman is unique, and so is every pregnancy. Talk to your doctor, listen to your body, seek help, and adapt your workout when necessary. 


Good training,