I just found out I was pregnant last night, so I am only 2 fetal weeks pregnant. My doctor just told me that I can only do exercise up to 140 bpm heart rate during pregnancy. This seems to be an old statistic to me: I thought they threw that restriction out? The doctor also told me that at this point the risk of miscarriage is 35 percent! I have been a nervous wreck after hearing that one: I am terrified, and I mean TERRIFIED, that I have already done something wrong: I work out hard! Is my doctor right??? How careful do I need to be? I will gladly comply with whatever is best for the baby, but I'm hearing lots of conflicting information! Please help!
freaked out by cautious doctor
- Thread starter erica34
- Start date
GonnaBeFirm
Member
Hi Erica -
I understand your worry. But, honestly, I think you're doctor is a little behind the times. I know you'll get some wonderful information from the others on this board, but until then, here's some information to ease your mind a bit.
Here's a link to an article from the Physician and Sportsmedicine Online:
http://www.physsportsmed.com/issues/1999/08_99/artal.htm
This article is from 1999 - and it is my understanding that the guidelines have actually been updated again - to include a recommendation to exercise for 30 minutes "most days" during pregnancy. You may want to print a copy for your OB - however - some doctors are not too fond of patients bringing in internet information.
There is also an ACOG pamphlet (you can order it for free online http://www.ACOG.com/from_home/pubqry.cfm) titled, "Exercise During Pregnancy". (do a search for "exercise, pregnancy" - it will show you the publication #AP119) I'm certain that your doctor might put more stock in this publication since it is the old ACOG guidelines that your doctor is quoting. You cannot read it online, so I'll quote you a few things:
First it states, "Becoming active and exercising on most, if not all, days of the week can benefit your health in many ways."
And then, in the Heart Rate section it states:
"The extra weight you are carrying will make your body work harder than before you were pregnant. exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it's important not to overdo it. Try to exercise moderately so you don't get tired quickly. If you are unable to talk normally while exercising, our actvity is too strenuous."
As for the miscarriage statistic, thats all it is, a statistic. You have to look at it as a 65% probability of everything being fine.
There are very few things that a woman can do to that will cause a miscarriage - mostly use of illegal drugs, etc. If you've been exercising at your normal level - I can't think of any reason for you to be worried that you've done something wrong.
Good luck to you!
Jennifer k
I understand your worry. But, honestly, I think you're doctor is a little behind the times. I know you'll get some wonderful information from the others on this board, but until then, here's some information to ease your mind a bit.
Here's a link to an article from the Physician and Sportsmedicine Online:
http://www.physsportsmed.com/issues/1999/08_99/artal.htm
This article is from 1999 - and it is my understanding that the guidelines have actually been updated again - to include a recommendation to exercise for 30 minutes "most days" during pregnancy. You may want to print a copy for your OB - however - some doctors are not too fond of patients bringing in internet information.
There is also an ACOG pamphlet (you can order it for free online http://www.ACOG.com/from_home/pubqry.cfm) titled, "Exercise During Pregnancy". (do a search for "exercise, pregnancy" - it will show you the publication #AP119) I'm certain that your doctor might put more stock in this publication since it is the old ACOG guidelines that your doctor is quoting. You cannot read it online, so I'll quote you a few things:
First it states, "Becoming active and exercising on most, if not all, days of the week can benefit your health in many ways."
And then, in the Heart Rate section it states:
"The extra weight you are carrying will make your body work harder than before you were pregnant. exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it's important not to overdo it. Try to exercise moderately so you don't get tired quickly. If you are unable to talk normally while exercising, our actvity is too strenuous."
As for the miscarriage statistic, thats all it is, a statistic. You have to look at it as a 65% probability of everything being fine.
There are very few things that a woman can do to that will cause a miscarriage - mostly use of illegal drugs, etc. If you've been exercising at your normal level - I can't think of any reason for you to be worried that you've done something wrong.
Good luck to you!
Jennifer k
Hi Erica,
I am also 2 fetal weeks! We are on the same schedule! I also worry that I may harm (or have) the baby. But I sort of like to think that it may be more difficult to do so than we believe with all of this advise. Think of all the women under conditions (e.g. past times, poor countires) without a ton of messages flying at them. They seem to do ok right?
Jennifer, thanks for the additional info bc I have also been concerned about working out. I know the guideline is old, but I have been trying to my heart rate around 140. Sure, it goes above it, but then I take a little rest and water and let it come back down.
Do you all really keep exercise to 30 min.??? I have still been doing an hour of work a day (which takes a bit longer than an hour sometimes bc of the rest.)
Gina
I am also 2 fetal weeks! We are on the same schedule! I also worry that I may harm (or have) the baby. But I sort of like to think that it may be more difficult to do so than we believe with all of this advise. Think of all the women under conditions (e.g. past times, poor countires) without a ton of messages flying at them. They seem to do ok right?
Jennifer, thanks for the additional info bc I have also been concerned about working out. I know the guideline is old, but I have been trying to my heart rate around 140. Sure, it goes above it, but then I take a little rest and water and let it come back down.
Do you all really keep exercise to 30 min.??? I have still been doing an hour of work a day (which takes a bit longer than an hour sometimes bc of the rest.)
Gina
GonnaBeFirm
Member
Hi Gina 
I think it is generally accepted that you can continue exercise at your regular intensity/duration - as long as you don't become exhausted and out of breath. It is important that you pay close attention to the cues your body gives you. I know that I had to modify quite a bit during the first trimester - my regular workouts just seemed much more strenuous.
During the second trimester I had to stop exercising altogether - I'm having excessive loosening of the pelvic ligaments which is causing me lots of discomfort. My point being - that I was exercising 4-5 days a week for about 60 minutes prior to pregnancy, but now I'm sedentary. I listened to my body and I'm fine with it (OK - I'm a little frustrated - but I've only got 10 more weeks to go).
I would also recommend the book, Exercising Through Your Pregnancy by James Clapp, MD. I borrowed it from the library. It is the most comprehensive book I've read on the subject - and the author is an OB/Gyn. He explains how exercise is actually beneficial for you AND your baby during pregnancy.
Jennifer k
I think it is generally accepted that you can continue exercise at your regular intensity/duration - as long as you don't become exhausted and out of breath. It is important that you pay close attention to the cues your body gives you. I know that I had to modify quite a bit during the first trimester - my regular workouts just seemed much more strenuous.
During the second trimester I had to stop exercising altogether - I'm having excessive loosening of the pelvic ligaments which is causing me lots of discomfort. My point being - that I was exercising 4-5 days a week for about 60 minutes prior to pregnancy, but now I'm sedentary. I listened to my body and I'm fine with it (OK - I'm a little frustrated - but I've only got 10 more weeks to go).
I would also recommend the book, Exercising Through Your Pregnancy by James Clapp, MD. I borrowed it from the library. It is the most comprehensive book I've read on the subject - and the author is an OB/Gyn. He explains how exercise is actually beneficial for you AND your baby during pregnancy.
Jennifer k
jgoycoolea
Cathlete
SHEILA!!!!!!!!!!
"I think it is generally accepted that you can continue exercise at your regular intensity/duration - as long as you don't become exhausted and out of breath"
IS THIS TRUE?
I would love to go to my regular intensity. I am modifying to an awful lot out of fear! I still don't understand the difference between breathing hard and gasping for breath.
Gina
"I think it is generally accepted that you can continue exercise at your regular intensity/duration - as long as you don't become exhausted and out of breath"
IS THIS TRUE?
I would love to go to my regular intensity. I am modifying to an awful lot out of fear! I still don't understand the difference between breathing hard and gasping for breath.
Gina
GonnaBeFirm
Member
Hi Gina -
Until Sheila has a chance to answer you directly, I've copied a post from Cathe to Denise on this subject.
Jennifer
-----------------------------------------------------------------------
Cathe Friedrich Jan-21-02, 01:38 PM (Est)
1. "RE: How hard is too hard?"
Hi Denise! Congratulations on your pregnancy. What a special time in you life.
Sheila Watkins is our pregnancy/prenatal/postpartum exercise expert on this forum. What I have done to help you is take pieces of her responses that she has answered others with to bring you up to date on what the new guidelines are. Lots of luck to you.
Sheila writes........
It is normal to feel breathless in early pregnancy. In fact, that can be one of the first symptoms of pregnancy. Without getting too technical, the progesterone in your system actually has an effect on the respiratory centers in the brain. It's actually a protective mechanism.
Now as for your heartrate................ In 1994 the American College of Obstretrics and Gynecology (ACOG) changed their guidelines regarding measuring exercise intensity during pregnancy. THEY ELIMINATED THE ORIGINAL 140 MAXIMUM HEARTRATE GUIDELINE ISSUED IN 1985!!!!!!!! (ACOG Bulletin #189, Feb 4, 1994). Human research had proven that taking one's heartrate was not a valid indicator of intensity during pregnancy due to the dramatic physiological changes in both the cardiovascular and respiratory system during this time. Two very valid ways of measuring exercise intensity during pregnancy are"Perceived Exertion" (i.e. on a scale of 1-10 if 1 is lying in bed and 10 is running up the Washington Monument with twins on your back) you want to be working at a 5-6 which correlated to "fairly light to somewhat hard." Research on very fit pregnant moms has shown that they can take it up "one more notch" to "hard." This as long as you listen to your body and make sure that you are drinking a lot while working out.) and the "Talk Test," which I like the best. If you can say sentences that are 2-5 words in length while working out, you are okay and the baby is getting adequate oxygen.
It is very important that you stay hydrated and listen to your body for ANY discomfort while exercising during both cardiovascular and strength training. You said that you stop when you are “gasping” while working with weights. You should not even get to that point while working out. You may need to drop the poundage or sets a bit to keep that from happening.
With these tips in mind, you can safely continue to work out. Give yourself permission to slow down if you need to. Remember, this is only a “season in your life.”
Now as far as strength training is concerned, if you are going to be strength training, here are some things to keep in mind (I have copied and pasted this from another post)......
Cathe (me) writes:
"At this early stage in your pregnacy, your strength training workouts are fine to do as usual. My only suggestion is that you go for strength maintenance and NOT try to lift heavier than usual weight at this time. The main two reasons for this are 1) You don't want to work in a very high heart rate zone, which can happen when lifting heavy weight. 2) You want to be be careful to not over stress your joints and ligaments since they gradually become softer and softer as your pregnancy progresses(due to relaxin hormone). By the way, this softening process is very normal and is the body's way of naturally preparing for childbirth. As a matter of fact, toward the end of your pregnancy you may find yourself having to lift even lighter weight since your balance and joint stability will have altered quite a bit.
I would also strongly recommend that you begin to strengthen your pelvic floor muscles by doing kegel(internal contraction) exercises throughout your pregnancy(even forever after is great). This will not only help to keep you from leaking urine when you sneeze, cough, or jump (since the baby puts more pressure on your bladder as he/she grows), but will keep your pelvic floor stronger overall(a big plus) since it will become stressed from holding the weight of the baby.
As you get into your fourth month of pregnany, it is no longer recommended that you work flat on your back. For this reason all flat bench work (ex. bench presses) should be done in an incline position and abdominal work is recommended in an all fours position. I'll provide you with ab examples if you need them.
As you end your second trimester and enter your third, you may find your center of gravity shifting, causing you to be a bit off balance at times. During these times, you may have to be more creative finding more comfortable positions to do certain exercises(or eliminating them altogether, if no safe modification is available, until after the baby comes). This is the time to especially take advantage of that spotter if you have one available.
You can continue to exercise right to the end of your pregnancy(of course, modifying more and more as you get closer to the end)as long as you are having no complications."
Good Luck and happy hugs to you Denise! If you have any further questions, just let us know!
Until Sheila has a chance to answer you directly, I've copied a post from Cathe to Denise on this subject.
Jennifer
-----------------------------------------------------------------------
Cathe Friedrich Jan-21-02, 01:38 PM (Est)
1. "RE: How hard is too hard?"
Hi Denise! Congratulations on your pregnancy. What a special time in you life.
Sheila Watkins is our pregnancy/prenatal/postpartum exercise expert on this forum. What I have done to help you is take pieces of her responses that she has answered others with to bring you up to date on what the new guidelines are. Lots of luck to you.
Sheila writes........
It is normal to feel breathless in early pregnancy. In fact, that can be one of the first symptoms of pregnancy. Without getting too technical, the progesterone in your system actually has an effect on the respiratory centers in the brain. It's actually a protective mechanism.
Now as for your heartrate................ In 1994 the American College of Obstretrics and Gynecology (ACOG) changed their guidelines regarding measuring exercise intensity during pregnancy. THEY ELIMINATED THE ORIGINAL 140 MAXIMUM HEARTRATE GUIDELINE ISSUED IN 1985!!!!!!!! (ACOG Bulletin #189, Feb 4, 1994). Human research had proven that taking one's heartrate was not a valid indicator of intensity during pregnancy due to the dramatic physiological changes in both the cardiovascular and respiratory system during this time. Two very valid ways of measuring exercise intensity during pregnancy are"Perceived Exertion" (i.e. on a scale of 1-10 if 1 is lying in bed and 10 is running up the Washington Monument with twins on your back) you want to be working at a 5-6 which correlated to "fairly light to somewhat hard." Research on very fit pregnant moms has shown that they can take it up "one more notch" to "hard." This as long as you listen to your body and make sure that you are drinking a lot while working out.) and the "Talk Test," which I like the best. If you can say sentences that are 2-5 words in length while working out, you are okay and the baby is getting adequate oxygen.
It is very important that you stay hydrated and listen to your body for ANY discomfort while exercising during both cardiovascular and strength training. You said that you stop when you are “gasping” while working with weights. You should not even get to that point while working out. You may need to drop the poundage or sets a bit to keep that from happening.
With these tips in mind, you can safely continue to work out. Give yourself permission to slow down if you need to. Remember, this is only a “season in your life.”
Now as far as strength training is concerned, if you are going to be strength training, here are some things to keep in mind (I have copied and pasted this from another post)......
Cathe (me) writes:
"At this early stage in your pregnacy, your strength training workouts are fine to do as usual. My only suggestion is that you go for strength maintenance and NOT try to lift heavier than usual weight at this time. The main two reasons for this are 1) You don't want to work in a very high heart rate zone, which can happen when lifting heavy weight. 2) You want to be be careful to not over stress your joints and ligaments since they gradually become softer and softer as your pregnancy progresses(due to relaxin hormone). By the way, this softening process is very normal and is the body's way of naturally preparing for childbirth. As a matter of fact, toward the end of your pregnancy you may find yourself having to lift even lighter weight since your balance and joint stability will have altered quite a bit.
I would also strongly recommend that you begin to strengthen your pelvic floor muscles by doing kegel(internal contraction) exercises throughout your pregnancy(even forever after is great). This will not only help to keep you from leaking urine when you sneeze, cough, or jump (since the baby puts more pressure on your bladder as he/she grows), but will keep your pelvic floor stronger overall(a big plus) since it will become stressed from holding the weight of the baby.
As you get into your fourth month of pregnany, it is no longer recommended that you work flat on your back. For this reason all flat bench work (ex. bench presses) should be done in an incline position and abdominal work is recommended in an all fours position. I'll provide you with ab examples if you need them.
As you end your second trimester and enter your third, you may find your center of gravity shifting, causing you to be a bit off balance at times. During these times, you may have to be more creative finding more comfortable positions to do certain exercises(or eliminating them altogether, if no safe modification is available, until after the baby comes). This is the time to especially take advantage of that spotter if you have one available.
You can continue to exercise right to the end of your pregnancy(of course, modifying more and more as you get closer to the end)as long as you are having no complications."
Good Luck and happy hugs to you Denise! If you have any further questions, just let us know!
THANK YOU!!! For all the great info! You guys are the best (and very well informed!) I am thinking about changing doctors: if my doctor doesn't know that ACOG guideline was taken down 8 YEARS AGO then god knows what else this woman doesn't know! She is clearly is not that concerned with keeping herself current before she dispenses medical advice and that is worrisome to me. I have enough to worry about during pregnancy: I don't need to also worry that my doctor isn't giving me up to date advice!
Stebby
Cathlete
Just thought I would share my experience. I just had my first child, a daughter, on August 14. I worked out hard right up until August 13. I kept my intensity level quite high (listening to my body so on days it didn't want to go hard, I backed off a bit). The only things I made sure to do were to drink tons and tons of water, and to pay careful attention to signals my body was sending me. I was doing Spinning classes 3 X per week until I delivered, and was also doing weight tapes (Cathe and Firm) 2-3 X per week. I had to reduce my weights some, but not that much (e.g. used 12 lb dumbbells where I used to use 15 lbs pre-pregnancy).
My daughter is absolutely fine. Her Apgar score was 9 and so far, she is gaining weight at a good rate, is generally peaceful (except when she's hungry) and is starting to have times where she is alert. So I have no misgivings about my heavy workout schedule. It has made all the difference in my recovery from my C-section, and by 4 weeks after she was born I was back to my pre-pregnancy workout routine, using all my pre-pregnancy weights.
My daughter is absolutely fine. Her Apgar score was 9 and so far, she is gaining weight at a good rate, is generally peaceful (except when she's hungry) and is starting to have times where she is alert. So I have no misgivings about my heavy workout schedule. It has made all the difference in my recovery from my C-section, and by 4 weeks after she was born I was back to my pre-pregnancy workout routine, using all my pre-pregnancy weights.
Michelle D.
Active Member
Erica,
Congratulations on your news! I too was told by my OB to keep my heart rate below 140 - both this pregnancy and my first pregnancy (two different OBs). It bothered me a little that they didn't mention new ACOG guidelines. But then I think my OBs have been conservative by nature.
I plan on listening to my body and using a perceived exertion test. I always make sure I am not breathless.
I too have known plenty of women who have exercised until delivery. My sister taught aerobics until the day before her baby was born. I really believe that exercise can make for an easier delivery and recovery.
Stebby, I can't believe your recovery time from a C-section! I know that your fitness level helped you out there. I was on bed rest for my first pregnancy (with twins) so I wasn't very fit. I had a horrible recovery from my C-section. I really hope to exercise my whole pregnancy this time around!
Michelle
Congratulations on your news! I too was told by my OB to keep my heart rate below 140 - both this pregnancy and my first pregnancy (two different OBs). It bothered me a little that they didn't mention new ACOG guidelines. But then I think my OBs have been conservative by nature.
I plan on listening to my body and using a perceived exertion test. I always make sure I am not breathless.
I too have known plenty of women who have exercised until delivery. My sister taught aerobics until the day before her baby was born. I really believe that exercise can make for an easier delivery and recovery.
Stebby, I can't believe your recovery time from a C-section! I know that your fitness level helped you out there. I was on bed rest for my first pregnancy (with twins) so I wasn't very fit. I had a horrible recovery from my C-section. I really hope to exercise my whole pregnancy this time around!
Michelle
I am sorry to seem so dense, but let me get this straight.
Stebby--if you kept your exercise intensity up high, does that mean at times you were in fact breathing quite heavily? And that you did this in the first trimester also? But if the high intensity and heavy breathing were too much on a given day, you didn't do it?
Gina
Stebby--if you kept your exercise intensity up high, does that mean at times you were in fact breathing quite heavily? And that you did this in the first trimester also? But if the high intensity and heavy breathing were too much on a given day, you didn't do it?
Gina
E
ebh87
Guest
Hi Gina - I just have a minute, but my story is very similar to Stebby's. My baby was born by C-Section a day before hers, I kept very fit during pregnancy and my recovery was quick and I am back to normal fitness-wise.
When I was pregnant, I kept my workouts challenging, but made sure that I didn't feel like I was pushing too hard if that makes sense. I also made sure that I drank lots of water before, during and after my workouts. I also cut back when I felt like I needed to - in the first trimester, I cut back on duration and intensity because I was tired and breathless. I lowered my step to 6" throughout the pregnancy and kept my cardio workouts to an hour (I used to run longer distances and did frequent runs of 10-12 miles). I lowered my weights just a little bit - 20-25% probably.
Hope this helps. You will do great - just listen to your body - it really works!!
Have a safe, healthy pregnancy!
Erica
When I was pregnant, I kept my workouts challenging, but made sure that I didn't feel like I was pushing too hard if that makes sense. I also made sure that I drank lots of water before, during and after my workouts. I also cut back when I felt like I needed to - in the first trimester, I cut back on duration and intensity because I was tired and breathless. I lowered my step to 6" throughout the pregnancy and kept my cardio workouts to an hour (I used to run longer distances and did frequent runs of 10-12 miles). I lowered my weights just a little bit - 20-25% probably.
Hope this helps. You will do great - just listen to your body - it really works!!
Have a safe, healthy pregnancy!
Erica
What I'm doing
Hi, Gina! I'm at 17 weeks right now, and I use the perceived exertion scale to monitor the intensity of my workouts, not heartrate. If I'm breathing heavily, as long as I'm not gasping for breathe, I'm okay since I was working out at that level prior to pregnancy. Sometimes that means I can do a Cathe tape or combo. Sometimes that means I need to do a less intense tape. My step is still at 8 inches, but I plan to lower it when I feel it is necessary.
In my response to another of your posts I recommended a couple of books, including the James Clapp book recommended above. Let me push those again. They'll help relieve a lot of your concerns and help cover the deficits of your doctor, who probably knows less about this subject than you do.
Good luck!
Erin and ? ( 17 weeks and counting )
Hi, Gina! I'm at 17 weeks right now, and I use the perceived exertion scale to monitor the intensity of my workouts, not heartrate. If I'm breathing heavily, as long as I'm not gasping for breathe, I'm okay since I was working out at that level prior to pregnancy. Sometimes that means I can do a Cathe tape or combo. Sometimes that means I need to do a less intense tape. My step is still at 8 inches, but I plan to lower it when I feel it is necessary.
In my response to another of your posts I recommended a couple of books, including the James Clapp book recommended above. Let me push those again. They'll help relieve a lot of your concerns and help cover the deficits of your doctor, who probably knows less about this subject than you do.
Good luck!
Erin and ? ( 17 weeks and counting )