Many women are too tired or too sick to exercise in the first trimester. If you feel up to it, you may continue your pre-pregnancy workout. Exercise offers so many benefits to both mom and baby that ACOG changed its guidelines for exercise in 1994. They recommend beginning a regular exercise program even if you did not before pregnancy. However, this should not be used as a method to lose weight. If you are overweight before pregnancy, ask your healthcare provider to refer you to a nutritionist. Here is my summary of ACOG's guidelines and Healthy Expectations' recommendations regarding exercise.

Pregnancy Fitness Do's

1. Be familiar with the ACOG guidelines. Use perceived exertion to monitor intensity. Regular exercise is preferable to intermittent exercise. Discuss your specific fitness routine with your physician or midwife. Be familiar with the signs to stop exercising and know when to contact your health care provider.

2. Include posture and pelvic floor exercises (Kegels) into your daily routine to prevent discomfort and chronic conditions. Strengthen the upper back, abdominals and stretch the lower back and hip flexors.

3. Set realistic fitness goals. Pregnancy is not a time to lose weight. It is safe to maintain your fitness level and make small, incremental gains. A sensible program includes three to four sessions each week of 20-30 minutes of low-to-moderate intensity aerobic exercise, light weight training and stretching.

4. Caloric intake should compensate for the calories expended during exercise. Pregnant women utilize carbohydrates faster during exercise than non-pregnant women. Eat a small snack including both carbohydrates and protein prior to exercise.

5. Stay well hydrated by consuming one half cup of water for every 20 minutes of exercise. Water exercise and breastfeeding require that you consume even more water.

6. Cardiovascular, respiratory and hemodynamic changes will slow you down during the second half of pregnancy. Pay attention to your level of perceived exertion and modify your exercise accordingly.

Prenatal Fitness Don'ts

1. Do not participate in sports that compromise joint stability, balance or cause falling.

2. Never hold your breath while exercising.

3. Limit time spent exercising in the supine position (flat on your back) to less than five minutes to prevent a possible lessening of blood flow to the baby.

4. Avoid over-stretching, twisting, lifting heavy weights and balastic stretching.

5. Don't compare your body to those of others. Each pregnant shape is different.

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