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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Flexibility
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Get Moving!
Get Motivated
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Head Injuries
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Home Gyms
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Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
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Osteoporosis & Exercise
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Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Prevention of Sports Injury
Proprioception
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Shin Splints
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Spinal Cord Injuries
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Sports Nutrition & Supplements
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Teen Sports Injuries
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7 Wonders of Walking
Adolescent Health
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Acne
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Chronic Diseases in Teens
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Female Physical Exam
First Period
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Junior High
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Mononucleosis
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Childbirth
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
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Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
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In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
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Nausea & Vomiting in Pregnancy
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Prenatal Classes
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Planning a Pregnancy
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Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
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Not Just Baby Fat
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Red Rashes
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Safe Summer Fun
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Introduction
Managing Your Pain
Movement Matters
Moving Forward
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Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
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Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
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The Smile You Want
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Smiling through the Senior Years
Teeth for Life
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Tobacco Risks to Oral Health
Tongue Piercing
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Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
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Insulin - the Key to Energy Management
Insulin Pumps
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Immunization and Diabetes
Internet Health Sites
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Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
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Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Traveling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
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ADHD in Children
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Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
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Back Pain Myths
Back Pain - Lower
Birth Control
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Check-Up
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Doctor Visit
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
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Family Doctor
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5 Ways to Stay Healthy
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Get Active!
Glare
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How to Talk to Your Doctor
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Medical Digital Technology
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Restore Your Core
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Stroke
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Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
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Bites and Stings
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Cuts and Scrapes
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First Aid Travel Kit
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Poisoning - Household
Emergency Care Guidelines
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Growing Older
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Can I see Well Enough to Drive?
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Get Active!
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Have Health, Will Travel
Health Tips for Seniors
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Maintaining Quality of Life as You Age
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Bisphenol A
Canada's New Blood System
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5 Tips to Manage Weight
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Battle the Bulge
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Breakfast is Important
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Building Your Bones
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Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
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Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
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Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
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New Ingredients for Your Shopping Cart
Iron
Kid's Food
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Mercury Levels in Fish
Night Snacking
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Nutrition Questions Top 5
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Essential Omega-3
Preventing Cancer Through Nutrition
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Power of Fruits & Veggies
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Understanding Food Biotechnology
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After a Heart Attack
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Changing Role of the Pharmacist
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Expanding Role of Pharmacies
Eye Protection - Sunglasses
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Generic or Name Brand?
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Medication Questions?
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Over-the-Counter Drugs and Pregnancy
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Pharmaceutical Studies
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Cell Phones and Driving
Childhood Obesity
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H1N1 Virus - Plan Ahead
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15 Great Reasons to Breastfeed
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Family Health Magazine - ACTIVE LIVING

Exercising During Pregnancy
Give your body and your baby a health boost

A woman’s body changes a great deal during pregnancy to create the best environment for her baby to grow. Once, we feared that exercising while pregnant might harm the fetus (unborn baby). Concerns existed about greater risk of miscarriage, early birth, low birth weight, poor pregnancy outcomes and resulting affects on childhood development. However, studies have not supported these fears. In fact, research shows that light to moderate exercise during an uncomplicated pregnancy benefits a woman’s health during pregnancy (see sidebar on page 23). It may help with birth and recovery. Exercise also maintains fitness, helping women feel good about their bodies. Rest assured that once the baby is born, light to moderate exercise will not affect the composition or production of breast milk.

Exercise during pregnancy

Following simple guidelines will help make exercising during your pregnancy safe and enjoyable.

  • Before starting or increasing an exercise program, have a thorough medical evaluation done by your doctor.
  • If you were active before pregnancy, continue activity during the first trimester but do not increase it.
  • If you were inactive, wait until the second trimester to begin a new exercise program.
  • Pregnant women can tolerate mild changes in core body temperature with light to moderate exercise. Core body temperature should not rise 1.5 degrees above resting temperature or above 38.9 C degrees during exercise.
  • To avoid becoming overheated, check your temperature, avoid exercising in hot environments, and drink enough fluids. Ten glasses of fluid (water, juice or milk) each day is recommended. Have a drink before, during and after exercise.
  • Make certain you are getting the appropriate number of calories and monitor your weight gain. Most women require an increase of 300 calories a day in the first and second trimesters. This may increase to 500 extra calories during the third trimester. Canada’s Food Guide to Healthy Eating provides helpful guidelines.
  • Dieting to lose weight is not recommended during pregnancy. Talk to your maternity care provider about appropriate weight gain.
  • Select a bra that is supportive and fits well to protect your back and breasts during exercise.
  • Check for separation of your abdominal muscles. This can be done by lying on your back and slowly raising your head and shoulders off the ground. Press two fingers into your abdomen just below your belly button. You should feel a soft gap between two hard muscles. Measure the space of the gap using your fingers. If the gap is greater than two finger widths, you may have separated abdominal muscles. If you are unsure consult your maternity care provider. During pregnancy, if you suspect abdominal muscle separation, abdominal exercises should be avoided.
  • Choose activities you enjoy. Exercising with a partner or group can help. When deciding whether exercise is appropriate during pregnancy, consider the type, frequency, length and intensity.

Reasons to stay active during pregnancy: studies show that pregnant women who exercise are likely to gain the following benefits:

  • Decreased risk of developing gestational diabetes (diabetes during pregnancy), high blood pressure and depression
  • Prevention of blood clots and varicose veins
  • Improved body image and maintained or improved level of physical fitness
  • Reduction and prevention of low back pain and joint injury
  • Reduced nausea, vomiting, constipation, heart burn and fluid retention
  • Reduced problems with passing urine too often or problems holding urine
  • Decreased risk of complications during the birth process, including signs of fetal distress, cord entanglement and abnormal heart rate in the baby
  • Women who exercise during pregnancy report easier labour and faster recovery after delivery compared to non-exercising women
  • After giving birth, exercising women are more likely to return to their pre-pregnancy weight and are less likely to develop postpartum depression.

Choosing the right type of exercise

Certain activities are not appropriate in any stage of pregnancy. This includes any exercise where blunt or penetrating injury to the abdomen is possible. Avoid exposure to too much pressure (such as during scuba diving), too little oxygen, or too much heat. Activities that are high-impact, excessively stretch joints, or require quick changes in motion are not recommended.

Exercising all major muscle groups is important both during and after pregnancy. Strength exercises may be continued or started after the first four months. Women who have previously been strength training can increase by 10 to 15 per cent during the second trimester. Focus on exercises that strengthen the body core, posture and pelvic area. Weights should not be so heavy that you must hold your breath during an exercise.

Recommended activities (low risk)

Activities to avoid
(high risk)

Swimming
Jogging
Aerobics
Dance
Stationary cycling or spinning
Cross-country skiing
Light weight training
Yoga and Pilates
Rowing
Road cycling
Downhill skiing
Court sports (such as
basketball or tennis)
Scuba diving
Horseback
riding
Ice hockey
Gymnastics
Martial arts
Water skiing

For aerobic conditioning, low-impact or weight-supported activities are preferred over running or high-impact activities. Good activities include stationary bicycling, water running, water aerobics and swimming. Swimming or water aerobics are a good choice since body weight is supported by the floating effect of water. Cool water temperatures help control body temperature. As well, compared to weight-bearing activity, the effort expended feels less. Brisk walking may be a good substitute for running or jogging as pregnancy progresses.

Avoid exercises that require lying on the back, especially after the first four months. This position could lower blood flow to the uterus (womb) and the baby. As well, during pregnancy, abdominal exercises are not recommended if the abdominal muscles are separated. However, following pregnancy, if abdominal muscle separation persists specific exercises can be done to encourage healing. Consult your maternity care provider prior to starting an exercise program.

Remember to warm up before and cool down after exercise. Include range of motion exercises for all joints, including the neck, shoulder, back, arms, hips, knees and ankles. Stretch all major muscle groups, but take care not to overstretch.

Frequency

Aerobic and strength training activity should be done regularly, allowing enough time to recover between sessions. If you were exercising before pregnancy, continue your regular routine. However, do not increase the frequency until the second trimester. If you did not exercise regularly before pregnancy, wait until after the fourth month of pregnancy to begin. Begin by exercising three times per week, alternating days. You can then progress to a maximum of four to five times per week.

Length

Start with 15 minutes of exercise, as well as a thorough warm up and cool down (at least 5 minutes each). As the pregnancy progresses, you can gradually increase the amount of time. If you did not exercise before pregnancy, keep sessions in under half and hour. If you are used to regular physical activity, 30 to 40 minutes of exercise is appropriate.

Intensity

Age (years)

Heart Rate Target Zone

Under 20 140 - 155 BPM
20 - 29 135 - 150 BPM
30 - 39 130 - 145 BPM
Older than 40 125 - 145 BPM

During pregnancy, avoid exercise routines requiring maximum effort. Use one of these simple methods of estimating exercise intensity.

  • Talk test – an exercising mother-to-be should be able to carry on a conversation comfortably when exercising. For many women, this may be the simplest and easiest method of monitoring exercise intensity.
  • Range of heart rate for age, modified for pregnancy – the table above shows the safe range of heart beats per minute (BPM) during exercise, based on the mother’s age.
  • Rate of perceived exertion (RPE) scale – this scale can be used to decide how difficult you find an exercise. A range of about 12 to 14 (somewhat hard) is appropriate for most pregnant women. Compare your heart rate to how hard you find an activity. The mid-range of your RPE should be at the low end of your heart rate target zone.

Rate of Perceived Exertion (RPE) Scale

6 14
7 Very, very light 15 Hard
8 16
9 Somewhat light 17 Very hard
10 18
11 Fairly light 19 Very, very hard
12 20
13 Somewhat hard  

From PARmed-X for Pregnancy

Warning signs

Stop exercising and consult your doctor if you experience:

  • bleeding or fluid gush from the vagina (birth canal)
  • steady and continuing contractions (more than six to eight per hour)
  • unexplained pain in the abdomen
  • absence of usual baby movement
  • sudden swelling of ankles, hands and face
  • unexplained fainting, dizziness, headache, vision problems or chest pain
  • swelling, pain and redness in the calf
  • little weight gain.

Exercise can benefit you at any time, including pregnancy. Most pregnant women can exercise regularly at light to moderate levels without harming themselves or their baby. When exercising, keep the warning signs in mind. If you do experience them, stop exercising and seek medical attention.

For more information

All the recommendations in this article may be found in more detail from:

PARmed-X for Pregnancy
Canadian Society for Exercise Physiology
www.csep.ca
Click Publications and look under PAR-Q forms

Position Statement on Exercise and Pregnancy

Canadian Academy of Sport and Exercise Medicine
www.casm-acms.org
Click Position Statement link under About CASM

FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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