A clinical approach to exercise during pregnancy.

Our knowledge is limited and there are serious theoretic concerns about combining a vigorous exercise regimen with pregnancy. The outcome data available, however, suggest that a healthy woman may begin or maintain a regular exercise regimen during pregnancy with benefit and without adversely affecting the course and outcome of the pregnancy. The data also suggest that the clear difference between theoretic concern and observed outcome is best explained by the hypothesis that the physiologic adaptations to exercise and to pregnancy are complimentary and feto-protective. Although the upper level of safe performance is not established, it appears that the otherwise healthy mother-to-be can obtain the benefits of a regular exercise regimen without undue risk to the embryo and fetus. The exact regimen can be flexible and individualized, provided that both the exercise and the pregnancy are monitored. In February 1994, a new set of guidelines for exercise during pregnancy and the postpartum period was published by the American College of Obstetricians and Gynecologists. These guidelines are more liberal than those mentioned previously. Interested parties should write to the American College of Obstetricians and Gynecologists, 409 12th Street S.W., Washington, DC 20024-2188 and ask for technical bulletin no. 189.