Many pregnant women know that maintaining a moderate exercise routine and a nutritionally sound diet provide both short- and long-term benefits to the mother and baby. But routines and regimens that may be helpful during one stage of gestation may be detrimental during another.

That’s what Hunter Clarke-Fields found. Before becoming pregnant with her second child, she led an active lifestyle. But when nausea and fatigue set in during the first trimester, she was forced to curtail her workouts. “Somewhere around 13 weeks, I started feeling better, so I eased back into my yoga—which I had stopped altogether—and brought my cardio exercises up to speed,” she says, now 26 weeks pregnant.

Although nausea and fatigue may compromise women’s exercise routines early on, these side effects usually subside by the second trimester. As the fetus grows, however, mothers may find certain positions and movements increasingly uncomfortable, tiring—even harmful.

By the beginning of the second trimester, women should avoid supine and inverse positions as these can restrict the baby’s blood flow, says certified Pilates instructor Mara Raskin. “During this time, the hormone Relaxin also kicks in, making ligaments looser and joints more vulnerable to injury. And as the belly expands, the body’s center of gravity shifts and can cause stress on the lower back and pelvic muscles,” she says.

At this point, Raskin suggests women focus on the upper and mid back, shoulders and chest muscles. “This will support their shifting weight, help maintain posture and strengthen the muscles that support the spine,” she says. “Women should also strengthen the pelvic floor muscles by drawing them in and up with Kegal exercises.”

Rose Willard does this. Now 14 weeks pregnant, the personal trainer has altered her routine to prepare for the road ahead. “I start with a five-minute warm up on the elliptical trainer, followed by weight training—using less weights and more repetitions than before—to strengthen both my upper and lower body,” she says. “I then do transverse abdominal exercises to stabilize my spine and end with another 15 minutes of cardio, making sure my heart rate doesn’t exceed the recommended 140 beats per minute. To strengthen the pelvic floor and PC muscles, I also do Kegel exercises.”

These days, Clark-Fields is focusing more on back and abdominal muscles to ease back pain and prepare for labor. “In addition to the back and ab equipment I use at the gym, I do a lot of balancing poses and planks to strengthen my abs and back. I also do cat stretches, downward dogs and some gentle side-to-side twisting,” she says. “As the pregnancy has progressed, I just listen to my body, and if an exercise doesn’t feel right, I don’t do it.”

Good idea, says Deborah Ehrenthal, MD, FACP, OB/GYN specialist. “If you’re in doubt or feel discomfort, don’t do it. Most important, if you experience bleeding or pain, stop and talk with your doctor. It may be completely unrelated but it should be checked out,” she says.

During exercise, wear loose, layered clothing and a supportive bra. Sip on water to stay hydrated, and precede and end your workouts with a small protein-carbohydrate snack to provide quick and long-lasting energy and maintain muscle.

That’s what Willard does. “I’ll have a natural peanut butter and jelly sandwich on whole grain bread about an hour beforehand and a banana and whey protein shake afterward,” she says. “I’ve also added 300 calories to my diet per day and have increased the frequency of my meals because I’m always hungry.”

Emily Moore, RD, LDN, prenatal nutrition educator, says small frequent meals are a good remedy for morning sickness and heartburn. She advises women to eat six meals every two to three hours and consume fluids between meals, rather than during. It may also be helpful to eat before getting out of bed.

“To avoid heartburn, don’t lie down immediately after eating, lay with your head slightly elevated and avoid caffeine, chocolate and highly seasoned foods,” says Moore. “Another common complaint, constipation, can be prevented by increasing high-fiber foods and fluid intake and engaging in moderate exercise.”

Moore believes good prenatal nutrition is paramount because it can affect the child’s metabolic and endocrine health throughout childhood and into adulthood. She suggests choosing whole grain products, fruits and vegetables for its fiber, vitamin, mineral and antioxidant benefits, and low-fat dairy products for its calcium content. Likewise, meat and beans provide protein and iron, which are necessary to healthy cell development and delivering oxygen to the baby.

“Many women are concerned about eating fish due to its mercury content, but fish contains essential Omega-3 fatty acids, DHA, which is vital to brain, eye and central nervous system development,” she says. “Rather than crossing fish off your list, choose ones low in mercury and high in Omega-3, such as flounder, herring, fresh salmon, sardines, squid and freshwater trout. Omega-3 fortified eggs are a good option too.” 

Exercising at least 30 minutes each day provides women with uncomplicated pregnancies with a variety of benefits. Before engaging in exercise, consult your physician.

Benefits of prenatal exercise

+Reduces backaches, constipation, bloating and swelling.

+May help prevent or treat gestational diabetes.

+Increases energy.

+Improves your mood.

+Improves posture.

+Promotes muscle tone, strength and endurance.

+Helps you sleep better.

+May improve your ability to cope with the pain of labor.

+May make it easier to return to your pre-pregnancy shape.

Prenatal nutrition

Prenatal nutrition can affect the child’s metabolic and endocrine health throughout childhood and into adulthood, thereby reducing his risk of obesity and chronic disease. Following is a list of recommended foods and daily servings for pregnant women. Supplement intake should be discussed with your provider or dietitian.

+Grains. Choose whole grains such as brown or wild rice, whole oats, quinoa, barley and popcorn. These contain fiber, vitamins, minerals and antioxidants which help regulate blood sugar and keep the mother feeling full longer. They also help to reduce the incidence of constipation. Don’t confuse the phrases “wheat,” “multigrain” and “whole grain.” “Wheat” describes the type of flour, “multigrain” has different types of flour but may not be whole grain, and “whole grain” products are only required to be 51 percent whole grain. To receive the most benefit, choose products with 100 percent whole grain. Daily servings: 8 ounces.

+Fruits and vegetables. Fruits and vegetables are low in calories and high in nutrients. They are also high in fiber, rich in antioxidants and other compounds and contain Vitamins A and C, as well as folate and calcium. Vitamins A and C are important to healthy cell development, and C aids in the absorption of iron. Iron and folate are found in dark leafy greens such as spinach, and iron is important in delivering oxygen to the baby. To get the most nutrients and fiber, eat whole fruits such as apples with the peel versus just apple juice. Also eat a variety of fruits and vegetables in an array of colors. Daily servings: 3 cups vegetables, 2 cups fruit.

+Meats and beans. The meat and bean group offers iron and protein, which is important for cell building. Choose low-fat or lean meats and poultry. Fish and Omega-3 fortified eggs are good sources of the essential Omega-3 fatty acid, DHA, which is important to the development of baby’s brain, eyes and central nervous system. Fish high in mercury, however, has been known to cause birth defects. Good fish options low in mercury and high in Omega-3 include flounder, herring, fresh salmon, sardines, squid and freshwater trout. Avoid those with high mercury content such as shark, swordfish, king mackerel, tilefish, marlin, orange roughy, ahi, bigeye and albacore tuna. Vegetarian options in this category include dried beans and peas, nuts and seeds, eggs and soy products. To reduce the risk of food-borne illnesses, avoid raw or undercooked meats, poultry, fish, shellfish and eggs, and fully cook leftovers and ready-to-eat foods such as hot dogs and deli meats. Daily servings: 6 ½ ounces.

+Dairy. Milk, yogurt and cheese are excellent sources of calcium, which is important in the formation of healthy teeth and bones. Adequate calcium can also reduce the risk of osteoporosis for the baby and mother later in life. Choose low-fat sources. Lactose intolerant women can get calcium through other foods such as almonds, dark leafy green vegetables, dried beans, tofu, fortified orange juice or soy milk, canned salmon with bones and sardines. Daily servings: 3 to 4 servings (i.e. 1 cup milk or yogurt, 1 ½ ounces hard cheese).