Exercise under physician guidance; “talk test” = should be able to speak while exercising; avoid supine position after 20 weeks GA
ACOG recommends ≥30 min of mod daily exercise. Avoid activities w/ high risk for abdominal trauma (eg, horseback riding, skiing/ snowboarding), or Scuba diving.Terminate exercise w/ bleeding, preterm labor, ↓ FM, LOF, chest pain, dizziness, dyspnea prior to exertion. Absolute contraindications to exercise: Heart or lung dzs, incompetent cervix, multi gest,VB, placenta previa, pregnancy-induced HTN, rupture of membranes
ruptured membranes
preterm labour
hypertensive disorders of pregnancy
incompetent cervix
IUGR
multiple gestations (>3)
placenta previa after 28th wk
persistent 2nd or 3rd trimester bleeding
uncontrolled type I DM
uncontrolled thyroid disease, or other serious cardiovascular, respiratory, or systemic disorder
previous preterm birth
mild/moderate cardiovascular or respiratory disorder
anemia (Hb ≤10 g/dL)
malnutrition or eating disorder
twin pregnancy after 28th wk
other significant medical conditions
weight gain: optimal gain depends on pre-pregnancy BMI (varies from 6.8-18.2 kg)
work: strenuous work, extended hours and shift work during pregnancy may be associated with greater risk of low birth weight, prematurity, and spontaneous abortion
air travel is acceptable in second trimester; airline cut off for travel is 36-38 wk gestation depending on the airline, to avoid giving birth on the plane
sexual intercourse: may continue, except in patients at risk for: abortion, preterm labour, or placenta previa; breast stimulation may induce uterine activity and is discouraged in high-risk patients near term
smoking: assist/encourage to reduce or quit smoking → increased risk of decreased birth weight, placenta previa/abruption, spontaneous abortion, preterm labour, stillbirth
alcohol: no amount of alcohol is safe in pregnancy; encourage abstinence from alcohol during pregnancy; alcohol increases incidence of abortion, stillbirth, and congenital anomalies → fetal alcohol syndrome
cocaine: microcephaly, growth retardation, prematurity, abruptio placentae