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A sedentary lifestyle—that is, one without deliberate exercise—has been specifi-cally identified as a health risk for both women and men. Unfortunately, despitethe numerous and well-publicized benefits of regular exercise, a majority ofAmericans still do not take part in any form of planned physical activity. But aregular habit of exercise established now will serve as an investment in long-termhealth and also improve the way you feel throughout pregnancy.

Several normal changes during pregnancy put new physical demands onyour body. Aside from a normal weight gain of twenty-five to thirty-five pounds,your heart will be dealing with a 50 percent increase in blood volume. Musclesand ligaments in the back and pelvis will he stretched and subjected to new ten-sions and strains. Unless you have a scheduled cesarean section, you will also gothrough the rigors of labor—which is aptly named—and the birth itself. Theseare physically challenging events, and those who arc well conditioned will usuallyfare better. In fact, their labor may even be shortened.

The increased stamina and muscle tone resulting from regular exercise willalso increase your energy level, improve sleep, reduce swelling of the legs, andprobably reduce aches and pains in the lower back. If you are on your feet all day,it may seem ridiculous to spend precious time for additional muscle motion. Butunless you are a professional athlete, it is unlikely that your daily activities, nomatter how exhausting, will specifically condition your heart and lungs. Thegood news is that you don't need to become a marathon runner to see some ben-efit in your health.

If you are not used to exercising, a goal of thirty minutes three or four timesper week is reasonable. It is always better to do light or moderate exercise on aregular basis than heavy exercise intermittently. While stretching and musclestrengthening are worthwhile, aerobic conditioning—in which increased oxygenis consumed continuously for a prolonged period of time—has the greatest over-all benefit.

The most straightforward and least costly aerobic activity is walking. Nofancy equipment, health-club membership, or special gear (other than a pair ofcomfortable, supportive shoes) is needed. Pleasant and safe surroundings, a flatsurface, and agreeable weather are advisable, however, as well as a companion.Another person (whether your husband, an older child, a relative, a friend, or an-other pregnant woman) will add accountability to the process, and the conversa-tion can be enjoyable and help the time pass quickly. Gentle stretching for a fewminutes before and after is a good idea, in order to warm up and then cool downleg and back muscles.

Alternatives to walking include:

A home treadmill. Advantages: No concerns about weather, aggressive dogs, or finding someone to watch your children. You can be flexible about the time of day to use it. Disadvantages: Cost, size, and noise.

An exercise video or book geared to pregnant women. Advantages: Same as above, with less cost. Disadvantage: Repetition could become boring.

A prenatal fitness class at a local hospital or health club. Advantage: Interaction with instructor and other women can be helpful and motivating. Disadvantages: Cost. Also, scheduling and child-care needs may be complicated.

Swimming. Advantage: Good aerobic conditioning involving many muscle groups, with no added strain on sore muscles and joints of the lower back and pelvis. Disadvantage: You need access to a pool.

Stationary cycling. Advantage: Good aerobic conditioning and (depending on your anatomy) probably less strain on your lower back than from walking. Disadvantage: Many women become increasingly uncomfortable on this equipment as pregnancy progresses.

If you are already well conditioned, you should be able to continue using your specific exercise routine. If you are already a confirmed jogger or an accomplished tennis player, you can probably continue these activities through the early months of pregnancy. Snow skiing, surfing, waterskiing, and horseback riding all pose specific risks during pregnancy because of the possibility of falls— especially as your center of gravity shifts and your balance becomes less reliable as the uterus enlarges. All of these activities should be reviewed with your physician throughout the course of your pregnancy. Note: Scuba diving is not recommended at any time during pregnancy.

A few special precautions about exercise during pregnancy:

Pregnancy is not a good time to take on a new, intense form of exercise, especially if it involves jumping, jerking, high-impact motion, or sudden changes in direction.

Exercise should not be so vigorous or prolonged as to cause exhaustion, overheating, or dehydration. During pregnancy your heart rate should stay below 140, regardless of the type of exercise you are doing.

After the twentieth week of pregnancy, you should avoid exercises that require you to lie on your back.

Exercise should not continue if any of the following pregnancy-related problems develop: preterm rupture of membranes; poor growth of the baby (intrauterine growth retardation); vaginal bleeding; high blood pressure; preterm labor; and cervical incompetence, a condition in which the cervix or "neck" of the uterus isn't strong enough to prevent a premature delivery. Exercise may also be limited if you are pregnant with more than one baby.

If you have specific health problems such as heart disease, high blood pressure, irregular heart rate, epilepsy, fainting episodes, asthma, arthritis, or anemia, review any exercise plans with your physician, whether or not you are pregnant. In addition to aerobic activity, a variety of gentle stretching and muscle conditioning activities can help prepare your body for the changes of late pregnancy and labor. Your doctor and/or childbirth class instructor will have suggestions for such exercises.

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