Margaret is due to have her first child this fall. She’s been working on finishing a nursery in her home and came to see me recently about a sore elbow caused by too much hammering.

When we were finished, I asked Margaret about her workouts. You see, Margaret is also training for the Sugarloaf Marathon next month.

For years, physicians warned women against exercising during pregnancy. Their recommendations were based on concerns exercising might harm the fetus or that it might cause complications like preterm labor.

Over the last few years, pregnant women are hearing entirely new advice from their physicians. Instead of being warned about exercising, women are now being encouraged to stay fit during pregnancy.

The American College of Sports Medicine and the American College of Obstetrics and Gynecology both recently endorsed exercise during pregnancy. They note the risks of gestational diabetes, back pain and preeclampsia, a potentially lethal disease of late-term mothers, are all decreased in women who exercise.

Some expectant mothers are taking it a step further and competing at high levels. Fans of the WNBA and of women’s college athletics know of many athletes like Margaret who trained and even competed at elite levels during their pregnancies.

Fortunately for this generation of athletes, there is now much more information out there to guide them. There are few real dangers of working out during pregnancy, but excessive body heat is one of them.

Experts recommend that women keep their core temperatures below about 103 degrees to avoid damaging the fetus. This restriction can affect the intensity of exercise, especially under very hot conditions.

Naturally, a pregnant woman’s abdomen can be more prone to trauma, and athletes in contact sports need to take this into account. Tackle football in the third trimester? It’s not hard to see that as a bad idea.

But other than these restrictions, the gloves are mostly off when it comes to working out during pregnancy.

Pregnant women can run, lift weights and compete in many sports just as they did before expecting. In fact, they probably should. Studies show that fit mothers may have better outcomes during delivery.

Some elite athletes are even leading the way when it comes to encouraging pregnant women to maintain their athletic identities. Summer Sanders, the former Olympic gold medalist swimmer, has produced a workout DVD for expectant mothers.

Of course, issues of hydration and nutrition become particularly important for pregnant athletes. Women may find sports that require extreme flexibility or balance difficult after the second trimester.

It’s also important to approach workouts with a realistic perspective. Goal-oriented athletes should be aware that by the sixth month most women’s capacity for weight-bearing exercise is only half what it was prior to pregnancy.

This physiological fact should not keep pregnant women out of the gym. As long as they are willing to listen to their bodies and adapt their workouts as they progress, women can expect to have nothing but positive experiences staying fit and active during their pregnancies. Some will even be competing.

The bottom line: Even in pregnancy, exercise is good medicine.

Dr. James Glazer is a sports medicine physician for Coastal Orthopedics and Sports Medicine in Freeport. He serves as a consultant for the U.S. ski team.

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