Hot tub and sauna in pregnancy: what to skip and what to do instead

Skip the hot tub, jacuzzi, sauna and steam room in pregnancy. KKH's advice is that too much heat raises your core temperature, and that can affect how your baby's spine and brain form. A warm bath or a cool swim gives you the same rest without the heat. If you've already had a soak, tell your gynae, and call sooner if you feel unwell.

How to unwind without overheating, step by step

1. Skip the hot tub, jacuzzi, sauna and steam room. SingHealth's do's and don'ts, written by KKH, say too much heat raises your core temperature, which can harm your baby's developing spine and brain.
2. Run a warm bath, not a hot one. KKH says warm baths ease muscle tension as long as they're not too hot, and Cleveland Clinic in the US suggests no higher than 37 degrees C, checked with a thermometer.
3. Sit on the edge of a condo or hotel jacuzzi and soak just your feet and calves. Cleveland Clinic says this isn't likely to raise your core temperature, as long as the tub is clean and you have no cuts on your legs.
4. Swim in the pool instead, since Singapore's pregnancy exercise guidelines, led by KKH, list swimming and aqua-fitness as recommended activities.
5. Pick a prenatal class in a cool room. The same guidelines list hot yoga and hot Pilates as activities to avoid, along with any exercise in excessive heat.
6. Tell the spa you're pregnant before any treatment. KKH's planner rules out tummy and breast massage, relaxation oils and any treatment that raises your body temperature.
7. Keep a bottle of water with you: the guidelines say to drink before, during and after activity, and Cleveland Clinic notes that saunas can dehydrate you.
8. Get out of the bath slowly. KKH says some women feel faint when they get out of a bath or stand up quickly, so sit up first, then stand.
9. Stop and cool down as soon as you feel dizzy or too hot. Rest on your side rather than flat on your back, as KKH advises later in pregnancy.

Why heat matters more in pregnancy

The worry is your core temperature, the heat deep inside your body, and SingHealth's KKH page says too much heat raises it. Cleveland Clinic explains that your baby's brain and spinal cord form in the first trimester. Its doctor says hot tubs are still not a good idea later in pregnancy.

The second reason is fainting. You have more blood in your body when you're pregnant, and Cleveland Clinic says hot tubs lower your blood pressure. You can feel lightheaded when you stand, and you could fall. KKH names getting out of a bath and lying on your back as times some women feel faint.

Singapore's weather keeps you warm enough already. Our guide to pregnancy heat in Singapore has tips for staying cool at home and outdoors.

Hot tub, sauna, steam room and more: what the sources say

Hot yoga and workouts in the heat

Singapore's guidelines on exercise in pregnancy, led by KKH with the SingHealth and NHG polyclinics, put hot yoga and hot Pilates on the list of activities to avoid. They also say to avoid exercise in excessive heat. Modified yoga and modified Pilates are on the recommended list, so you keep the class and lose the heated room.

The guidelines' talk test helps too: you should still be able to hold a conversation. Our prenatal yoga guide shows which poses suit each trimester, and our guide to safe exercise during pregnancy covers how much is enough and how to train in the heat.

Spa days, condo pools and babymoons

Hotel spas and condo jacuzzis are where most of these choices come up. At a spa, book a prenatal massage with no heat treatments. KKH's spa rules are in our 26 weeks pregnant guide, and prenatal massage in Singapore covers when it's safe and what it costs.

Planning a trip? Our babymoon guide has the best weeks to go, and flying while pregnant covers airline cut-offs and doctor's letters.

Concerts and loud music

We found no Singapore hospital advice on concerts, so this comes from the CDC's guidance for pregnant workers in noisy jobs. It says sound travels through your body, and very loud noise may be able to damage a developing baby's hearing. The ears develop by about 20 weeks, and babies start responding to sound around 24 weeks.

The CDC advises staying out of areas louder than 115 dBA, roughly as loud as a chainsaw. Ear plugs don't change that, because they don't fully protect your baby's ears. Bass is the other thing to watch, since low rumbles and vibration travel through your body more easily, so pick seats far from the speakers and don't lean on them.

When to see a doctor

Call your gynae's clinic or go to your delivery hospital if any of these happen.

• Dizziness or faintness that doesn't settle when you rest. Singapore's exercise guidelines and SingHealth's KKH page both list it as a reason to see a doctor.
• A fever. KKH lists fever among the medical concerns that need a hospital visit.
• Bleeding from the vagina, which is on the same KKH list.
• Your baby moving less than usual, also on KKH's list. Go the same day; don't wait for your next check-up. Our baby kick counter helps you keep track.
• A severe headache, changes in your vision or tummy pain, which KKH lists too.
• A fall, such as slipping on a wet pool deck. Cleveland Clinic says to tell your doctor, and to get care straight away if you're in doubt.

At KKH, go to the Delivery Suite (Level 2, Women's Tower) from 22 weeks, or the Urgent O&G Centre (Basement 1, Women's Tower) before 22 weeks. If you're delivering at SGH or NUH, our guide to premature labour signs lists their routes. Call 995 if someone faints and doesn't come round, or for heavy bleeding: MOH lists loss of consciousness and excessive bleeding among the emergencies for 995.

Frequently asked questions

Can I use a hot tub, sauna or steam room while pregnant if it's just a few minutes?

KKH's advice is no treatments that raise your body temperature, and it names the sauna, steam room and hot tub. Cleveland Clinic says a steam room has the same effect as a hot tub, even though you're not in water. We found no Singapore source that gives a safe number of minutes, so skip them all.

I used a jacuzzi before I knew I was pregnant. What should I do?

Stop from now on, and tell your gynae at your first visit so they can talk it through with your dates. If you have a fever, tummy pain or any bleeding, call your clinic sooner. Our guide to your first gynae visit covers when to book and what happens there.

Can I take a hot bath while pregnant?

A warm one, yes. KKH says warm baths ease muscle tension as long as they're not too hot, and suggests a soak in the bath to help you wind down before bed. Cleveland Clinic suggests keeping the water at 37 degrees C or below. Get out slowly, because KKH notes that some women feel faint stepping out of a bath.

Can I do hot yoga while pregnant?

No. Singapore's guidelines on exercise in pregnancy list hot yoga and hot Pilates as activities to avoid. Modified yoga is on the recommended list, so a prenatal class in a cool room is the swap.

Can I use a massage chair while pregnant?

We found no advice on massage chairs from KKH, SGH, NUH or HealthHub, so ask your gynae first. KKH's rules for a prenatal massage or spa treatment are no tummy massage and nothing that raises your body temperature. Applied to a chair, that means no rollers on your bump and the heat setting off.

Is it safe to go to a loud music concert while pregnant?

We found no Singapore hospital advice on concerts. The CDC's advice for pregnant workers is to stay out of areas louder than 115 dBA, even with ear plugs, and to move as far from the noise as you can. Sit well back from the speakers, and step out if you can feel the bass rumbling through your body.