Working out during pregnancy can be confusing. Whether you’re new to exercise or have been training for years, there’s still so much old school advice floating around that it can be overwhelming.
It used to be that the risks of prenatal exercise exceeded the benefits and pregnancy was therefore seen as a state of confinement. Restrictions were placed on variables such as heart rate max and type of exercise, limiting many options.
However, over the last two decades an onslaught of research has helped not only to debunk many of these myths but has helped to show the benefits of regular exercise to both mother and fetus. There are a myriad of reasons to exercise and research has helped to show that exercise during pregnancy may not only help reduce the aches and pains often brought on by pregnancy (back aches, constipation, bloating and swelling) but it may also:
Help promote better sleep
Help prevent or treat gestational diabetes
Increase energy and improve mood
Promote muscle tone, strength, endurance, and improve posture
Help maintain or build strength (important for postpartum)
Help condition for labor and delivery
More recently, studies looking at the fetal and newborn cardiovascular system have shown that exercise during pregnancy is correlated with lower heart rate and increased heart rate variability (positive changes). Additionally regular maternal exercise in the 3rd trimester is associated with resting fetal heart effects to that of a trained response; meaning, that the fetal heart may also becoming conditioned as a result of a mother’s consistent physical activity.
Currently the exercise recommendations for healthy pregnant women (without other contraindications) are consistent with those of a general healthy adult population. Exercise should always be discussed and cleared by a physician however it is generally accepted that you can continue with activities you were doing prior to pregnancy within reason. This might not be the time to try to set a PR or achieve that world record you’ve been chasing but you can continue to build strength. Additionally, the old advice of not starting anything new is wrong! You can start exercise during pregnancy for the first time but you’ll want ease into it slowly. Before we get into the essentials, here are a few (fairly well known) precautions:
Avoid contact sports, activities that put you at risk of falls (gymnastics, horseback riding and water or downhill skiing).
Exercise in thermoneutral environment- you’ll want to keep your body heat fairly regulated avoiding situations where it may rise too high i.e. hot yoga, saunas and outdoors on the hottest day of the year.
Avoid training environments and programs that may compromise oxygen delivery to the baby. The Valsalva maneuver, altitude training, scuba diving, and exercising at an intensity you haven’t exercised at before are all examples. You should be able to have a conversation while working out.
These being said, I love seeing pregnant women getting their strong on and believe. Here are the first three essentials when thinking about the next few months.
1) Do what feels good. It's really important that you stay as comfortable as possible throughout your pregnancy. It is perfectly fine to challenge yourself but pushing through morning sickness or pain can be harmful physically and mentally. You should like what you're doing and, your workouts should make you feel strong and fit. The point of exercise at this point in your life is to give you energy- not to make you want to puke.
2) Understand Diastasis Recti and check for it frequently. The rectus abdominis, the muscle responsible for the "six pack", has a seam down the midline (the linea alba) separating it into right and left sections. As the belly grows, the linea alba becomes stretched and widens and the recti muscles are not held together as tightly. You can think of the linea alba as a zipper- when pressure or stress is applied the zipper will pull apart. Although this can result in a bulge it usually does not cause direct pain, but can result in back and pelvic pain.
To Check: lie on your back with knees bent. Slowly raise your head and shoulders. Using the two or three middle fingers of one hand press horizontally just above the belly button. You will feel a distinct separation between the two sides- you want to measure the width of that gap (how many fingers) and check for the firmness of the linea alba. Three or more fingers wide and a soft central seam indicates diastasis recti. You will want to avoid exercises that require a crunch, leg raise or front loading (think plank).
3) Learn the importance of breath. As a yoga instructor we spend every class discussing proper breathing techniques, especially diaphragmatic breath. Pregnancy aside, many people have a hard time accessing a diaphragmatic breath, resulting in the assistance of the muscles of the shoulders and chest, causing muscular dysfunction and stress. Due to decreased movement of the respiratory muscles, and increased abdominal pressure, breathing during pregnancy becomes more challenging.
Exercise to Practice: Lie on your back, knees bent. Relax the abdominal wall, shoulders and neck. Place your hands on your belly. As you exhale, forcefully blow all of the air out of your lungs, by pulling belly up and in towards the sternum. On the inhale allow the abdominal wall to relax and rise. The general rule of diaphragmatic breath is to exhale as you exert as, the pelvic floor and abdominal muscles will only shorten on an exhale as the diaphragm ascends. For more resources, check out this book and this article.
Stay tuned for next week's Fitness Essentials of Pregnancy, Part 2.