I had every intention of continuing with my regular exercise routines (albeit toned down quite significantly) throughout my pregnancy. But, it was a lot harder to do than I thought it was going to be. My energy was totally zapped from the get go. I struggled to make it through my daily incidental movement requirements, let alone fit in an actual workout. The good news, this was completely normal. And I think my body was sending me some pretty strong signals that I would need to slow down from my usual high frequency and high intensity style of training over the next 9 months.
The question we often get asked by the newly pregnant Mumma is what should they be doing? In this article Womens Health Physiotherapist Libby Borman offers tips for each of the three trimesters to help you get the most out of exercise during your pregnancy.
The official word
- There are numerous potential health benefits for women who exercise during pregnancy, including better weight control, improved mood and maintenance of fitness levels.
- Regular exercise during pregnancy can also decrease the risk of pregnancy-related complications such as pregnancy-induced hypertension and pre-eclampsia.
- Before exercising when pregnant, consult your doctor, womens health physiotherapist or healthcare professional.
- You may need to modify your existing exercise program or choose a suitable new one if you were exercising very little before getting pregnant.
- Exercise should be a combination of aerobic and strength-conditioning and it is essential to start pelvic floor muscle exercises.
The American college of obstetrics and gynaecology (ACOG) exercise recommendations during pregnancy in 2015 state: “ For healthy pregnant and postpartum women, the guidelines recommend at least 150 minutes per week of moderate-intensity aerobic activity (ie, equivalent to brisk walking). This activity should be spread throughout the week and adjusted as medically indicated. The guidelines advise that pregnant women who habitually engage in vigorous-intensity aerobic activity (ie, the equivalent of running or jogging) or who are highly active “can continue physical activity during pregnancy and the postpartum period, provided that they remain healthy and discuss with their health care provider how and when activity should be adjusted over time”
- Lower the impact a little from day 1. This isn’t for the baby but for you and your future bathroom habits. It might feel fine now but the increased load and changes in hormones can make your body less capable of absorbing the forces involved with impact exercise. Lowering the impact could help prevent incontinence and prolapse issues later in life. An easy way to do this is simply to take the ‘jump’ element out of most exercises, for example swap jump squats for regular squats, jump lunges for reverse lunges and just ease off the pace or distance a little with your run work.
- Avoid super heavy weights and exercises that cause your abdominal muscles or pelvic floor to feel strained (ie. intense core exercises). You should not feel any outward pressure on your belly or downward pressure onto your pelvic floor whilst exercising.
- Avoid rapid position changes. Your cardiovascular system is changing as your body is setting up the supply to the uterus and placenta. This can impact your blood pressure and make you feel dizzy/breathless.
- Leave time for a longer warm up and cool down period than usual, again to look after your blood pressure.
- Have regular sips of water and be prepared with light snacks to replenish energy and nip nausea in the bud.
- It’s very important you don’t overheat in your first trimester, so if you feel your body temperature rising significantly, you get flushed or your heart rate rises significantly, slow down, take a break and sip on some cool water until your body temperature is back to normal.
- You may need to modify the position you do some exercises in.
- Lying flat on your back is discouraged from 19 weeks onwards. This is because the weight of the uterus and foetus can occlude a major vessel inside you, and could cause symptoms such as breathlessness, dizziness and strange feelings. Seek advice from an experienced trainer as they will know how to modify most exercises. You should not be lying flat on your stomach either.
- Front Planks, or any exercise where the belly is “hanging” down or feels unsupported is discouraged from 20 weeks onwards.
- Be aware of your posture and gently activate your deep abdominal muscles to support your back. Be aware of your upper back – are your enlarged breasts pulling you into a slumped position?
- Avoid all isometric exercises; this can increase the heart rate of your baby (true from trimester 1 but even more important now).
- It is important to stretch regularly but aim for it to be a gentle stretch. Over stretching is risky as pregnancy hormones are helping your ligaments and muscles loosen so that your body can accommodate the growing baby. Over-stretching at this time can cause joint instability and problems further down the track.
- At this stage you are preparing for the big arrival (exciting)! I work with my clients during the third trimester specifically to prepare for a smooth delivery. There are several positions you can practice as part of an exercise program to help get the body ready for birth. This needs to be done with a qualified professional and is possibly one of the best gifts you can give yourself as a mummy-to-be.
- This is also the time to start really winding down. You will start to feel less energetic as your pregnancy draws to a close, as your body will be reserving energy. Reduce the intensity of your exercise but definitely keep moving.
- Treat yourself. Several of the sessions I complete with my clients toward the end of their pregnancy are half exercise, half gentle massage. Your body will be sore from carrying around that extra weight and a light exercise session followed by specific prenatal massage is perfect for you right now. Just make sure the person massaging you is prenatal qualified, as there are some trigger spots that need to be avoided.
Why not take a break from exercise altogether?
Finally, if you are wondering why you shouldn’t use your pregnancy as an excuse to stay on the couch for 9 months, check out the long list of benefits those who exercise during pregnancy are rewarded with:
- Higher cardiorespiratory fitness
- Less urinary incontinence
- Less back pain
- Better weight gain control
- More straight forward delivery
- Improved mental health and reduced risk of depression.
- Reduced risk of gestational diabetes and preeclampsia
In summary, a comprehensive training program during pregnancy will change as your body changes. It should include a combination of warming up, stretching, strength training, cardiovascular fitness and restorative activity. To get a program designed for you to optimise your health during pregnancy, contact Renee at BUF Bayswater. And remember to communicate any concerns with your medical team!
Always remember – your situation will be individual to you, and it’s best to work with a professional to make sure you are doing what is best for your body.
Libby is a Women’s Health Physiotherapist practicing in Yokine, WA. She has a special interest in incontinence, pelvic floor dysfunction, pelvic floor prolapse, sexual dysfunction, and muscular pain & dysfunction.
If you want more information please visit https://www.lifereadyphysio.com.au/clinics/yokine/ If you have any questions about your pregnancy and postnatal recovery, send Libby and email on firstname.lastname@example.org