Exercise
During
Pregnancy

Exercise During Pregnancy By: Mike Everts

During pregnancy, your body goes through many changes beyond weight gain or mood swings. Understanding these changes is the first step to help monitor your appropriate exercise routine. Benefits of exercising while pregnant include reduction of lower back pain, leg cramps, swelling and fatigue. Exercising during pregnancy will also help you after pregnancy to more quickly regain your pre-pregnancy body. Despite the benefits, it is important to also be cautious when choosing an exercise program because of the numerous changes occurring in your body during pregnancy.

Let's start with the heart and cardiovascular system. A woman's heart rate will increase 10-15 beats per minute to sustain increasing needs for oxygen (carried via the blood). Because body weight increases, the need for oxygen during workouts increases by about 15-20%. This means the maximal intensity of the pregnant woman's workout needs to adjust/reduce accordingly.

Next, the endocrine system is greatly affected. The growth of the fetus is supported by the enlargement of the woman's pituitary and adrenal glands. Estrogen and progestin levels increase and ligaments become softer (especially in the pelvis) to help in "propulsion" of the baby during birth. This is important relative to exercise, because a woman's ability to properly stabilize their pelvis decreases and it can cause improper back posture, and muscular imbalance. Because the articulations of the spine are also softened, the ribs become more mobile and less supported. Metabolism also increases which increases a women's internal temperature. Therefore staying hydrated becomes increasingly important. As far as exercise strategy goes, I recommend that beginners follow a corrective exercise strategy focusing on core strength and stabilization, increasing flexibility and balance, and improving endurance. During pregnancy, body weight and composition, and the center of gravity change and a corrective exercise strategy needs to take these into account. A corrective exercise strategy can help avoid future muscular and skeletal stresses and improve posture and stabilization strength.

Any workout routine should have some element of focus on resistance training, cardiovascular training, nutrition (speak to your doctor especially about proper doses of prenatal vitamins), and flexibility. Weight training

The weight training portions of your workout should not be more than 20 minutes (The amount of weight should be light to moderate in order to keep unnecessary stress off your developing baby.) It is important to ease into your workouts with a warm up and flexibility program before the resistance training begins. Pay attention to areas on your body that are newly or unusually tight since becoming pregnant. Next, start with only one set of each resistance training exercise. Slowly increase the number of sets as you adapt and the exercises become easier.

If you are not a beginner and consider yourself to be intermediate or advanced I would maintain the same exercise prescription. However, I would utilize resistance training more suited for your condition level (perhaps 30 minutes of your full workout) and add a set or two rather than the more cautious one-set rule.

Two stages of exercising that are important are warming up and cooling down. Even with an exercise such as walking, this will help you to avoid and prevent muscle soreness and stiffness. Try to include 5 to 15 minute sessions of warming up and cooling down while you exercise during your pregnancy. The best warm up activity is one that is kept at a low-intensity, rhythmic activity, such as walking, or riding a stationary bike. Follow that up with slow, controlled stretches, before proceeding with a higher level of activity. A gentle cool down is also important as you exercise during pregnancy. In order to have an effective cool down, stretch each muscle, one at a time.

Contraindications:

Pregnant clients should not perform self-myofascial release (foam roll) on the inside of the lower leg and avoid varicose veins and areas of swelling. Never do an exercise that hurts or feels uncomfortable and never exercise to the point of exhaustion.

First Trimester:

For your first trimester, you can continue training at the same level as before pregnancy. Know your limits. The important thing is to constantly evaluate how you feel - if it begins to feel too strenuous, or if you begin see symptoms such as cramping, bleeding, fatigue, morning sickness, etc. Pay close attention to your energy levels since more oxygen and blood is now required during exercise.

If you feel out of breath, which is common during the first trimester, slow down or take a break. The first few months are an adjustment period, when your blood volume is initially too low to accommodate both you and a growing fetus- this can result in breathlessness and faintness. Adjust your exercise levels accordingly.

As a rule, never allow your heart rate to exceed 135 BPM. Constantly monitor your heart rate and your breathing. The fetal heart rate is matched to yours; if your heart races, so too will that of your baby.

As a side note it is a good idea to focus on strengthening your pelvic floor muscles by performing Kegal exercises. To perform a Kegal exercise, contract your pelvic floor muscles; envision starting and stopping a flow of urine. Ideally a woman should perform up to 100 repetitions per day throughout her whole pregnancy.

Drink plenty of water. A woman's metabolism increases during pregnancy which increases a the internal temperature. Therefore staying hydrated becomes increasingly important.

Don't over do it with your flexibility training. There is a surge of the hormone, relaxin, in your bloodstream. Relaxin induces hyper-flexibility in your joints and musculature, to allow the expansion of the uterus and the repositioning of the pelvic floor. It is common for women to strain muscles, tendons and ligaments during pregnancy as a result of this "super flexibility". It is still important to stretch during and after exercising. Be aware of your limits and try not to exceed them.

Second & Third Trimester:

As the pregnancy progresses, reduce the intensity level. This tends to happen naturally. Remember that even if you are exercising less intensely, the true level of what you are doing is more challenging due to the increased weight of the baby.

It is now more important than ever to listen to your body. Reduce the intensities and duration of your workouts and always stay as hydrated as possible.

During the second and third trimester, focus on exercises that keep your body in an upright position either standing or seated. Also try to utilize exercises that do not keep you in the same position for an extended period of time. Especially avoid exercises on your stomach and always weigh on the side of caution. It is also a good idea in the third trimester to also avoid exercises that require you to lay on your back. Avoid all prone and supine exercises in the 3rd trimester.

In the last trimester, avoid ballistic movements, such as jumping, squatting, lunging, or running.

Postpartum:

After pregnancy, there is a necessary delay that needs to be respected before returning to any kind of rigorous fitness program. Especially if you are nursing, the laxity in your joints needs to be reset and this takes time.

The physical effects of pregnancy can last up to 4 months. The very popular Kegal exercise is one that you can begin almost immediately after birth (after the first 24 hours has past.)

I recommend a similar total body approach as mentioned earlier that combines the elements of flexibility, cardiovascular and resistance training, and nutrition to get back into shape. Areas that are likely to need the greatest attention after pregnancy will be the abdominals, glutes, and lower and middle back.

Below is a short list of signs that you should stop exercising:

Bloody discharge or any gush of fluid from the vagina
Unexplained pain in the abdomen
Persistent headaches, changes in vision, faintness or dizziness
Marked fatigue, heart palpitations or chest pains
Sudden swelling of ankles, face or your hands

Michael Everts' references for this article include NASM and ACSM guidelines, The Journal of Endocrinology, American College of Obstetricians and Gynecologists

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