A Guide To Exercise During Pregnancy.

Some of you during pregnancy, particularly in the first trimester (first 13 weeks) feel nauseated, tired, way too friendly with the toilet, and are dealing with both pounding headaches and tender breasts. All perfectly normal, by the way!

Meanwhile, some of you wouldn’t even know that you were pregnant if it weren’t for the test results! It’s important to remember that every pregnancy is different, and expecting Mums experience a wide array of symptoms, both in terms of type and intensity.

However no matter your symptoms, one of the most difficult aspects of pregnancy tends to be feeling a bit “out of control”. As you body grows and changes on a daily basis, it can feel like you energy level, mood, cravings and body in general are at the whims of this little peanut growing inside you.

So while you strive to be your healthiest during this time, both for yourself and for your baby, don’t forget to give yourself the grace your deserve. After all, some days, your workout might not happen because you are nauseous or tired and can’t do anything but vomit or sleep. Or while you may desperately want to eat eggs because they are rich in choline and protein, the smell of cooked eggs might make your eyes water and your stomach flip upside down. And pregnancy cravings? They can feel totally uncontrollable.

Do not worry! You can make choices that best fit your body and growing baby.

The typical physiological changes that occur during the first trimester include:

• Increased blood volume

• Increased heart rate

• Fatigue

• Breast tenderness

• Breasts feel fuller and heavier

• Headaches

• Increased urination

• Insomnia

• Vivid dreams

• Morning sickness (nausea and vomiting)

If you’re someone who experiences many of these symptoms either during the first trimester or throughout the whole pregnancy, your goal would be to simply to make it through while taking care of yourself and resting as much as possible. You may not feel like moving your body much, and if that’s the case, just do the best you can to exercise and move as much as you can. You may find that you can only get in one or two workouts in a week or even just a walk and that’s ok!

However, if you feel pretty good during your pregnancy, then you can exercise regularly.

Despite what you may have heard from well-meaning friends, and family members, exercise during pregnancy has many benefits! During pregnancy, you are training for one of the most physically demanding events of your life. You’d never try to run a marathon without any training, would you? So why not treat labour and delivery the same way? Exercise during pregnancy is very important!

Movement affects your body’s levels of hormones, neurochemicals, and endorphins to improve your mood and your psychological health, and may also help alleviate common pregnancy symptoms, provide opportunities for social engagement, improve your ability to recover from labour and delivery, attenuate excessive prenatal weight gain, and keep your body strong during pregnancy.

Maintaining good posture and alignment through exercise can help the baby sit in a position that allows for an easier labour and delivery experience. What’s more, physical activity during pregnancy can improve your ability to carry extra weight more comfortably.

During pregnancy, your body increases its production of a hormone called relaxin, which, as the name suggests, works to relax and soften the ligaments in the pelvis (as well as soften and widen the cervix). While this is very helpful in preparing your body for childbirth, it can lead to compensatory movement and overuse of certain muscles and muscle groups in some women, such as those in your lower back. Exercise, specifically, strength training, helps improve movement patterns and may reduce the risk of musculoskeletal injury during pregnancy.

Some women also find that exercise helps reduce or alleviate their nausea, fatigue, morning sickness, and headaches. However, this depends on how bad your symptoms are and should be evaluated on a case-by-case and day-by-day basis. Some women may find it helpful all of the time, while others may find it helpful some of the time. Still, others may find that it’s never helpful. However, you should never force yourself to exercise when you’re feeling awful.

When it comes to having a healthy pregnancy that sets you and your baby up for healthy days ahead, any exercise you do should encourage proper posture and alignment, increase strength and lean muscle mass, strengthen the core and balance the tone of the pelvic floor, develop a solid aerobic foundation, promote health levels of body fat, and yield health improvements without over-stressing the body.

Improve Posture and Alignment

Maintaining the posture and alignment is important for healthy living in general – helping to increase mobility, reduce everyday aches, and potentially minimise the risk of exercise injury – but it becomes doubly important when you’re growing a life inside you!

During pregnancy, maintaining good posture can help reduce the risk of lower back pain as well as muscle and joint problems that can accompany pregnancy. As your baby grows and your body changes, it may also help keep your baby in a desirable position, thus possibly affecting how labour and delivery play out.

Gain Strength

Having strong, balanced muscles and good overall stability helps relieve stress on your tendons, ligaments and joints. That is particularly helpful as your body changes and your tummy grows throughout pregnancy. And since building muscle takes time, your best course of action is to begin strength training (or adapt your current strength training programme to meet you pre-pregnancy goals) as early as possible.

Muscles that deserve particular attention during pregnancy include those of the upper back, anterior core and posterior chain including glutes, hamstrings and lower back. For instance, while a strong upper back is important to help support your breasts as they increase in size throughout your pregnancy, a strong core helps your body carry the growing weight in your uterus. During pregnancy, the weight of your growing baby pulls the pelvis forward. Strong glutes and lower back can help to keep the sacrum, at the base of the spine, in a more neutral position, thereby reducing irritation on the sacroiliac joint and unnecessary stress on the pelvic floor muscles.

Plus, once your baby arrives, you need to have the strength to haul around your baby and car seat and changing bag and pram and shopping etc. You need to be strong to perform these everyday tasks safely!

Maintain or Improve Body Composition

When pregnant, maintaining and even increasing your levels of lean, metabolically active muscle mass encourages healthy body fat levels and insulin responses, thereby reducing the risk of gestational diabetes.

Gestational diabetes affects as many as 9% of pregnancies and can lead to larger, harder-to-develop babies who have a greater risk of developing Type 2 Diabetes in later life. Also, once women develop gestational diabetes their risk of developing Type 2 Diabetes following pregnancy increases dramatically.

However, since it is not recommended that women try to lose weight or body fat during pregnancy, simply trying to stay strong can help you have the healthiest pregnancy possible.

Improve Core and Pelvic Floor Integrity

Good core and pelvic floor strength may increase your likelihood of carrying your baby in a good position and can help you feel stronger and more supported during your strength training and daily activities. Plus, it may reduce your risk of pelvic floor dysfunction, incontinence, and pelvic organ prolapse – all of which are common during pregnancy.

That said, strength is not the only factor in establishing a healthy pelvic floor. And, in fact, many times women have hypertonic (i.e. always “flexed”) pelvic floor muscles that need to be retrained to fully relax, so that they can fully contract when necessary.

Build a Good Aerobic Foundation

Your cardiovascular fitness refers to the ability of your lungs to provide oxygen to your working muscles and is a general marker of heart health. When it comes to preparing your body for pregnancy, good CV fitness is a must because once you’re pregnant, your heart and lungs are responsible for providing oxygen to two living beings!

Improving your aerobic fitness through CV exercise also increases your body’s ability to handle the physiological and psychological stress that comes with pregnancy. A good aerobic base is also linked to better quality sleep, which should be a big priority for your in this phase of life.

Lower Stress Levels

Most women know that pregnancy is stressful. You are experiencing a number of big changes in your body and life. Coping with these changes can be difficult for many women. Exercising and staying active during this time can help ease psychological stress and also help improve sleep, which is vital to handling stress in a healthy way.

How Hard Can I Exercise Now That I’m Pregnant?

You may have heard the age-old advice, “Just keep doing what you were doing before you were pregnant, but don’t start anything new”. While this isn’t exactly poor advice, it’s not entirely accurate.

If you were training before you were pregnant, you can absolutely continue now that you’re pregnant (while listening to your body of course). But even if you were not exercising before pregnancy, by all means, you can start exercising now – given that your GP and midwife have cleared you for exercise.

The catch here is that while someone who was training at a moderate to high intensity pre-pregnancy can continue training at that intensity throughout pregnancy. If you were sedentary pre-pregnancy, you should be exercising at a low-to moderate intensity throughout your pregnancy.

Research also shows that steady state, low-to-moderate intensity cardio is safe throughout pregnancy regardless of a women’s training state or previous bodyweight, meaning it’s fine to start exercising in pregnancy as long as your intensity is appropriate.

High-intensity cardio (including high intensity interval training) can have its place in pregnancy as well; but that exact place is very individual. Listening to your body is paramount, and pregnant should be viewed as a time to potentially maintain aerobic fitness levels, but not necessarily increase them, in already trained women.

What’s more, high intensity cardio in pregnancy is only safe in women who have regularly exercised at high intensities prior to getting pregnant. That is because previously trained women have a higher cardiac output (the amount of blood that the hear can pump out per minute) as well as higher VO2 max (the maximum amount of oxygen that can be taken up and used by the body’s tissues) during exercise.

Exercises to Avoid

Particularly from the second trimester (week 14), you want to avoid front-loaded exercises such as the front plank, push-up on the ground, and mountain climbers that place a lot of stress and pressure on the front of your tummy. These types of exercises may exacerbate the separation of your abdominal wall that commonly occurs in pregnancy (otherwise known as diastasis recti or DR).

Lying on your back....

In the past, it was advised women not to lie on their backs because the weight of the baby could press on and block the mother’s vena cava, the main vein that carries blood back to the heart from the lower body. However, more recently, some experts have stated that as long as you feel OK while lying on your back, and you don’t feel lightheaded or nauseated, and your breathing is not impaired during or after the bout of exercise or stretching, you should be fine to lie on your back, but avoid doing so for longer than 60 to 90 seconds.

Impact

I would also recommend that you start reducing higher impact exercises from around 14 weeks as your belly (and baby!) grows. The increased downward pressure on your pelvic floor is already increasing with the weight of the baby, and it increases exponentially when you perform high-impact exercises like running or jumping. These exercises are associated with an increased risk of injury in pregnancy, since pregnancy alters your centre of gravity.

Excessive impact can also contribute to pelvic floor dysfunction, incontinence, and even pelvic organ prolapse.

I hope you've found the above information helpful and please get in touch if you have any questions.