The purpose here is to present general training considerations and specific exercise guidelines for pregnant women who typically need modified workouts to maximize the conditioning benefits from their workouts and more importantly minimize injury risk.
Pregnant women can safely aerobic endurance exercises for improved cardiovascular fitness paired with resistance training for musculoskeletal fitness.
As a personal trainer, I incorporate a number of recommendations into exercise programs for this special population.
A pregnant woman may seek out exercise for a number of reasons, from feeling self-conscious about her changing body, wanting to have a healthy baby, wanting to stay in shape through every stage of her pregnancy, to be able to handle the rigors of labor and delivery or the need for additional social interactions and support during this new phase of adulting.
An expecting mum who exercises regularly may continue participating inappropriately adjusted sessions of physical activity to maintain cardiovascular and muscular fitness throughout pregnancy and postpartum.
Previously sedentary women may also benefit from regular exercise during pregnancy. As your personal trainer, my role is to provide you with a program and coaching that is consistent with your physical capabilities, additional support, motivation, and professional guidance.
Pregnant and still wants to exercise? Great! Start by consulting your doctor or primary healthcare provider before starting a new exercise program or modifying a current program.
In the presence of obstetric or medical complications, it will be important to have your doctor's input about every aspect of your exercise program.
Recommendations with respect to exercise during pregnancy relate to three key concerns or potential adverse outcomes.
Insufficient oxygen or energy substrates to the fetus.
Hyperthermia - induced fetal distress or birth abnormalities.
Increased uterine contractions.
The great news is that a properly designed fitness program, with a Certified Personal Trainer, should pose a very low risk for women with no complications.
Benefits of Exercise During Pregnancy
You can attain maternal health and fitness benefits, and subject your growing baby to minimal risk through following your physician's recommendations regards you and participation in a modified exercise program.
Benefits for expecting mums who engage in a properly designed prenatal exercise program.: (Adapted from the American College of Sports Medicine 2000)
enhanced cardiovascular and muscular fitness and function
faster recovery from labor
quicker return to pre-pregnancy weight, strength, and flexibility
reduced back pain during pregnancy
smaller postpartum belly
improved energy level throughout the day
Fewer obstetric interventions
the shorter active phase of labor and reduced pain
reduced weight gain
enhanced maternal psychological wellbeing that may reduce stress, anxiety, and postpartum depression
higher probability of adopting permanent healthy lifestyle habits
Getting you healthy first, is my first objective. A properly designed prenatal exercise program may be beneficial in the primary prevention of gestational diabetes. The effects of regular exercise on insulin secretion, insulin sensitivity, and glucose metabolism may improve glucose tolerance and thereby decrease the probability of developing gestational diabetes, preventing or treating physical discomforts, weaknesses, and lack of stamina.
In the absence of either medical or obstetric complications, exercise during pregnancy appears to be associated with many of the physical and psychosocial health benefits typically observed in pregnant women.
Accommodating Mechanical and Physiological Changes During Pregnancy
As your personal trainer, I follow these recommendations for accommodating the cardiovascular, respiratory, mechanical, ametabolic, and thermoregulatory changes experienced during normal pregnancy.
Cardiovascular Response
Pregnancy alters the relationship between heart rate and oxygen consumption, I use the rating of perceived exertion (RPE) scale to prescribe exercise aerobic intensity. an RPE rating on the original scale between 12 ("light" to "somewhat hard") seems appropriate for aerobic conditioning during pregnancy. There, however, is no universal this is it RPE for all expecting mothers, each program I give clients has to be individually tailored, and I encourage my clients to give continuous feedback to further adjust the exercise intensity or duration or both depending on how they feel on training day.
After the first trimester of pregnancy, the back lying (supine) position results in the restricted venous return of blood to the heart because of the increasingly larger uterus. this position reduces cardiac output and may cause supine hypotensive syndrome.
Consequently, as your trainer, exercises performed on the back will be phased out before the second trimester. These include some of your favorites, abdominal curls/crunches/situps, bench presses, supine exercises on the medicine ball, and stretching exercises with your back on the floor.
As an alternative, I teach a modified curl up with your belly properly splintered for safety and support, along with exercises in the crawling and side-lying position.
I use bilateral plate loaded equipment for my clients at Tiger Athletic allowing for almost every part of your body to be safely conditions in the standing or seated positions only, this is particularly beneficial because of the changes in the center of gravity later on in your pregnancy that may affect balance and proprioception increasing the probability of injury.
Respiratory Response
Expecting mums may increase their minute ventilations by as much as 50%, resulting in between 10% to 20% higher oxygen utilization at rest.
As a result, there will be less oxygen available for aerobic activity. Additionally, as the pregnancy progresses, the enlarging uterus interferes with diaphragm movement, increasing the effort of breathing and decreasing both subjective workload and maximum exercise performance.
As your personal trainer, I adjust an expecting mum's exercise program to avoid training at high levels of fatigue, reaching physical fatigue, or volitional failure.
Mechanical Response
As the uterus and the breasts become larger as the pregnancy advances, a woman's center of mass changes, this may adversely affect her balance, body control, and movement mechanics. Consequently exercises requiring balance and agility are carefully prescribed, special attention to activity selection during the third trimester of pregnancy.
Although my personal training programs are designed to strengthen all major muscle groups, which is very important, I emphasize abdominal and pelvic floor strength because these muscles provide the basis for postural support and prepare mum for delivery.
For example, strengthening the transverse abdominis, which is the deepest abdominal muscle located underneath the rectus abdominis and obliques, helps to support the lumbar spine and prepare a woman for the pushing stage of labor.
Metabolic Response
The need for more oxygen during pregnancy is parallel with the need for more energy substrate. Expecting mums typically use an extra 300 calories per day to meet the increased metabolic requirements for homeostasis of their expanded life function.
I advise clients to attain an adequate intake of carbohydrates - rich foods through a balanced but expanded nutritional program. Talking to your doctor or having me refer you to a registered dietician is the best first step in you providing your body with the best possible nutrition for the best possible outcome both in the gym and with your beautiful baby.
Thermoregulatory Response
Pregnancy elevates an expecting mum's basal metabolic rate and heat production, which may be further exacerbated by exercise. This most likely happens in the first trimester of pregnancy. I advise pregnant clients to facilitate heat dissipation through adequate hydration, appropriate clothing, at Tiger Athletic we have more windows than walls and massive air conditioners so we can create an optimal training environment for each client.
If a client feels overheated or fatigued during an exercise session, I recommend decreasing the exercise intensity and beginning the cooldown. Severe headaches, dizziness, and disorientation are indications of potentially serious conditions that require referral to your or the closest medical facility.
Contraindications for Exercise
Expecting mothers, without obstetric or medical complications can continue to exercise during pregnancy and rive related health and fitness benefits.
However, certain conditions present contraindications to exercise:
(adapted from the International Federation of Gynecology and Obstetrics 2000)
Pregnancy-induced hypertension (preeclampsia)
Ruptured membranes
Premature labor during the current pregnancy
Persistent bleeding after 12 weeks
A cervix that dilates ahead of schedule (incompetent cervix)
Significant heart disease or restrictive lung disease
Multiple-birth pregnancy creates the risk of premature
A placenta that blocks the cervix after 26 weeks
As your personal trainer, I recommend the following relative contraindications, should be evaluated by your doctor or healthcare provider before participating in an exercise program.
(adapted from International Federation of Gynecologists and Obstetrics)
Poorly controlled type 1 diabetes, seizures, hypertension, or hyperthyroidism
Extreme obesity
Extremely low body weight (BMI < 12)
Historically sedentary lifestyle
Unevaluated maternal cardiac arrhythmia
Severe anemia
Heavy smoking
Chronic Bronchitis
Orthopedic limitations
My job as your trainer is to place your health and safety before all things. Any of the following conditions are a reason to discontinue exercise and immediately seek medical advice.
(adapted from the American College of Sports Medicine)
Any signs of a bloody discharge from the vagina
Any gush of fluid from the vagina
Sudden swelling of the ankles, hands, or face
Persistent, severe headaches, visual disturbance; or inexplicable bouts of fainting/dizziness
Swelling, pain, or redness in the calf of one leg
Elevation of pulse rate or blood pressure that persists after exercise
Persistent contractions (6-8) per hour that may suggest premature labor
Inexplicable abdominal pain
Insufficient weight gain (less than 1 kilogram per month during the last two trimesters)
Exercise Guidelines
The following are guidelines from the American College of Obstertricians and Gynecologists. These guidelines apply to expecting mothers who don't have additional risk factors for adverse maternal or prenatal outcome (adapted from Inernational Frderation of Gynecology and Obstetrics, 2002)
30 minutes of exercise on most, if not all the days of the week
Avoid exercise in the supine position (on your back) after the first trimester
No weight bearing/Low impact activities such as cycling/swimming are favoured for reducing injury risk and continuing physical activity throughout pregnancy
Exercises that present even potential for even mild abdominal trauma should be avoided.
Activities that have a high risk for loss of balance/falling should be discontinued prior to the third trimester
Large increases in body temperature should be minimized through adequate hydration, appropriate clothing and a safe, spacious training floor free of obstacles and tripping hazards
Many of the physiological and morphologic changes of pregnancy persist 4 to 6 weeks postaprtum, so mums should resume pre pregnancy exercise programs gradually after giving birth.
General Exercise Guidelines For Pregnant Women
Consult your healthcare practitioner before starting a new exercise program
Exercise at a comfortable level where you can have a conversation
Donnot exercise if you have a fever
See your healthcare provider if you experience bleeding, a large amount of discharge, or swelling in your face and hands
Avoid lying on your back after the third month
Avoid straining or stretching to the point of discomfort
Wear appropriate clothing and dress in layers
Use well maintained equipment
Stay hydrated throughout the day not just at gym
Avoid exercising in hot/humid conditions
Avoid training to the point of exhaustion/failure/overtraining
Tiger Athletic
Tiger Athletic Fitness & Conditioning is my private, appointment only strength & conditioning gym in the heart of Sandton. Our personal trainers are health and fitness professionals who use an individualized approach to assess, motivate, educate, and train clients. We design safe, effective, fun exercise solutions for in-person and online personal training clients.
Our ‘Fit for Life’, health first approach helps us to help you reach your goals safely and effectively through health and fitness assessment, best in class coaching, modern resistance, and cardio equipment, calisthenics, and boxing to provide a pragmatic, extraordinary 50-minute workout that is simple, efficient and effective.
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