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Exercise While Pregnant - An Overview

BACKGROUND - Why Exercise?


Strenuous activity, including structured exercise, has been assumed for decades to be detrimental to the health and safety of parent and baby during pregnancy. Though as we collect more and more real data on this subject, it's proving to be the opposite. Continuing an existing exercise routine, or starting a targeted and thoughtful program while trying to conceive or at the beginning of a pregnancy will more often than not add to the health of the pregnancy and even prevent the occurrence of many weight, metabolic and hormonal illnesses that can occur during pregnancy.


The act of carrying a baby to term, and childbirth, whether vaginally or cesarean, is one of the most physically demanding processes we will ever experience. And then, after, our bodies must recover and return back to a relative pre-pregnancy state, be able to breastfeed if desired, and continue to carry and care for baby outside of the body. Regardless of how your experience unfolds, your body will be forever changed, and it can take 12 months or longer for that change to settle into a relative state of "normal".


You wouldn't hang out on the sofa in the months before running a triathalon? So why are we told to take it easy while we're pregnant?


Moving our bodies throughout pregnancy will help our bodies adjust to the physiological changes more readily. It helps keep our muscles relaxed and toned, and keeps our blood and lymph flowing. We already know exercise helps us feel good, look better, sleep better and keep the weight off during every other stage in our lives, and the same goes for pregnancy. Women who exercise while pregnant report less depression, even when only exercising two or three days a week. Additionally, safe and effective exercise can help prevent or manage gestational diabetes and excessive weight gain, can help increase or maintain muscle that helps stabilize our bones and joints, preventing some of the stress injuries endured during pregnancy weight gain, like sciatic and pelvic girdle pain, knee and back pain. An adequate amount of strong muscle and connective tissues around our joints can help counteract the effects of relaxin and other hormones that cause the loosening of our ligaments that is needed to accommodate a growing baby. Babies born to parents who exercise during pregnancy have better outcomes, may incur less birth trauma and are born at a healthy weight, and are less likely to develop obesity or other metabolic disorders of their own throughout their lives.

I ALREADY EXERCISE, but now I'm pregnant... What's next?

If you already had an established exercise routine of any kind when you become pregnant, it's unlikely that you will have to make any significant changes to your routine in the first trimester. Always seek guidance from your OB or midwife in regards to how your specific exercise program may affect your pregnancy, and whether any adjustments should be made and when. As your pregnancy progresses you may need to change what types of movements you perform, what type and how much resistance you use, how often or for how long you exercise for.

IS IT TOO LATE TO START?

NO! There's no wrong time to start an exercise program during pregnancy, but obviously the sooner you start, the more benefits you will receive long term. The first trimester often comes with a lot of big changes that may make motivation difficult - nausea and morning sickness, fatigue, and some joint instability being most noteworthy. Doing what you can and finding ideal times in your day where your symptoms don't interfere will help you maintain some forward momentum, but this is also a good time to begin learning to listen to your body and take it easy, or rest, when necessary.


Second trimester is often considered the "honeymoon period" when people feel their best during pregnancy. This is absolutely a time for you to increase intensity and resistance in your training. Developing strong muscles and cardiovascular endurance during this time will give you the skills to better endure the third trimester, and prep for labor and birth. If you were slow to start, obviously starting at a slow pace and working up to a relatively moderate intensity during this time will be best, but if you've been consistent with training before pregnancy and throughout the first trimester, don't hesitate to continue to ramp up your workouts. Take into account any modifications you may need to make to accommodate your belly and any other physiological changes, and consult with a professional who has the knowledge to guide you on the best safe and effective movements to help you keep going.


Third trimester is likely not the best time to start an intense training regimen, but it's also not a terrible time to start exercising to prepare for birth. Performing exercises that can help improve your mobility and help to activate your pelvic floor and deeper core muscles can help you to prepare for labor, and give you skills and a baseline to start getting back into moving and exercise in postpartum.

WHEN SHOULDN'T I EXERCISE?


Any unusual pain, or dramatic increase in the intensity of general soreness may be an indication of over-exertion. Any abdominal, lower back or pelvic pain or cramping should be closely monitored or overseen by an OB, and especially any accompanying bleeding or unusual discharge. Any movements that cause pain should be stopped immediately until reviewed by an experienced PT or trainer. Your OB or Midwife should always clear you to exercise, especially if you have any high risk conditions, are carrying multiples or have a history of pregnancy or birth complications, but the presence of many conditions is not an automatic disqualifier for exercise during pregnancy.

HOW DO I ADJUST?


During the first trimester, there aren't any significant changes that need to be made to the way you exercise, as long as you are comfortable. Once you begin "showing", it becomes more important to limit any exercises that put stress on the outer abdominal muscles, like crunches, sit ups and leg lefts, and shift your stance to help better balance you and accommodate any pelvic changes and your growing belly when performing squat and hinge movements. This will help you not only remain comfortable and be able to continue to move, but it will help to reduce the risk of the abdominal separation that naturally occurs from becoming dysfunctional in the long run (called diastasis recti). Being mindful of rotational movements as your body changes will also help prevent any injuries. Working with a trainer experience with perinatal fitness and pregnancy will ensure you get the most out of your exercise program, and your pregnancy.

In summary, please don't accept the narrative that rest and limiting exertion is necessary during pregnancy. It couldn't be more false. Thoughtful, intentional exercise can not only help prepare you for pregnancy, but it can help prepare you for parenthood and life after birth!

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