Guide To Prenatal Exercise For Every Trimester
Is It Safe To Exercise During Pregnancy?
Our understanding of exercise in pregnancy + postpartum has come a long way in the recent years, and we are much more likely to treat the “normal” pregnancy as a normal physiological process – not a disability.
We always recommend a pregnant woman to seek clearance from a healthcare provider before starting or maintaining an exercise program. This is because each woman’s circumstances need a tailored approach. Despite this, in the presence of a routine, healthy pregnancy, staying active does wonders for both your own, and your baby’s health in many ways.
However, in the presence of a routine, healthy pregnancy staying active does wonders for both your own, and your baby’s physical, emotional and intellectual wellbeing.
The World Health Organisation (WHO) recommends a woman between the ages of 18-64 participate in 300 minutes a week of low-to- moderate intensity exercise each week, or 150 minutes of moderate intensity exercise each week.
It may come as a surprise that this doesn’t change when a woman falls pregnant (in a normal, healthy pregnancy).
We used to say “don’t start anything new” in pregnancy, in terms of activity. We now recommend that a previously inactive woman actually START moving, and build up gradually over the course of the pregnancy to meet the minimum recommendations by the end of the pregnancy.
This might be as simple as a 10 min walk daily, that builds gradually. Other great beginner exercises include indoor biking, prenatal pilates or yoga.
Why Exercise During Pregnancy?
For the normal, uncomplicated pregnancy, consider the type of exercise that provides physical and mental benefits to your wellbeing, without overly stressing your nervous system, joints, and energy levels.
Impact activity such as running is fine to continue in early pregnancy, but as your pregnancy progresses, there is increased laxity of your ligaments as well as the increased load on your pelvic floor, which is worth considering – not to mention it becoming increasingly uncomfortable.
My biggest advice is to take a common-sense approach. Be well hydrated, well rested, well fed and stay out of extremes of temperature (keep cool).
Low impact activities such as walking, swimming, stationary cycling, weight training, pregnancy-specific yoga, and pilates are safe throughout the whole of pregnancy.
I recommend staying off a traditional road bike and away from team or contact sports, for mitigating the risk of contact & impact injury to yourself or your baby, as well as a sudden change of direction being too straining for your ligaments & joints during pregnancy.
Impact Of Exercising On Your Baby
Regular exercise appears to improve your baby’s’ ability to deal with intermittent changes in uterine blood flow + oxygen delivery that are part of everyday life.
Your baby’s heart rate will increase during the exercise session and decrease at the cessation of the exercise session. The magnitude of increase in the baby’s heart rate is proportional to the effort, stress and exercise intensity, and so should be taken into consideration.
Your baby may be better able to cope with the transition to life in the outside world, being used to some level of physical stress. According to Clapp (2012) “Newborns of exercising mothers don’t have trouble adapting to the transition to life outside the uterus, and are alert and easy to care for.
The sound and vibratory stimulation increase the baby’s brain development.
According to Clapp (2012) babies of exercising women have a slightly higher intelligence scores at 1 year.
The American College of Obstetrics & Gyneacology (ACOG) report that activity in pregnancy does not increase your risk of miscarriage, low birth weight or early delivery.
When a pregnant woman beyond early second trimester lays on her back or right side, the weigh of her baby can put pressure on some of the returning veins to the heart. This can mean reduced blood flow to both herself and her baby. She will usually feel dizzy, nauseous or out of breath, and have the feeling to need to change position.
For this reason, pregnant women should avoid back lying positions during exercise as much as possible. Standing still for too long can also make it harder for bloor to return back to the heart, and can make a woman feel faint, and so is also best avoided for prolonged periods of time.
Best Exercises For Expecting Mothers
There are so many great ways to move when pregnant, and you shouldn’t be afraid to continue your usual activities (with some exceptions) but with less intensity and load, and avoiding anything that involves impact, high speed or contact sports.
Prenatal yoga, pilates, light weights and bodyweight exercises, stationary cycling and swimming are my pick in this period.
If you were an avid runner before falling pregnant, there is nothing to say you can’t continue to run at a reduced intensity & duration during pregnancy.
However, I recommend not continuing too long into your pregnancy, as the weight of your baby and changed weight balance places lots of pressure on your pelvic floor, and we want to avoid adding to this!
I usually recommend to cease running by early in the second trimester, and replace it with cycling indoors, cross trainer or walking for cardio exercise.
Cycling indoors can be as beneficial as running for cardiovascular without the pelvic floor or joint load
This is another go-to pre-natal exercise. Highly recommended for a full body workout without any pressure on the joints
Strong core & glutes for an easier pregnancy as your belly expands and places increased pressure on your joints
Relaxing yoga poses and breathing exercises to help you through the different emotions you experience during pregnancy
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Safe Exercises For 1st, 2nd & 3rd Trimester
When I think of the first trimester, I think of morning sickness, extreme fatigue, and for many women uncertainty about what they should be doing that is safe in terms of exercise.
In my own experience, gentle exercise can help to improve both energy levels and morning sickness. When women feel empowered to move in a safe way, their experience in the early part of pregnancy is more positive.
However, the most important thing is to listen to your body, and if it is impractical and you don’t feel well enough to exercise in the first trimester of pregnancy, please don’t beat yourself up!
If you are able to be active, great news!
Try to stick to your usual routine (unless you are a professional athlete & training more than an hour a day of moderate-vigorous intensity. Athletes should seek guidance from their care provider about appropriate volume modification).
Try to listen to your body, make adequate time for rest, hydration and ensure you stay appropriately cooled.
Hot yoga is on the list of “not-to’s”, especially during the first trimester.
Luckily, the second trimester is dubbed the “feel good” trimester, and for most women morning sickness subsides or reduces.
Your bump is growing, but not big enough for you to be too uncomfortable. This is a great time to get back into a healthy exercise routine. Regardless of your pregnancy experience, it is always advisable to consult your doctor or caregiver with regards to exercise.
The most important thing if you haven’t been able to exercise during the first trimester is to take it easy, and slowly build up.
Start with 15 minutes of walking or other light familiar exercise and see how you feel. Prenatal pilates or yoga are fantastic to really get you in tune with our body, and breath, which is so important for labour and delivery.
Regular gym goers may get back into prior gym activities, but its best to work with a prenatal qualified instructor, or stick to basic, light weights and machine-based lifting. Reduce the mount you life to no more than 60% of your pre-pregnancy weights, and this will reduce as your body weight & size of your bump increase.
The hormone, Relaxin is circulating well in the body at this point, and means that there is more softness to your ligaments than usual, particularly around the pelvis. For this reason, I tend to recommend shorter and narrower stance (length apart front to back) and avoiding weighted single leg exercises.
For obvious reasons, early in the second trimester, you will reach the point where its no longer comfortable to lay on your stomach, and so finding alternative positions is important.
Movements that compress your abdomen (i.e. sit-ups) should be avoided from early in pregnancy, to avoid squashing your growing baby and overworking the large abdominal muscles which are prone to separating as your bump grows in pregnancy.
Running will become increasingly uncomfortable, and as much as its safe for you and your baby at low intensities, there are less straining cardio activities that are beneficial for both, your pelvic floor and your joints.
Avoid laying on your back if uncomfortable, as mentioned previously, as there is less blood flow to both yourself and your baby when back-lying and right-side lying.
Much like the second trimester, you will be modifying some positions and exercises to allow for the changing nature of your body and bump.
Due to increased weight and change of your centre of gravity, your balance becomes more challenged than it was before becoming pregnant.
Anything that may be too challenging on your balance should be avoided or supported with a hand on the wall or a bench, and yoga and pilates positions will need to take a wider stance to make room for your bump.
Kneeling on all 4s seems to be a common position for butt and core strengthening in pregnancy and has its place – but as the weight of your bump increases, consider only short periods of time in this position or removing it all together.
Your expanding bump places increased pressure on the pelvic joints, and can cause discomfort in this (and many other) shapes. When moving from lying to sitting, (i.e. getting up out of bed) it is advisable to roll to your side, and prop yourself up from this position by swinging legs over the bed.
This helps to avoid placing to much pressure on your abdomen and the tummy muscles which are prone to separating as your bump gets bigger.
If you haven’t already been performing Kegel, or pelvic floor exercises, now is a good time to set good habits for postpartum. I believe pelvic floor needs to be functional, and mimic what you need to be able to achieve as a new mother. It’s great to get into the habit of lifting & squeezing your pelvic floor whenever you need to do something that is even slightly straining – lifting, pushing, going from sitting to standing.
Moving from sitting to standing is a key action to master with pelvic floor and a great way to learn to co-ordinate pelvic floor and breath together. Use your exhale breath to lift your pelvic floor, and inhale breath to release.
If you must lift something heavy, cough, sneeze, push a heavy pram up hill- these are all great times to get into the habit of protecting your pelvic floor with strengthening exercises.
With regards to general exercise, “training” should start to give way to “preparation for birth.” By this I mean to stay active, but with a focus on positive movement and mental preparation for building faith that your body is designed to make and deliver babies, rather than exercising at great intensity.
By the third trimester you should definitely be on low impact movement, (think walking rather than running and jumping).
You may be dizzy at times, especially in first and third trimester due to all of the changes happening in your body, so take your time to move positions or get up from sitting and lying to standing.
Download A Free Research-based Pre-Natal Exercise Guide
Written by an experienced physiotherapist & mother, Rosie Dumbrell – For first time mothers, pregnant women and health professionals
Back & Pelvic Strengthening Exercises For Pregnant Women
So much about our bodies change as we go through the pregnancy journey. Back pain is common in pregnancy, due to weight gain, as well as the changing centre of gravity.
Our growing bump and breasts move our centre of gravity much further forward, which means more pressure on our spine.
Luckily, there are many ways that we can reduce or avoid back pain in pregnancy!
We know that staying active is key to avoiding unhealthy weight gain and maintaining good strength and range of motion in pregnancy. The World Health Organisation (WHO) recommends that a pregnant woman exercise the same amount as a non-pregnant woman of the same age. This amounts to 300 minutes of low to moderate activity per week, or 150 minutes of moderate activity each and every week.
We often blame hormones, (particularly the hormone, Relaxin) for our niggles, but Relaxin actually peaks at around 12-16 weeks in pregnancy, and back pain is most commonly felt from week 18 onwards.
Relaxin is responsible for a degree of softening of our ligaments to allow for childbirth, but I want to reassure you that your pelvis isn’t “unstable”, and so we want to move away from thinking and talking about it in this way.
We also know that women of higher socio-economic status and have low job satisfaction have higher rates of lower back pain.
For a pregnant woman with general back pain, the type, intensity and duration of exercise may change. But, we still want to be active as much as we can each day; balancing with adequate rest, of course.
Yoga, swimming, prenatal pilates and light functional strengthening exercises, particularly for the butt and core are key to help prevent and relieve back pain in pregnancy, and should be included in your weekly routine.
Other ways to reduce back pain are:
- Wearing supportive shoes (and avoiding high heels)
- Avoiding prolonged sitting, changing from sitting to standing or taking regular standing. Walking breaks if you have a sedentary job
- Doing some simple postural + functional strengthening exercises to improve posture
- Wearing support garments + a supportive bra (like our gazelle + ultimate support)
- Sleeping with a pregnancy pillow, like the belly bean, or at least a pillow between your knees to assist in neutral pelvic and spinal alignment
- Addressing any concerns you have around work, returning to work + having a plan in place
- Addressing any concerns you have around childbirth, courses that encourage you to take control of your birth choices such as hypno-birthing and calm birthing can’t come highly enough recommended
Some discomfort is normal, as your body adapts and grows to housing another human being.
By staying positive, active, and making plans around work and birth, you actually can have an amazing back-pain-free pregnancy.
We hear a lot about how we should strengthen our pelvic floor AFTER having a baby, but what about during pregnancy?
Research suggests that pelvic floor strengthening during pregnancy can help with reduction in both incidence & symptoms of Stress Urinary Incontinence in early motherhood. So how do you correctly strengthen the pelvic floor?
The key to pelvic floor and core strengthening lies in understanding your anatomy, timing & coordination with the breath, as well as avoiding excessive load, beyond what you can control your pelvic floor and core.
On an inhale, release the pelvic floor, and on an exhale draw the muscles from your coccyx to pubis, and then add an additional lift. Think zipping up from front to back, and then up internally towards your spine. You can think of it like the muscles you would use to prevent passing wind, then urine, and then adding an additional lift. Release these muscles on an inhale breath and repeat.
You can build up to holding the pelvic floor contraction over several breaths (i.e. not releasing on the inhale, but holding for 2,3,4,8 breaths, and then releasing.
It’s important to note, that overactive pelvic floor is just as common as under active, or weak – and so we also need to work on “down training” the pelvic floor, and especially in child birth – we want a strong, but not overactive, pelvic floor.
To work on down-training, exhale to engage pelvic floor, and then release on the inhale, and then continue to release on subsequent 3-4 breaths without the contraction on exhale. Each inhale try to soften and release this area more. Try one exhale per pelvic floor lift to 5-8 inhale &release breaths.
Once you have mastered the pelvic floor activation or “kegel”, it’s time to think about functionality, and how to implement such activation throughout your daily activities.
When going from sit to stand for example, using an exhale breath & pelvic floor lift, when squatting, when lifting anything, exhaling on exertion (not ever holding your breath though!), and carrying this breath pattern through into motherhood.
9th Month-Exercises To Prepare For Birth
I can’t recommend highly enough to consider moving your body and attending to your mind, in preparation for birth.
We want to encourage strength in pregnancy to give us strength and stamina in labour and birth, yet we also want to encourage softness and openness, a stress-free environment for your baby to grow within. All of these will help your baby to arrive with as much ease as possible when the time comes.
Women will spend up to 2 years planning their wedding, but scarily, won’t give much thought at all to their baby’s birth.
Preparing for birth – whether things go 100% to plan on the day – gives you a sense of empowerment, confidence and an understanding of your choices leading into this important day.
My midwife once said to me that women will spend up to 2 years planning their wedding, but won’t give much thought to their birth.
We need to educate ourselves, train and plan for this day in many ways, to give ourselves the opportunity for an empowering and positive birth.
Mindset, confidence in your body, confidence in your care provider and birth environment, and being flexible with your birth plan are all key to working towards the birth you desire.
There are even “gentle caesareans” nowadays, where if you have to go down this route for one reason or another, you can still have a gentle and empowering experience for you and your miracle.
Hypno-birthing, Calm birthing, and courses of this nature, as well as working with a birth support person such as a midwife or doula, are the best “exercises” I can recommend to prepare for birth.
On a physical level, staying strong through your legs and core through prenatal yoga or Pilates can help prepare you for the rigours of labour and motherhood.
Pelvic floor exercises are vital for both strengthening and releasing purposes.
Remember to also exercise with Kegels and do functional activities such as stand, squat, any lifting, pre-tensioning when you cough or sneeze, are all so important.
As we near closer to birth, we want to create more space in our hips and perineum, rather than just strength.
Stay calm, maintain being at ease and surrender… Perineal massage, pelvic floor release exercises (focusing on relaxing and letting the pelvic floor go or soften), and getting ourselves into the relax and digest and parasympathetic nervous system should be your focus.
There are so many amazing yoga poses and positions that can also help with preparation for birth and assisting your baby’s position.
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