Safe and Effective Exercises for a Healthy Pregnancy

Safe Exercise While Pregnant: Barbells and Babies?!

This has to be the most common question I receive on the topic of prenatal exercise, "what should I do- what's safe?"

Here's the whopper of an answer- it depends. Shocking, I know, but if you'll humor me for a bit, I'll attempt to narrow down what It depends on. I promise that by the end of this blog post, you'll have a better understanding of how to answer the question for yourself!

First, let's discuss why you might consider prenatal exercise as part of your pregnancy wellness regiment. First and foremost, exercise is one of the best practices you can partake in for improving your general health and wellness- why would we expect that to differ when we're expecting? Secondly, in case this is your first go of it and you've not interviewed your mom or friends who are moms about their experiences, birth is a marathon. No, really- the physiological demands on the body are quite literally comparable to running a full 26.2 mile race. You wouldn't skip training for an event like that (I hope), so it makes sense to train for this event as well. Another reason you might be exercising while pregnant is to get relief from pregnancy pain- low back, SIJ, pubic symphysis pain, lightning crotch and the like. Lastly, for those hoping to have a vaginal delivery, your pelvic floor muscles and the joints of your pelvic girdle must be robust and mobile. While stretching would typically be top of mind, training to have the capability of expressing strength and control through your full range of motion is a more fruitful and long-lasting way to achieve this goal. I like to call this "strength through length."

With the why out of the way, let's get to the real reason you're here- how do I know what constitutes safe exercise for pregnancy? To answer this, we first must discuss hormetic stress. I know what you're thinking- hormetic what? This term refers to how we get stronger in response to the appropriate dosage of a stressor. For instance- repeated ice baths can make an individual more capable of handling cold exposure as a stressor (not advocating a cold plunge while pregnant, to be clear). The catch is to get the dosage right. As a mentor of mine once said, "the difference between what's considered medicine and poison is often the dosage." The same is true for stressors like cardiovascular exercise and strength training while pregnant. If these stressors are applied at the correct dosage, we can expect to see improved cardiovascular fitness and increased muscular strength.

You might be asking yourself, "how do we know what the correct dosage is then?" There are three main things to consider when gauging the appropriateness of prenatal exercise. For starters, are there any pregnancy complications or known contraindications to/ precautions for exercising while pregnant? These are things your birth professionals should have diagnosed and explained such as preeclampsia, placental defects, gestational diabetes, cervical insufficiency, etc. In these cases, the risk may dictate what intensity of exercise is recommended, or if may even outweigh the rewards associated with exercise altogether. Another consideration is your previous level of fitness. What's appropriate for someone who was a world class athlete actively training just before conceiving is going to be a whole heck of a lot different than what's appropriate for someone who had never done any training at all prior to their pregnancy. The last way to know if the dosage is correct is to ask what kind of adaptation the exercise is fostering- positive or negative?

You'll know if the exercise is creating positive or negative adaptations by examining the status of a few key areas during and following the exercise. These areas include:

1. Health of baby

This one is fairly obvious. If exercising is causing harm to your baby, or to their development… time to consider dialing it back a bit.

2. Your cardiovascular fitness

If you're doing cardio while pregnant and notice improvement in your cardiovascular fitness subsequently, great! If, however, you notice decreased fitness and/or develop cardiovascular symptoms, not so great. All of that extra blood volume and cardiac load might be a good reason to take it easier here.

3. Your musculoskeletal health & strength

If you had any of the common aches and pregnancy pains and they get better or go away- this is obviously great. If what you had gets worse, and/or you develop new aches and pains… maybe not so much. If you maintain or increase your strength as a result of the resistance training you're doing- that would also be a positive adaptation!

4. Your pelvic health

Similar to the above, new onset of pelvic floor symptoms, or worsening of pre-existing conditions would be a no-bueno response to exercise. That'd include things like urinary incontinence and urgency, pain with intimacy, gas or fecal incontinence, constipation, incomplete bladder/bowel emptying, etc. If, however, you have no new or worsening symptoms, or if your previous symptoms ameliorate- awesome, keep on going!

TLDR:

Exercising while pregnant is recommended for most folks in order to optimize their pregnancy wellness and birth outcomes. Determining what kinds of exercise and at what dosage are appropriate is a highly individualized and somewhat complicated pursuit. I'd strongly recommend working with a pelvic health rehab professional that can help you both with optimizing your pelvic health AND with creating a bespoke pregnancy exercise regiment (though I'm admittedly a bit biased)