How to prepare your body for the physical demands of pregnancy & birth
Pregnancy and birth are some of the most physically demanding life events a
woman may go through. Preparing your body for growing life for almost 10 months
inevitably ending in birth to a human is a lot to absorb. Getting your body strong for the
entire process of pregnancy and delivery is one of the most important things you can do
for yourself and your unborn child. Pregnancy affects all of the body systems from
respiration to digestion, and movement can not only make these systems run more
efficiently but will also help you have an easier pregnancy, birth, and postpartum. The
type of movement you do during pregnancy may affect you during your postpartum
recovery and beyond.
Historically, exercise during pregnancy has been viewed in different ways
depending on the culture or necessity of movement to the woman. It's amazing to think
that women have been naturally moving throughout pregnancy since the beginning of
time. Some cultures view pregnancy as a sacred time where a woman should not move at all.
While in others, women have to move throughout pregnancy based on their situations.
Fast forward to current times and culture where we understand more about the anatomy
and physiology of pregnancy and childbirth. We (the medical and fitness community)
better understand how specific types of movement can potentially help a woman have
an easier pregnancy, delivery, and recovery. If you attempt a Google search or ask your
OBGYN which type of exercise(s) is most beneficial during pregnancy, chances are you
will get a range of answers. Although OBGYNs understand the anatomy and physiology
of pregnancy and birth, their understanding of specific exercises to perform for best
results during pregnancy is often limited.
Let’s take a closer look at the types of exercise that are recommended during
pregnancy, the duration and frequency these can or should be practiced, and
movements to avoid.
Beneficial exercises during pregnancy
When you are about to start exercising during pregnancy, an
important question you'll want to ask yourself is “will this exercise or movement benefit me during my pregnancy and help me avoid pregnancy-induced pain or help me prepare for birth and recover from birth?" Movements that accomplish this are going to help you feel better, potentially have easier childbirth, and speed postpartum recovery.
1. Strength training
This is one of the best ways to prepare for birth, improve function during
pregnancy, and hopefully add to a faster recovery from childbirth. Strength
training can be in different exercise styles or formats. It can be movements using
body weight-free weights or machines. When determining how much resistance or weight
to use, it is best to test out different levels of resistance and make sure when
you're performing a strength exercise you are not putting added stress on the
abdominals. Also, while lifting, using proper form and avoiding movements that
cause you to hold your breath or “bare down” is important. Strength training can be done in a
variety of formats like pilates, yoga, or barre work. Just be aware that not all
pilates and barre exercises are comfortable or recommended during pregnancy
or postpartum (see below). Strength training can be done by repeating one
exercise after another in a circuit format, it can be done in timed intervals and it
can be done by muscle group. There are many ways to get strength training
incorporated into your exercise routine. We know that strength training builds
muscle, improves stability, and reduces pain and injury, all-important for this time
in your life.
2. Primal movements
Primal movements are similar to strength training exercises and can be used in conjunction
with strength training exercises. Primal or functional movements are simply movements that benefit your everyday life and help you perform and reduce injury as you are mimicking your everyday tasks. When you are pregnant this becomes more important, as your stability, balance, and posture are compromised. Primal movements include:
We perform these movements daily subconsciously and incorporating them into
our strength training routine is necessary to avoid injury and continue to build on
realistic movement. Think about all of the things you do as a mother-to-be,
bending, lifting, and moving in non-conventional ways without thinking about it!
3. Pelvic floor “centric” exercises
This muscle group, often misunderstood, is the most important area to focus on
when preparing for birth. This is another very important component that will keep you
strong and prepared for childbirth, and reduce the chance of a variety of pelvic floor dysfunction. Learning how to engage and connect with these muscles may require some visualization and diaphragmatic breath techniques internally. Externally, some examples of these exercises include pelvic tilts, bridging, and clamshells to name a few. These exercises are
mostly easy to do in any phase of pregnancy. As mentioned earlier, if anything does not feel good or a position is not comfortable, please do not do it or stop immediately.
4. Cardiovascular exercise
Cardiovascular exercise is important to incorporate into your exercise routine
and comes with many benefits from endurance to circulation. What types of
cardiovascular exercise, the intensity, frequency, and duration do matter. Most
doctors may give recommendations to walk because, for most people, walking is
low risk and can be done anywhere with no special equipment. One of the only
issues with prescribing walking during pregnancy especially towards the third
trimester is walking can create subconscious postural distortions. In the third-trimester
women tend to externally rotate their femurs (the duck waddle). When you are walking
in this position you are potentially creating a chain of compensation that may create
injury from compensating on muscles not meant to be used. It is very important that when walking you listen to your body, observe and feel your body especially as it gets tired, and make sure you aren’t rounding your spine or rotating your feet. Usually, any compensation
will go into the lower back which is a sign you may be walking with improper form. My
additional advice is to keep walks under 30 minutes and make sure you do an
extended warm-up and stretch at the end of the walk. Walking 3-4 days a week is
ideal and I would not advise more than that.
The next recommended type of cardiovascular exercise is swimming. Unfortunately,
depending on where you live, it may be difficult to swim. If you have access to a pool
and can swim, I highly recommend it. Swimming is an amazing nonimpact form of exercising.
Finally, the last type of cardiovascular exercise recommended is biking. Because of the risk
of falling and or the positioning, I recommend a recumbent bike where your low
back is supported, especially in the latter part of the 2nd trimester and throughout
the 3rd trimester. Like walking, I would also suggest no more than 30 minutes, 3
days a week.
5. Flexibility and stretching
Many women want to know more about flexibility during pregnancy because
some stretching movements can provide physical relief. During pregnancy,
women may become hyper-mobile due to the increase of the hormone Relaxin in
the body. This may create more elasticity in the joints, which can potentially be
concerning with range of motion and injury. In fact, more hyper-mobility may
create more instability and weakness in certain areas of the body like the
connective tissue, and thus create more tightness in the surrounding soft tissue.
Bottom line, while stretching or participating in yoga or similar, be mindful of the
range of motion and careful not to “overextend”. Seek out classes or instructors,
that work specifically with prenatal women.
Exercises to avoid during pregnancy
Now that we've discussed beneficial exercises for you during pregnancy,
it’s important to define the exercises that are viewed as risky or potentially harmful.
1. Any exercise or activity where there is a risk of falling (i.e. skiing, horseback
riding, etc) or trauma to the belly (i.e. kickboxing or sparing).
2. There are many different views on spinning and running. I believe spinning in
small amounts and staying seated or “in the saddle” is not putting your body
at risk for injury as long as it’s done at moderate to low intensity, The same
applies to running. I know some athletes run throughout their pregnancies
with no complications. For women who are not trained runners, my concern is
the long-term effects running will have on the pelvic floor, so I advise avoiding
3. Any movement that creates “intra-abdominal” stress or tension. The pelvic tilt
may create some tension but forward flexion like in the case of a sit-up or
static plank may put too much pressure on the Linea Alba or the ligament that
connects the right and left side of the abdominal wall. When pregnant and
postpartum, consider rolling to your side before sitting upright as that too will
have similar effects.
Seeking fitness professionals like myself may also not be easy, so please always
proceed with caution especially if you have not been exercising. Staying strong during
your pregnancy will not just benefit you in the short term but it will hopefully prevent
long-term effects of pelvic floor dysfunction that may disrupt your quality of life as you
age. The ACOG officially recommends that ALL women exercise during their
pregnancies, with the exception of some contraindicated medical conditions.
For a list, please visit www.ACOG.org.
Danielle Spangler is the creator of Core MOM (Corrective Obstetrical Related Exercise), a program that focuses on functional movement combined with diaphragmatic breath work and pelvic floor exercises that help women prepare for childbirth. She has specialized in prenatal and postpartum fitness for almost 30 years. As a prenatal master trainer at Sports Club/LA, Danielle wrote a continuing education course on prenatal fitness for the National Academy of Sports Medicine® (NASM) in 2005. In addition, Danielle owns a Pilates studio in Redondo Beach, CA, and serves on the education advisory board for the Medical Fitness Network. Danielle has created two other continuing education courses, one through Fitness Learning Systems and the other through Med-Fit. Danielle holds a bachelor's degree in kinesiology and has earned a certification in applied functional science from the Gray Institute.