Working out during pregnancy

There's no disputing that staying as fit and active as you are able to during your pregnancy provides both you and your growing baby with numerous health benefits. Research has shown that regular exercise throughout pregnancy can help (not only Mama to) maintain a healthy weight but it can also help reduce the risk of baby being born at a significantly larger than average birth weight (known as fetal macrosomia). Staying fit and active will help keep your body strong and conditioned to help you avoid (or reduce the severity of) the aches and pains often experienced during pregnancy such as pelvic/pubic pain, sciatica and back pain. Other proven health benefits include improved circulation, lower blood pressure, improved bowel movements (goodbye pregnancy constipation!) better quality of sleep, reduced risk of gestational diabetes, improved endurance levels and breathing techniques and, ultimately, ensuring that your body is strong enough to get you through (and recover quickly from) the biggest workout of your life...labor! 

What's more, regular exercise during pregnancy can have a significantly positive impact on your mental health. During what is a highly hormonal and often stress/anxiety inducing time, regular exercise can help improve mood and energy levels by releasing 'feel good' hormones (serotonin and dopamine) and reducing stress hormones (cortisol). 

Practicing certain movements and stretches nearer to your due date can also help encourage your baby into an optimal birthing position, which can contribute to a smoother birth with less medical interventions; helping to bring your baby into the world calmly and positively. 

So, we all know how important regular exercise is during pregnancy but during a time of (hormone fuelled) physical, mental and emotional change, knowing what kind of exercise is safe and the most effective can often be very confusing. So here's our top tips for how to exercise safely and effectively during pregnancy:

• Listen to YOUR body as it changes through the different stages of pregnancy - every single woman has a unique experience during pregnancy so there is no point whatsoever in comparing yourself to your favourite celebrity or fitness influencer and trying to emulate their pregnancy workout routine. Yes, of course, take inspiration and ideas from others but always listen to how YOU are feeling physically and mentally on a daily basis and exercise accordingly. This will also change throughout the different stages of your pregnancy as your mind, body (energy levels) and hormones go on their wonderful pregnancy rollercoaster ride so be careful to review and adapt your exercise routine throughout each trimester as you feel is needed. It's common, for example, to struggle to exercise at all during the first trimester when morning sickness and exhaustion hits hard (and simply getting to and back from work is a win!) but then to feel much more energetic and ready to re-introduce exercise during the second trimester. During your third trimester, as baby grows and pregnancy hormones step it up several notches, your body can feel much less stable and any aches or pains (for example in your pelvis/pubic area, hips or lower back) can feel much more intense so it's really important to reduce/adapt your program accordingly. In the last few weeks before your due date, it's important to shift the focus of your exercise program from strength and control to release and relaxation; practicing slower, more gentle movements and stretches to help open the pelvis, release the muscles of the pelvic floor and encourage baby into an optimal birthing position and practicing slow, calming breathing techniques to prepare you for the marathon that is labor. 

• Stick with familiar exercise - pregnancy is not the time to try that brand new workout that's just launched or hit a PB in the gym; it's a time of massive hormonal and physical change and so it's really important to stick with exercise that your body is super familiar with. Pregnancy hormones (mainly Relaxin) help soften the ligaments of the pelvis and soften and widen the cervix in preparation for labor (very clever!) but, unhelpfully, they also make the ligaments and, therefore joints, in the rest of the body a lot less stable! So it's really important that you don't put unnecessary strain on your lax ligaments (which will in turn put strain on your joints and overload your muscles) with unfamiliar exercise and movement patterns. Our only exception to this piece of advice would be gentle, prenatal specific yoga and Pilates classes, which we highly advise trying during your pregnancy (even if you have never done Pilates or Yoga outside of pregnancy).

• Prioritise your pelvic floor - there has never been a more important time in your life than now to focus on learning correct techniques for strengthening your pelvic floor! The muscles of the pelvic floor are severely weakened during pregnancy; as the baby grows and the uterus becomes heavier, it is the pelvic floor that bears the weight and can drop as much as 2.5cm! This is made even worse by the labor process, especially if you have a prolonged labor with any unforeseen complications. However strong your pelvic floor may be, you're likely to notice that, as your pregnancy progresses, it becomes harder and harder to prevent the odd accident when you laugh or sneeze or (it happens to the best of us and usually when working out in our favourite, ever so slightly see through leggings!). If you already know how to activate and strengthen your pelvic floor then continue with your usual exercises and practice them daily (yes daily!)...you literally can't do enough Kegels! If you don't know what you're doing, go to a prenatal Pilates class or find a prenatal qualified PT or pelvic floor physio to work with. Learning how to relax and release your pelvic floor in the few weeks before your labor is also crucial for a smoother birth (with less risk of severe tearing!). Check out our pelvic floor conditioning blog post for our top tips. 

• Practice/learn breathing techniques - during early pregnancy, as the hormone progesterone is elevated (to allow your blood to carry more oxygen to your baby) causing you to breathe more often, it's common to experience breathlessness. As pregnancy progresses and the uterus grows and puts pressure on the diaphragm, it's also very common to experience breathlessness or to find it more difficult to breathe deeply. This is made worse by the postural changes that happen during pregnancy which, put even more pressure on the respiratory system. So, it's even more important than usual to focus on utilising correct breathing techniques during and after your workout to ensure you're circulating enough oxygen-rich blood to your muscles and aiding post-workout recovery. We recommend practicing slow (conscious) deep diaphragmatic breathing at the beginning of your workout before you start moving and then stopping regularly throughout your workout to check you are maintaining this deep breathing technique. Pilates and yoga classes can help you learn deep diaphragmatic breathing if you're not already familiar with it. It's also super important (in the lead up to your due date) to practice slow, meditative breathing techniques to help with endurance levels and to help you stay calm, focused and positive during labor. Staying as calm as possible during labor will, in turn, help with oxytocin stimulation (the love hormone that we produce during labor!) which can help with a shorter and smoother labor. 

• Take extra care with any pregnancy aches/pains - as frustrating as it can be (especially if you are usually super active and injury free) pregnancy hormones causing your body to be much less stable and the growing weight of your baby causing postural changes (as well as any previous injuries or weakness in your body) can cause severe physical issues during pregnancy. If you do suffer any severe pain/physical problems (such as Pelvic Girdle Pain, Pubic Symphysis, hip pain/sciatica, severe back pain) it's so important to listen to the advice of your doctor/physio/pregnancy healthcare providers and adapt your exercise program as advised. This is likely to mean exercising much more moderately and less intensely than you might be used to and can be very frustrating but it's so important for your long-term, postpartum physical (and mental!) wellness that you don't push through severe pain and risk causing long-term damage. Listen to your healthcare providers and listen to your body and take each day one at a time; adapt your exercise program (including lots of rest) as necessary. Try and remember that not every day will be the same and, even with severe pains, there will be some days when you'll be able to manage a gentle walk, stretch or swim but then you might need to completely rest for a day or two. 

• Abdominal weakening and separation (diastasis recti) - something that most women seem to worry about when they get pregnant is how to safely exercise without causing prolonged damage to their stomach muscles. Diastasis Recti (DR) is the separation of the outer abdominals (the Rectus Abdominals) down their centre line (the Linea Alba) which is something that happens naturally during pregnancy, as the baby grows. It happens to the majority of pregnant women (66% during the third trimester and 27% during the second trimester) and is a completely normal process that happens to accommodate your growing baby. Regardless of whether you get a DR or not, every woman will experience a certain degree of abdominal weakening as the muscle fibres are stretched throughout your pregnancy. This needs to be taken into consideration when adapting any abdominal work in your pregnancy workout programme. After around 16 weeks it's not advisable to do any active abdominal exercises (so say goodbye to moves like sit ups, ab crunches and planks) which actively use your outer abdominal muscles (the Rectus Abdominals and Oblique Abdominals) and encourage strengthening them when they're in a weakened/compromised state. This can potentially lead to abdominal coning/bulging and even abdominal hernias they look as gross as they sound - Google them!). It could also increase the severity and postpartum healing time of a DR. Instead, focus on exercises which strengthen the deeper abdominal muscles of the core (the Transverse Abdominals). Work with a Prenatal fitness expert or attend prenatal Pilates classes to learn how to correctly and safely activate and strengthen the deep abdominals of the core during pregnancy. It's important to note that (as with all pre-natal fitness guidance) exactly how and when you adapt your abdominal exercises may vary from woman to woman, depending on factors such as pre-pregnancy abdominal strength/condition, pre-pregnancy fitness experience, natural muscular anatomy and condition and the size and exact positioning of baby. So please do seek personalised guidance from prenatal fitness specialist, especially if you have concerns about a DR or any abdominal bulging/coning/doming.

• Consider your babies birthing position - during the last few weeks before your due date, include lots of gentle movements and stretches which can help encourage baby to move into the optimal birthing position (a head-down, Occiput-Anterior position where the front of the baby’s head faces your back). Work with a prenatal qualified Pilates/fitness specialist if you need guidance on this but lots of gentle pelvic tucks/releases in a four-point kneeling position as well as lots of pelvic movements (tucks/releases and circles/clocks) on the fitness ball can work well. Bouncing on the fitness ball, gentle squats and lots of walking can also help. However, after 35 weeks, if you find out your baby is in a breech position, it's important to avoid movements such as squats and bouncing which may encourage baby to engage in this breech position. Work with your doctor/delivery team and take their advice on how to best encourage baby to turn around into an optimal birthing position. 


• Exercise for your mind as well as your body! Pregnancy is a hormonal and emotional rollercoaster ride and a time of mega change, when things can often seem completely out of your control. It's very common to experience intense highs, followed by moments of feeling very low and/or anxious. So it's really important to adapt your workout programme to help you feel mentally strong and in control and not just focus on keeping physically in shape. How you feel mentally is likely to change on a daily basis and throughout the day. So, even if you have a prenatal fitness program, it's important to bear in mind that you'll probably have to see how you feel each day and then be flexible in adapting your program. Give your mind the love and kindness it deserves; if you wake up feeling a little down and overwhelmed one day, do whatever you think will make you feel better. That might be a high-intensity, fun group workout class (that really gets those happy hormones pumping) or it may be a super gentle yin yoga class with lots of calming, breathing. Or it might be gentle walk in the fresh air or a day of rest on the sofa! Listen to your own mind and body and be 100% honest with yourself about what you need every day throughout your pregnancy.

• Ask the experts! If you're scared or confused, seek professional guidance! Pregnancy, as incredible as it is, can be a really overwhelming and confusing time, especially if it's your first pregnancy or if you've experienced difficulties getting pregnant or suffered previous miscarriages. So, unless you're experienced in working out during pregnancy, get some professional guidance for your own peace of mind! Check that any personal trainer/Pilates/yoga instructor that you decide to work with is specifically prenatal qualified. Please take care in any large group classes; only attend prenatal classes/classes where the instructor is pre-natal qualified as much as possible and avoid large group classes (as it will be very difficult for the instructor to give you any time for pregnancy specific adaptions). One of the biggest concerns for most women (especially first-time pregnancies) is risk of miscarriage so we'd like to stress here that working out during pregnancy (so long as you are sensible and listen to your doctor/prenatal healthcare team) cannot harm your baby! Your baby is surrounded by fluid in the amniotic sac, which is nestled inside the uterus (which is surrounded by organs, muscles and then your physical body) creating a really safe, protective environment. If you're still really nervous during the first trimester, when risk of miscarriage is higher, we advise sticking to really gentle exercise such as walking, swimming, Pilates and yoga (usually better for morning sickness too!). After 12 weeks the risk of miscarriage drops to less than 1% and hopefully, you'll be feeling more confident to get back to your usual workout programme strong Mama!

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