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Exercise and Pregnancy – Fit for Two
Something was clearly bothering Diane. “I think I’m going to have to stop exercising,” she sighs. As her personal trainer, I was appalled by that statement. After all, she has made amazing strides in her training and has truly redefined her physique. After a pause, she continued: “I just found out that I’m pregnant…”
Sadly, many women still believe that pregnancy requires a sedentary lifestyle. To make matters worse, some people continue to train during pregnancy without understanding the contraindications to exercise. This can seriously jeopardize their own health and well-being, as well as that of their unborn child. There is so much misconception and lack of information about training during pregnancy that many gynecologists are not even sure how to properly advise their patients on this subject. However, when implemented properly, an exercise regimen can offer pregnant women many benefits and few downsides.
As a personal trainer, probably the most common complaint I hear from women is their inability to shed the extra pregnancy pounds they gained. During pregnancy, a woman goes through many physiological and hormonal changes that alter her metabolism and body shape. Gaining 50 pounds postpartum is commonplace, and most people aren’t prepared for the event.
While it’s certainly possible for women to reshape their bodies after pregnancy, the best way to counteract postpartum weight gain is to stay in shape during pregnancy. By sticking to an exercise program, women can almost regain their original shape shortly after giving birth. In addition to the short-term calorie-burning effects associated with an exercise program, a disciplined training program can also increase muscle mass. This in turn increases the body’s resting metabolic rate, which helps to burn extra calories consistently – even while asleep!
Additionally, adopting an exercise routine can help boost energy levels and reduce pregnancy-related fatigue. It’s not uncommon for a woman to sit at home all day, feeling unattractive and lethargic as her tenure progresses. Regular exercise can promote a better sense of well-being and help boost a woman’s self-esteem during this fragile time.
Many other exercise-related benefits have been reported, including reduced incidence of back pain, reduced edema, and reduced leg cramps. It also has a positive effect on labor and delivery. Research shows that women who train during pregnancy experience a shorter active labor and less fetal stress. One study even found that offspring of active women had significantly lower body fat levels than sedentary women—even after a five-year follow-up period!
However, pregnancy training has many unique principles, and extra care must be taken to ensure safe, effective exercise. The goal of exercising during pregnancy should be to maintain the highest level of fitness and maximum safety. By knowing the basic guidelines for pregnancy training and adopting a dedicated exercise program, women can reap all the rewards of staying fit during and after pregnancy without risking harm to themselves or their fetus.
Before starting a routine, it is imperative to obtain a physician’s clearance to rule out any possible exercise-related contraindications. Conditions such as high blood pressure, bleeding, cardiac arrhythmias, and other ailments can be potentially harmful. At this delicate time, even things that seem harmless under normal circumstances can have dire consequences. Therefore, medical clearance is an essential prerequisite before undertaking a training program and regular follow-up visits should be performed to monitor any changes in health status. In this case, an ounce of prevention really is worth a pound of cure.
Assuming no contraindications, women should plan to exercise regularly. A three-day-a-week training regimen is ideal, preferably with at least one day of rest between sessions. Therefore, training on Monday, Wednesday, Friday or Tuesday, Thursday, Saturday will provide the greatest effect while allowing adequate rest and recovery.
In general, aerobic exercise, especially high-intensity and striding exercises, is not recommended. During pregnancy, hormonal changes loosen connective tissue, which can lead to joint instability. Bounces, jumps, and rapid changes in direction—common elements of any cardio class—place enormous stress on joints and tendons. This will greatly increase the risk of injury in these areas. Additionally, the flow of cardio classes, geared towards groups rather than individuals, makes it difficult for pregnant women to maintain control. Therefore, it is best to maintain proper form and function by continuing with a personal exercise program consisting of cardiovascular activity, stretching, and strength training.
When choosing a workout facility, the workout area must be well-ventilated and air-conditioned. During pregnancy, basal metabolic temperature rises, which can predispose women to overheating—a phenomenon that has been shown to lead to neural tube defects. Therefore, pregnant women should avoid exercising in high temperature and humid places, and pay attention to monitoring body temperature changes.
Your workout should begin with a 10-minute cardiovascular warm-up on a treadmill or stationary bike with low resistance to warm up your muscles. A proper warm-up helps blood flow throughout the body, which reduces the risk of joint injury. Selected activities should be performed at approximately 50% of your maximum heart rate. To estimate this number, subtract your age from 220 and multiply by 50%. Therefore, a 30-year-old woman’s target heart rate is 95 (220-30=190 x .5=95).
After aerobic exercise, it is beneficial to do light stretches for about ten minutes. As the connective tissue relaxes, attention should be paid to the degree of stretching. Stretching should not be done to the point of maximum resistance, but should be done in a relaxed manner that stays within your comfort zone. Slow, still stretches are recommended, and you should be sure to avoid any ballistic, bouncing movements.
Next, a full weight training session should follow. While there are many ways to achieve this, a full-body workout that targets each major muscle group in one workout is probably the best way to go. This allows blood circulation to all areas of the body and maintains the goal of optimal health with maximum safety. High reps are recommended (approximately 12 to 15 per set), and two to three sets of each exercise should be performed.
During the weight training phase, it is important to follow certain safety precautions. Weight training shouldn’t be done at maximal intensity — don’t try to pump extra reps. Repetitions should be smooth and controlled, and women should maintain basic form throughout. Breathing should be regulated with each repetition, and women should never hold their breath when lifting weights. Finally, heart rate should be measured during peak activity to keep your maximum heart rate within a comfortable range.
Additionally, certain exercises are contraindicated due to the physiological and hormonal changes that occur during pregnancy. First, avoid exercises that require bending at the waist. This can cause dizziness and heartburn in pregnant women and put undue stress on the lumbar spine. Therefore, exercises such as straight-leg deadlifts and bent rows should not be performed.
Second, it’s best not to use any overhead weightlifting exercises. Due to the increased lordotic curve associated with pregnancy, overhead exercise puts more pressure on the lower lumbar region, leading to an increased incidence of lower back pain. Therefore, exercises such as military presses and inclined chest presses are contraindicated.
Finally, exercise in the supine position should be avoided after the first trimester. Pregnant women are more likely to feel dizzy when lying down due to a tendency to lower blood pressure (hypotension). Also, when lying on the back, the fetus tends to compress the vena cava, reducing venous blood flow and potentially causing harm to the fetus. Therefore, exercises such as bench presses, crunches, and horizontal triceps extensions must be discontinued at the end of the third month.
After weight training, it’s best to end your workout with a cool-off period. The cool down should consist of about 10 to 15 minutes of slow walking or stationary cycling combined with additional gentle stretches using the same principles as the warm up. This will ensure that your body temperature gradually stabilizes and will help flush lactic acid out of your muscles.
That’s it, a safe and effective comprehensive routine! The entire workout will last about an hour to an hour and a half, allowing women to feel fit and energized. By following these simple principles, women can stay in shape throughout pregnancy and end up looking as good or better than they did before conception!
By the way, despite her fears, I convinced Diane that it was good for her to keep exercising—and she continued until eight months. I am happy to report that she now has a healthy baby boy and is within 5 lbs of her ideal weight after delivery. She’s back in her routine again with a baby girl due next.
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