The benefits of training during pregnancy are clear and have been researched, but how about the help that exercise can give you while giving birth… and afterwards?

I know that exercising all those months during my pregnancy helped enormously to maintain my health, which includes body awareness and hormones.

During labour, the benefits were also very apparent, especially when pushing, and overall recovery afterwards. I didn’t really need to push full force and I could control my breath as well as my contractions just fine. It was a bit like squatting heavy with a really bad case of constipation. I didn’t even feel the need to abuse my hubby or anyone else, and no need for medication (too late anyway, since it all took about 19 minutes).

Recovery felt much more rapid than I had expected. And Little Sprout had a 9/10 APGAR score, slept well from the start (anywhere), grows well and is rarely sick.

After 3 weeks I got bored of staying at home all the time and went to my gym for my first training. It felt great. And then I crashed completely for the next 2 months. Oops.

Nutritionwise, I had a complete blackout. I could take the easy way out and blame it on hormones but frankly, it was my own stupid fault, since I didn’t have enough milk to breastfeed and in my panic thought that by eating seven kinds of crap, milk would come too. Milk didn’t come; pounds came instead and piled up everywhere. DAMN.

Now, thankfully, 6 months out I’m back on track, I eat healthy portions and healthy food again, I’m back to training 4-5 times a week, and my extra weight is slowly decreasing into the “green zone”.

Starting up your training again after giving birth is tougher than I thought it would be. Even if you have had a good active pregnancy and have the perfect baby (and let’s be honest, the chance of that is about 1:1.000.000), that baby suddenly takes up vast amounts of time that used to be yours to spend. You start from scratch while being sore overall and you go without sleep for what seems like two hundred years at a time. Your partner is cranky.

And everybody who bothered you with “good advice” during your pregnancy is coming back at you with a vengeance now you’re down and out, with advice on how to raise your newborn cute little purple-faced, snub-nosed turbo poo-machine that apparently only sleeps when you don’t.

So how the hell do you fit your training into that crazy schedule as well?

When and where do you start?

And how long should it take to feel strong again and shrink into your usual shape?

Good news: it is possible and even fun to train with a baby around… it just takes some extra organizing.

get going again

According to your level of fitness and strength and how you feel after giving birth, you could give yourself a training break (not counting short walks with the baby) of at least about 2 weeks.

Start with longer walks with the baby outside when you feel like it. I started with 30 minute walks, 10 days after giving birth, plus some short sets of light squats and careful stretching.

After that: slowly build up your stamina and physical condition.

Take the baby with you whenever you can. They love going places. And they’re asleep most of the time anyway during the first few months when they’re not drinking milk or crapping their pants. My gym let me stash the pram within sight in the kitchen area and my little monster loves participating so I sometimes just hang her in her baby carrier and start training with her hanging on at the front.

in the gym

I found that I could easily do these exercises in the gym and it’s actually most of the stuff I used to do before.

• Farmers walks (Go light! Your abs are still stretched out and they need time to recover.)
• Squats (I could do these with stitches, but you might want to skip these at the start)
• Deadlifts
• Lunges
• Step-ups
• Cross trainer (heaviest setting)
• Shoulder press
• Dips
• (Modified) light Turkish get-ups

outside

No gym? No excuse: go do some exercise in the park.

Make your initial walks longer as the days go by to increase your stamina. Babies love being outside, and it’s good for them too.

Have fun: find a fallen tree trunk and try log walking for balance, log squatting, backflips (haha)… all fun. As an added bonus, this stuff will make you feel like you’re 10 again.

Other exercises:

• Pram lunges (or just lunges)
• Step-ups on a handy park bench or stable non-slippery log
• Interval short pram sprints (preferably without launching your baby)
• Squats (using pram for assistance if necessary)
• Park bench push-ups
• Park bench dips
• Park bench plank
• Stretches (careful)
• Etc etc. — use your imagination and go by how you feel (Here are some more ideas, from a couple of new mothers at Precision Nutrition.)

Most of the above indoor and outdoor exercises, and many more, are possible with a baby in a pram or baby belly carrier, but be a Good Mommy and please avoid anything that involves lifting heavy stuff that you wouldn’t want to squash your little sprout with if you let go of it. These include dumbbell presses, barbell shoulder presses, overhead squats. Or exercises that involve sprinting or jumping. Duh.

the basics of getting back into shape

1. Never ever neglect your nutrition for a longer period of time, especially if you have a permanent tendency for Mediterranean curves (like me).
2. Take your time to start up: pushing the limit is fine, but crossing it might mean crashing. QED.
3. Ask for professional help if you have to: there is no shame in that. It’s really difficult to keep yourself on the right track day in, day out. This can be anyone from a counsellor to a physiotherapist who specializes in post-pregnancy rehab.
4. Try something new you always wanted to try but never got around to like dancing, powerlifting or yoga. I started kick-ass street defense classes.

PS: I forgot just how good exercise is for fertility too. Number two is on its way.

Besides having to live through loads of crap and well-meant advice during my pregnancy, I could say I’m probably a statistical anomaly where typical pregnancy ailments and age risks are concerned:

• I’m 40
• I’m (strictly speaking) overweight
• This is my first

All the above are elements that could have seriously hampered my chances of success in getting and staying pregnant. So why do I feel great?

Apart from an admitted possible genetic disposition towards easy pregnancies, I mainly blame training and good food for that.

I’m not going to yap on to you about how beneficial weight training can be, pregnant or not. Current research has already had enough to say about that, and you wouldn’t have gone on reading this far if you didn’t think there’s some truth in it anyway. Besides, you can find more on this subject elsewhere on this site.

I’m into month seven now, and still training 4-5 times a week, using mainly free weights, and experimenting with what feels right as my insides get turned inside out over the months.

How weight training’s benefited me

I try to make objective regular self-observations regarding benefits for me of weight training, actively keeping my weight training and physical condition up to scratch and observe how I feel from day to day, as there is so little research material to compare my results to.

For example, I consciously focus on my back staying strong, and I definitely find that I am not developing a typical arched sore pregnancy back as my belly grows, one of the major problems many pregnant women experience.

I double checked this and other practical points at an otherwise fun birthday party last weekend where (oh horror) 5 other pregnant ladies in the age-range of 35-40 years old and pregnancy month 4 to 8 were comparing ailments ranging from back pain, leg/knee pain, indigestion, sleeplessness, nausea, flatulence and tiredness to hormonal fluctuations with the range of Mount Everest.

None of them trained or even touched a free weight with a stick in case it might bite them.

They were very surprised I couldn’t relate to any of their woes (which made me feel like a freak, a very happy one that is), and even the hormonal fluctuations thing was discredited by my sweetheart. Admittedly, sweetheart knows what’s good for him in any case, but I tend to believe he was telling the truth, as he was visibly gloating while casually mentioning it to all the other washed out and desperate looking daddies-to-be.

What I do

Here are some of the exercises that I’ve personally found comfortable and do daily without discomfort. I would not recommend most of them for beginners, but they could be an inspiration to those who could get some help in figuring out what fits the well-trained bump.

Some articles argue that using machines instead of free weights is preferable when pregnant, and advise women not to do squats and avoid free weights. Arguments (among others) are that machines would be safer and keep you range of motion in check, and your abdominals inert. Leg extensions would keep you balanced better than squats.

I personally don’t get this point of view at all. I do use machines if useful, but prefer free weights where I can exactly because they give me the opportunity to find my best balance without being squeezed into a certain position.

I saw some real gems while doing some extra internet research. One suggested doing “hyperextensions for lower back“. Ladies, just look at the mentioned picture and imagine yourself doing this with a watermelon attached to your front. ‘Nuff said. And how about some “bent over shoulder laterals“? Why? HOW? Medicine ball prehistoric crunches? AARGH!

If you want to use some of the below exercises, but are not sure about proper execution, weight to use or are unsure if the exercises fit your actual level of physical condition, err on the wise side: ask your OB and/or PT whether you should/could do them and get somebody to spot you if you feel wobbly or unsure at first.

General rule: use lighter weights than you would in a non-pregnant state.

Some obvious do’s and don’ts (some out of the Duh! box):

• don’t start a new strenuous exercise program when pregnant and untrained
• don’t experiment with some new training wonder thingie you saw on TV
• don’t overtrain; listen to your body
• don’t go on a weight-loss diet when pregnant
• don’t let other people’s comments keep you from training

• do eat regularly and go for real food, not crap
• do consult your physician and PT
• do listen to your body
• do have fun when training
• do take the time to recover

The list below is not exhaustive. There’s so much else you can probably do, but it’s a start. I’m not getting into training schedules or how much weight to use either. Alternate, combine, in short, don’t get bored: just go for it. And above all: Have fun!

Legs

• Split squats weighted or unweighted, wide(r) stance
• Any type of squats that feel comfortable, weighted or unweighted, wide(r) stance
• Deadlift

Back:

• Lat pull-down wide grip
• Lat pull-down reverse narrow grip
• Dumbbell row
• Advanced: Pull-ups, which will probably change to assisted pullups as you gain weight (see: Mistressing the Pull-up)
• Push ups (if comfortable)

Core:

• Kettlebell pick-up
• Side bend weighed
• Farmers walk, try: one hand loaded, both hands loaded with equal or dissimilar weights (e.g. 20 pounds right hand and 30 pounds left hand).
• Plank variations

Shoulders/arms:

• Military press, seated or standing
• Dumbbell side raises, standing or seated (on medicine ball)
• Dumbbell front raises, standing or seated (on medicine ball)
• Barbell press, hands 90 degrees (like lifting a baby, something you will probably do a lot in the coming few years, so best be prepared)
• Dips
• Biceps using dumbbells

Endurance:

Walk, swim, bike, cross-train, whatever. Jogging or running I cannot honestly recommend as I find it uncomfortable (wobble, WOBBLE, burp…).

Stretching:

Do stretch if you feel like it, but be careful not to overstretch as your ligaments loosen up during pregnancy (although, to be honest, having a fairly muscular build myself, I don’t really notice it myself).

• Back stretches
• Leg stretches/hip stretches
• Calf stretches
• Shoulder/arm stretches
• Front of chest stretches

I remember my younger sister telling me how creepy it was when total strangers would grab her belly in stores etc. when she was pregnant. Now regular site reader, world traveller, and cheese/chocolate aficionado, Lieke updates me on the “enjoyment” of having her body on public display. From the WTF? files…

Have you experienced similar bullshit? What’s up with this? Let’s hear your comments!

I’m 6 months pregnant and already a crappy mommy. How’s that for a new record?

I’ve just turned 40. I’m pregnant because I wanted to be, thankfully without any external assistance (apart from the one you might expect), and in damn record time too. I’m healthy and active, I try to work out 4-5 times a week according to the Gospel of Squat, and yeah: I do that with all necessary precautions and adaptations to accommodate my ever growing bump.

Truth be said, it was already kind of there because despite of being healthy like a pig, I’m also a bit overweight according to most standards, even after losing 25 pounds last year. Apart from the occasional, not even weird craving I usually don’t give in to (crisps and ice cream), I try to eat healthy stuff I cook myself. And I feel fit and great.

SO WHY THE HELL AM I ALREADY MADE OUT TO BE A CRAPPY MOMMY-TO-BE?!

For many people, being pregnant means being in a state worse than physically handicapped.

It apparently also means abstaining from any (let alone strenuous) exercise. Eating “ well” is highly recommended but can be anything from stuffing yourself because you’re “ eating for two” to counting every single damn calorie you ingest.

Also recommended by my army of apocalyptic friends and family: sitting around and not moving at all for 9 months. They even research the internet on my behalf for any scary pregnancy condition I (or the baby) might attract because of my lifestyle.

I’ve been having fun collecting insane advice about my ever-growing bump:

1. Do you drive?! (5 times)
2. You shouldn’t work out AT ALL! You might drop the baby (umpteen times)!
3. Do you swim?! (+ lots of dirty looks on the beach from older women why think I’m behaving irresponsibly)
4. While swimming: (screeching voice from the shore): YOU! HEY YOU! Who, me? YES, YOU!!!! GET OUT OF THE WATER NOW! Are you talking to me? YES, YOU!!! GET OUT! NOW!!!!! But why?! (thinking: sharks? Tsunami? WTF?) THE WATER IS DIRTY! IT’S UNHYGIENIC!!!! (look down: crystal clear, fishes dancing around my toes…)

Well, dear friends and family, I am just not buying into that shit.

Instead of listening to you I:

1. Consulted my physician/gynecologist and guess what: OH HORROR! He gave me the green light to go on with, training, eating and living like I was a normal person, barring any pregnancy complications, in which case (duh!) I should consult him again.
2. Talked to my PT, who adapted my training program and food recommendations to fit the bump.
3. I (sometimes smiling, sometimes grimacing with gritting teeth) pointed out the above to anyone trying to persuade me that “what everybody says” was actually better advice.

And guess what: they shut up.

So, for all of you ladies in the same situation as me: keep up the good work as it’s only going to benefit, not harm you; do what you have to do, want to do and can do, using your physician’s advise and your own common sense.

• Listen to expert advice and your body, and say screw you to anyone else.
• Kiss your partner and thank them for caring.
• Nod to your mom and do your own thing.
• Smile at your friends and say: thank you, I’ll think about it.
• And beat up anyone else on the useful pretext of “ pregnancy hormones” .

She writes:

All you pregnant ladies out there: we’re learning each and every day how and why training during your pregnancy is so good for you AND your baby (NOTE: this information comes from one of the most prominent pregnancy and exercise researchers, Dr James Clapp III, who has studied many pregnant competitive Olympic athletes):

• you accumulate less body fat
• you have a positive sense of well-being and vigor when you might tend to be pessimistic, depressed or lethargic
• you have a reduced incidence of upper respiratory tract infections (colds, sinusitis, etc)
• you’ll tend to have an easier, shorter and less complicated labour
• you can actually IMPROVE your fitness level and physical performance (I can attest to that!)
• your baby has developed an improved tolerance to stress and as such, can handle the stress of labour much better than a baby of a sedentary woman (i.e., fewer drops in heart rate with each contraction)
• your baby has less body fat, but is still able to maintain it’s body temperature
• your baby will most likely be more mature at birth, meaning, they respond readily to environmental cues and will self-quiet themselves if disturbed when napping
• your baby will also be a better sleeper (less likely to wake easily)
• your baby will probably perform better on standardized intelligence tests as they advance in age
• your baby will grow to be a less-fat adult (which is great news in our society of excess overweightness)

If you missed Cassandra’s excellent podcast on training and pregnancy (and other woman-related issues), see here.

Podcast with Cassandra Forsythe

Book review

If there’s a woman in your life who’s considering weight training (or a man in your life who trains women), The New Rules of Lifting for Women is an excellent introduction to the field of women and weight training.

NROL is written by a kickass trifecta of three major names in the business.

Lou Schuler is a well-known fitness journalist who has written several books, including The New Rules of Lifting, The Book of Muscle, and The Home Workout Bible. He’s been a contributor to Men’s Fitness and Men’s Health, serving as the fitness director of the latter for several years.

Cassandra Forsythe is emerging as one of the most authoritative voices in women’s nutrition and training. She’s a Registered Dietitian who holds a PhD in Kinesiology, an MSc in Human Nutrition and Metabolism and a BSc in Nutrition and Food Science. Her main research interests are low-carbohydrate nutrition, dietary fatty acids, cardiovascular disease, diabetes, weight-loss, female-specific nutrition and training, and the female athlete triad. Her other book is Women’s Health Perfect Body Diet: The Ultimate Weight Loss and Workout Plan to Drop Stubborn Pounds and Get Fit for Life

(She’s also, by the way, pregnant. We explore her insights on being an unusual combination — a serious female athlete, Dr. Nutrition, and pregnant — in the podcast.)

Alwyn Cosgrove is one of the best-known strength coaches in the biz. He’s a former Taekwon-do international champion who now works as a strength and conditioning coach with a wide variety of clientele, including several Olympic and national level athletes, five World Champions and professionals in a multitude of sports including boxing, martial arts, soccer, ice skating, football, fencing, triathlon, rugby, bodybuilding, dance and fitness competition.

Podcast with Cassandra Forsythe

Cassandra and I get chatty with it for nearly an hour. Topics covered:

• What was it like to be part of the NROL team with Lou Schuler and Alwyn Cosgrove?
• The awesomeness of
  • female muscles and strength
  • mountain biking
  • tire flipping
• Cassandra’s early background as a gymnast and lifting after a serious spinal injury
• What happens to women’s bodies when they weight train
• Training with dudes in the gym
• Challenges encountered in training more seriously, and confronting taboos about women’s weight training
• Problems in finding social support (especially from other women), and why push presses aren’t necessarily compatible with bridesmaid’s dresses
• Disordered eating and “exercise bulimia” among “ordinary” women — “healthy” and “unhealthy” approaches to exercise and food
• The female athlete triad
• The myth and pressures of “perfection” and the reality of being an “imperfect expert”
• The role of stress in women’s lives and why we need to lighten the hell up
• Pregnancy, nutrition, and weight training — including sugar cravings, boot camp, and log pressing while pregnant
• The up-and-coming areas for women’s nutrition and fitness
• What’s wrong with kids these days

As Cassandra points out, it’s unusual to have a podcast with two women weight trainers chatting so honestly about the realities of training and bodily experiences. But that’s just the kind of good stuff that Stumptuous.com is devoted to bringing to the people!

Listen online by clicking below:

Or download in MP3 format for good listenin’ on your iPod. (65 MB – yeah, it’s a biggie!) Right-click on the link, if you want to save to your hard drive first (recommended).

Book review

As I’ve mentioned, NROL is a super introduction to the field of women and weight training, and it’s solidly backed by coaching experience and scholarly evidence.

This would make a great gift for your mom, sister, girlfriend/wife, best friend, etc. — anyone who’s considering weight training but hesitant about whether women should do it. It would also make a great gift for folks who may know their way around the gym a little, but want to become more grounded in some of the fundamental principles of program design and sports nutrition.

The first section of the book provides a primer on sex-based physiology, and why women and men should train the same: with relatively heavier weights, higher intensities, and more challenge overall.

The first section debunks common myths — most notably that women will “get too big” from weight training; that certain types of training can make muscles “longer”‘; and a key point: the myth that men’s and women’s muscles are substantially different.

It explains why weight training is essential for all women, not just athletes, and how weight training improves health, leanness, athletic performance, and daily-life function.

The first section also explains much of the logic behind the training plans provided: the importance of progressive overload, which exercises to choose and why, and why not to waste your time with gender-specific “toning”. (It explains why kickbacks suck. Hooray!)

The second section provides nutrition basics such as how many calories active women need, why protein’s important, and how to supplement with post-workout recovery nutrition. It suggests meal plan and preparation techniques, and there’s no fancy weird stuff or secret/magical ingredients — just clear, basic ideas for organizing your nutrition.

The third section provides a step-by-step, carefully crafted workout program in great detail. If you follow the program closely (and you should, if you want to reap the benefits), it’ll take around 6 months to complete. The lifts are basic yet effective. There’s lots of variation to keep you learning and interested.

Total beginners might be slightly intimidated by the presence of complex exercises such as squats and deadlifts — but hey, they can just come here and get help figuring out the technique!

All in all, this is a super starter text for anyone interested in women’s weight training.

Reviewed by Erin Weiss-Trainor

Having experienced the joys of being pregnant three times over for a total of 839 days (who’s counting), it’s clear just from watching Lauren Brooks’ latest DVD, Baby Bells: Fit Pregnancy Workout With (Optional) Kettlebells that it would have been a great addition to my training regimen as I aimed to stay fit and strong as each of my babies grew. Similar in training structure and instruction to Brooks’ first DVD, Baby Bells offers a variety of lower intensity and equipment options, along with modified positions to accommodate a wide range of abilities and the changes in a woman’s body as pregnancy progresses. For those who have used kettlebells in the past, and are looking to continue training during their pregnancy, this DVD is a great follow-up to Brooks’ first DVD, The Ultimate Body Sculpt and Conditioning with Kettlebells.

With a more mellow and calming feel than her first DVD, Lauren, 6 ½ months pregnant with her second child, introduces viewers to the benefits of exercise during pregnancy and the precautions that need to be taken when exercising during pregnancy, as outlined by the American College of Obstetricians and Gynecologists. Encouraging participants to listen to their bodies and always err on the side of caution, the DVD takes viewers through a three-part workout where three to five exercises are completed circuit-style and then repeated.

Along with bodyweight exercises such as push-ups, many of the standard kettlebell exercises, such as two-handed swings, sumo squats, one-arm rows, step back lunges, and tricep presses are included. Lauren shows how kettlebell size should change with each exercise and gives options to perform these with dumbbells or bodyweight alone. As Lauren demonstrates the higher intensity versions, an inset video provides alternatives for modifying the position and range of motion of the movements. Participants are encouraged to take as much rest as they need between exercises, and between sets within each part. Paired with a joint mobility warm-up and a cool-down with stabilizing and stretching geared specifically to target muscles and joints that are under more stress during pregnancy, the entire workout takes just over 35 min and can easily be performed anywhere with little to no equipment.

For experienced kettlebell users who want to experience increased energy and strength during their pregnancy, and prepare their bodies for an easier delivery and recovery from childbirth, this DVD provides a complete and enjoyable way to do so. With less specific instruction on kettlebell form than the first DVD, those who are both pregnant and new to this type of training can get the same benefit, but would be best to stick with bodyweight or dumbbell options. Learning the basic kettlebell movements is best mastered when a woman’s body is not going through the many changes of pregnancy, or having to worry about a cumbersome belly.

Something about watching Brooks swing the kettlebell around her gorgeous belly makes you appreciate the strength and power of a pregnant woman. Once again, Lauren inspires. While many women may use the excuse of pregnancy to literally “eat for two” and stay away from the gym, the energy that Lauren radiates proves that making fitness and healthy eating a priority even during pregnancy is good for mom and for a healthy baby.

Lauren Brooks is a fitness and strength trainer in San Diego, CA. Lauren earned her B.S. in Kinesiology with an emphasis in Fitness, Nutrition, and Health from San Diego State University. Lauren Brooks is certified by the American Council on Exercise and Russian Kettlebell Challenge.

Lauren’s site |  Previews of the DVDs

Early guidelines about training during pregnancy were largely based on speculation and expectations about middle-class women’s roles, rather than on clinical research and demonstrated results in a particular population. Luckily these guidelines have been updated and now reflect women’s experiences more realistically. The 1994 bulletin of the American College of Obstetricians and Gynecologists indicates that “[t]here are no data in humans to indicate that pregnant women should limit exercise intensity and lower target heart rates because of potential adverse effects.”

Kettlebell coach Lauren Brooks. Eat your heart out, Demi Moore.

Similarly, the 2001 Canadian guidelines indicate that regular exercise has a number of benefits and few drawbacks for women. And yet, a recent study shows that in the United States, “Half of obstetricians do not routinely discuss exercise. The majority is hesitant to advise sedentary gravidae to start exercise and is conservative with respect to exercise intensity. Action may be needed to convince more Obs to routinely recommend exercise to all healthy patients.” (Entin, Pauline and Kelly Munhall. “Recommendations Regarding Exercise During Pregnancy Made by Private/Small Group Practice Obstetricians in the USA.” Journal of Sports Science and Medicine 5 (2006): 449 – 458. Full text)

Ideally women should be fit and active before getting pregnant, so if you are thinking of conceiving, begin an exercise program now (but of course, if you’re reading this, you’re probably already exercising!).

One of the important truisms about activity during pregnancy is that pregnancy is not the time to begin a strenuous exercise program. In fact, pregnancy is not the time to make any drastic physical changes.

However, women who are already accustomed to regular activity and exercise generally find pregnancy no disruption to their normal routine, and previously sedentary women can safely begin a moderate exercise program as late as the second trimester.

For ideas, check out Lauren Brooks’ new DVD, Baby Bells. Lauren (see photo to the right) is a certified kettlebell coach who’s written an article elsewhere on this site. She trained with kettlebells throughout her pregnancy.

general concerns

There is a bit of folk wisdom which suggests that women should not engage in exercise after having had a baby. There are dire predictions about souring the milk and so forth, having your uterus fall out, or heaven knows what. This is as realistic as the tooth fairy. Studies have shown no increase in acidity of breast milk after mom’s exercise. Regular postnatal exercise reduces or eliminates most of the unpleasant postpartum symptoms of physical and mental stress, depression, and so forth, as well as promoting a faster recovery. Postpartum exercise appears to help promote insulin sensitivity.

My sister and brother in law doing some tummy rubbing before the birth of my nephew. They are so damn cute I can barely stand it!

Furthermore, children of moms who exercised before, during, and after pregnancy were shown to be relatively leaner themselves five years later.

While exercise during pregnancy has clear benefits, many women tend to cease doing it. The two primary reasons for quitting exercise are significant weight gain and interestingly, the demands of care for other children.

This points to the importance of support systems (such as child care) for pregnant women in order to enable them to continue to exercise during pregnancy.

“Muscle conditioning” exercise (i.e. weight trainng) is considered low-risk and safe. Self-monitoring of training is essential during this period, however, using tools such as the rate of perceived exertion (RPE).

This is a good time to keep a journal that records eating, training, workout reports, notes on how you feel, heart rate, recovery, etc. Here are some general concerns for training during pregnancy.

joint laxity

This is a crucial issue for weight trainers. The body “softens” connective tissue in order to prepare for delivery. Great for pelvic expansion during the crucial moments, not so great for folks trying to keep their kneecaps stuck to their legs during training. On the plus side, strong muscles help to hold things together and improve overall stability, so strength training will be helpful as long as care is exercised.

overheating

Another significant issue for weight trainers. Dress to stay cool, drink lots of fluids (even though you’ll feel like you have to pee every ten minutes), get a fan on you if possible, and monitor the situation during your training sessions. If you need a break to cool down, take one. Oxygen will be less available to you, and you will find that in later months of pregnancy, the baby presses upwards on your diaphragm, making it harder to breathe deeply.

nutrition

Good nutrition is essential during pregnancy, but hey, you knew that didn’t you? It is often difficult for female athletes to accept the inevitable weight gain that occurs during pregnancy, but this isn’t a time to diet or be nutritionally stingy. You may notice wild fluctuations in blood sugar (leading to a feeling of “I have to eat NOW!!”), so try to eat at regular intervals and not go more than a couple of hours without a small meal. In the first trimester you may be limited in what you can tolerate, and formerly appealing things may make you feel sick, but this is usually restricted to the first three or four months. You may experience an increase in appetite, including nearly uncontrollable cravings for carbohydrates (mmmm donuts). This does not signify weakness or gluttony on your part; let the hormones do their work and get a balanced diet as best you can. Due diligence requires me to tell you to take in at least 300 kcal over maintenance each day, but if the pregnant women I’ve known are any indication, you’ll be chowing down like someone who just wandered out of the wilderness into a hot-dog-eating contest.

supplementation

Don’t take any supplements during pregnancy or breastfeeding other than a good-quality whey protein and a multivitamin (your doctor may recommend additional vitamin or mineral supplementation). Aside from the lack of knowledge about the safety of creatine during pregnancy, the last thing you want is more water retention. Given the issues with overheating and heart rate, thermogenics and stimulants are contraindicated (this includes caffeine, so cut down on this as much as you can; my experience indicates that the smell of coffee makes many pregnant women sick anyway). Obviously, use of any hormonally-based substances, including prohormones, is a huge no-no at this time. Fish oil has been suggested as desirable supplement for pregnant women, but the research suggests that more study needs to be done before this is a given.

medical supervision and ongoing monitoring

As part of your regular medical checkups, have your doctor advise you on possible changes to your body (e.g. cervical dilation, threatened miscarriage, hypertension etc.) that may require you to modify your program. Ensure that you keep your doctor up-to-date on what kinds of activities you’re engaging in, and whether you notice any worrisome symptoms such as persistent bleeding.

exercise choice

As the pregnancy progresses, avoid exercises which involve lying on the back, or pressing against the stomach (such as chest-supported rows). You may find that you need to modify or eliminate exercises which involve excessive head movement, such as stiff-legged deadlifts, if they cause nausea or dizziness. Avoid prolonged periods of standing. Balance will eventually be a concern, so in the second and third trimester, reduce and eventually eliminate the Olympic lifts and perform demanding overhead lifts while seated (see the section on physioball use below). One of the most typical problems encountered by pregnant women is back pain. Their center of gravity shifts and extra weight is added over nine months. Women tend to slouch the shoulders and arch the lower back to compensate for these changes, which of course leads to discomfort. A strong abdominal column as well as a strong back gained through weight training before pregnancy can alleviate much of this problem, so assistance work geared to this need is helpful. Bodyweight exercises, such as unweighted squats, present a useful alternativeas the pregnancy develops, as do exercises which take some weight off the joints, such as swimming or cycling.

exercising for two

A growing fetus is a greedy little thing (as parents will attest, not much will change in that respect once it’s born, either). The body will adjust its substrate utilization to ensure that the wee tenant gets the best of what you have. Your nutritional needs will change as will your body’s response to exercise. Pregnancy dramatically alters glucose and insulin response to prolonged exercise, as well as blood lipid profiles. These return to normal postpartum. It has been speculated that this represents a glucose conservation mechanism and a protective shunting of energy substrate for fetal use. In other words, physiology dictates that fetus is numero uno when it comes to getting first dibs on the good stuff.

recovery

Be prepared for reduced recovery and adjust your training accordingly. Be aware that some of the modalities you may use for active recovery, such as hot tubs, may be inappropriate during this time. You’ll probably want to do a lot of sleeping anyway.
postpartum urinary incontinenceSorry, squeamish readers, I had to mention this. After giving birth, many women notice problems with mild to moderate urinary incontinence during exertion, such as squatting or deadlifting. Kegel exercises are a must during pregnancy and after delivery. You may find, to your chagrin, that you will occasionally experience some slight laxity in this regard even with careful attention to treatment. Simply plan it into your workouts: avoid caffeine, go to the bathroom before your workout, wear a pad, and remember that there are a lot of other women out there experiencing the same thing. While we’re on the topic of embarrassing things, you may also notice hemorrhoids which are aggravated by lifting. Again, normal and treatable, though unpleasant. Are you starting to comtemplate growing the baby in a jar yet?

training frequency

An interesting finding of recent research on pregnancy is that exercise frequency is a determinant of birth weight (the higher the birth weight, in general, the healthier the baby), and that too much exercise can be as detrimental as too little. Women who exercised more than 5 times weekly and fewer than 2 times weekly were both at risk for having lower birth weight babies (interestingly, intensity did not appear to be as significant a factor as frequency). This finding points to a “happy medium” of 3-4 weekly sessions of structured exercise for pregnant women. In this case I mean 3-4 weekly sessions of training, rather than general activity. Daily activity and movement, in some form, is the ideal.

Other research suggests that a lower volume of exercise in the second and third trimester is associated with better fetoplacental growth (although the mother demonstrates more fat gain rather than lean body mass gain relative to a higher volume of exercise). The more recent ACOG document (2002) argues that daily or near-daily moderate exercise of 30-minute sessions is recommended.

It seems evident that total workload should be reduced as the pregnancy progresses. For most women this is intuitive, since the demands of a growing fetus tend to reduce their desire to go all-out in the gym. Few women have the urge to do a maximal lift while eight months pregnant; the idea of a nice nap is likely more appealing.

However, some athletes feel that they cannot tolerate a reduction in training volume or intensity. For these women, the research gives a clear caution which must be heeded.

My preggo sister, always fashionable even walking around with a watermelon stuck to her

whither weight trainers?

A difficulty encountered with the research on pregnancy and exercise is that the majority of studies look at cardiovascular exercise, and will often use endurance athletes as a population or sample,perhaps comparing them to sedentary women. While we can make inferences from this work, we cannot expect that all elements will apply precisely to women who weight train.

Guidelines on weight training are sparse, and hint at using lower intensities by defining appropriate rep ranges (between 15 and 25 reps per set). This appears to indicate a lack of familiarity with structuring weight training programs, as well as the needs of experienced weight trainers for whom such a low intensity may be inadequate. Thus we need to begin to theorize about how best to develop a strength training program based on the evidence we have.

Given concerns about joint laxity, heart rate, oxygen consumption, and overheating, it seems inappropriate to suggest that weight trainers build their program around long sets of lower intensity. Rather, I would think it sensible to take an approach which uses shorter sets combined with a lower intensity, resulting in a similar overall volume. So, for example, let us say that our pregnant trainee normally performs 3 sets of 10 reps in the squat, using a weight which is somewhere around 65-70% of her 1RM. For an experienced trainer this is a relatively low intensity to be using, so we assume that she can continue to use it as long as she is comfortable with it.

However, we might modify her program so that she is performing something like 6 sets of 5 reps each, or even 10 sets of 3 reps, for the same total volume, but changing the demands of each set to reflect the increased need for rest and moderation.

Eventually you might also substitute some machines for certain free weight exercises to reflect challenges to balance (though bear in mind the challenge of joint laxity, and choose machines wisely, avoiding those which require you to exert the most force in the weakest position, such as pec decks).

For example, the bent-over position assumed during a one-arm dumbbell row might produce dizziness and back pain, so an intelligent substitute might be seated cable rows, or even a modification to the free weight exercise which includes a higher support and so less of a forward lean.

Many of these considerations do not come into play until the second or third trimester. Many women have successfully met significant athletic challenges while in their first trimester. In the firsttrimester, the primary concern is usually nausea, dizziness, and blood sugar swings. Attention to hydration and nourishment should = help; sipping at a carb drink (if you can tolerate it) during the = workout can be useful. Training can be mostly normal during this = period. However you should begin to consider decreasing intensity and volume from the fourth or fifth month onwards.
physioball phunA nifty piece of gym equipment which is beginning to be used as a pregnancy accoutrement as well as equipment for labouring women is the swiss ball, aka the physioball, aka the giant vinyl beach ball thingy that “core stability” devotees seem to be into these days. Since these are relatively cheap, it’s not a bad idea to pick one up.

In later months of pregnancy, many women experience significant pelvic pain as the weight of the baby presses down and ligaments stretch. One undignified but useful position which appears to alleviate this pain is getting down on hands and knees and hugging the ball, resting the weight of the upper body on it, and rocking back and
forth if desired.

Bridging exercises with the physioball can help relieve back pain and strengthen torso and hip extensors.

Pregnant women may also find it more comfortable to use the ball in place of a chair or bench while sitting during normal activities (such as desk work or watching TV), as well as during exercise. The squishiness of the ball provides cushioning for increased weight, and the instability of the ball helps with torso mobility and awareness.

Women in later stages of pregnancy can use the ball to help modify common exercises, such as squats. Wall squats with the ball are performed by placing the ball between your back and the wall, and rolling down the wall with it into a squatting position.

Finally, women in labour may find some relief from sitting on the ball during contractions, and rocking back and forth.

sources

American College of Obstetricians and Gynecologists. Exercise During Pregnancy and the Postpartum Period. Technical Bulletin No 189, ACOG, Washington, DC, 1994.

Bessinger R.C., R.G. McMurray, and A.C. Hackney. “Substrate Utilization and Hormonal Responses to Moderate Intensity Exercise during Pregnancy and After Delivery”. Am J Obstet Gynecol 186(4):757-64 (April 2002).

Campbell., M.K. and M.F. Mottola. “Recreational Exercise and Occupational Activity during Pregnancy and Birth Weight: A Case-Control Study”. Amer. J. Obstet. Gynecol 184:403-408 (2001).

Carey G.B., T.J. Quinn, and S.E. Goodwin. “Breast Milk Composition After Exercise of Different Intensities”. J Hum Lact 13(2):115-20 (Jun 1997).

Clapp, J.F. “Morphometric and Neurodevelopmental Outcome at Age Five Years of the Offspring of Women who Continued to Exercise Regularly Throughout Pregnancy”. J Pediatr 129(6):856-63 (Dec 1996).

Clapp, J.F. 3rd and K.D. Little. “The Interaction Between Regular Exercise and Selected Aspects of Women`s Health”. Am J Obstet Gynecol 173(1):2-9 (Jul 1995).

Clapp J.F. 3rd, et al. “Continuing Regular Exercise During Pregnancy: Effect of Exercise Volume on Fetoplacental Growth”. Am J Obstet Gynecol 186(1):142-7 (Jan 2002).

Dumas G.A., and J.G. Reid. “Laxity of Knee Cruciate Ligaments During Pregnancy”. J Orthop Sports Phys Ther 26(1):2-6 (Jul 1997).

“Effect of Recreational Exercise on Pregnancy Weight Gain and Subcutaneous Fat Deposition”. Med Sci Sports Exerc 27(2):170-7 (Feb 1995).

Herrera, E. “Implications of Dietary Fatty Acids During Pregnancy on Placental, Fetal and Postnatal Development: A Review”. Placenta 23 Suppl A: S9-S19 (April 2002).

Horns P.N., L.P. Ratcliffe, J.C. Leggett, and M.S. Swanson. “Pregnancy Outcomes Among Active and Sedentary Primiparous Women”. J Obstet Gynecol Neonatal Nurs 25(1):49-54 (Jan 1996).

Kardel K.R. and T. Kase “Training in Pregnant Women: Effects on Fetal Development and Birth”. Am J Obstet Gynecol 178(2):280-6 (Feb 1998).

Koltyn K.F. and S.S. Schultes. “Psychological Effects of an Aerobic Exercise Session and a Rest Session Following Pregnancy”. J Sports Med Phys Fitness 37(4):287-91 (Dec 1997).

Lee G. “Exercise in Pregnancy”. Mod Midwife 6(8):28-33 (Aug 1996).

Hale RW, and Milne L. “The Elite Athlete and Exercise in Pregnancy”. Semin Perinatol 20(4):277-84 (Aug 1996).

Howells, D. “Exercise in Pregnancy.” Pract Midwife 5(4):12-3 (April 2002).

Margolis, R.S. “Exercise and Pregnancy”. Md Med J 45(8):637-41 (Aug 1996).

Pivarnik. J.M. “Cardiovascular responses to aerobic exercise during pregnancy and postpartum”. Semin Perinatol 20(4):242-9 (Aug 1996).

Schramm W.F., J.W. Stockbauer, and T. J. Hoffman. “Exercise, Employment, Other Daily Activities, and Adverse Pregnancy Outcomes.” Am J Epidemiol 143(3):211-8 (Feb 1 1996).

Sternfeld, B. “Physical Activity and Pregnancy Outcome: Review and Recommendations.” Sports Med 3(1):33-47 (Jan 1997).

Sternfeld, B, C.P. Quesenberry Jr, B. Eskenazi, and L.A. Newman. “Exercise During Pregnancy and Pregnancy Outcome “. Med Sci Sports Exerc 27(5):634-40 1995 May

TanJi J. “Exercise During Pregnancy and Pregnancy Outcome”. Clin J Sport Med 5(4):267 (Oct 1995).

Veille, J.C. “Maternal and Fetal Cardiovascular Response to Exercise During Pregnancy”. Semin Perinatol 20(4):250-62 (Aug 1996).

The first immediate, and hopefully self-evident, concern postpartumis recovery from the delivery. This will vary depending on the difficulty of the birth. Quite likely, mothers will be too distracted by episiotomy stitches and feedings every two hours to do much of anything at first! It is important to allow time to recover from the acute effects of this physically challenging event.

The second concern is gradual re-introduction of physical activity in a way that is appropriate for each woman. Everyone is different, so even if one hears apocryphal stories of women who are back to running half-marathons a week after delivery, it probably doesn’t apply to most women! It is essential to re-start slowly, and within one’s limits, as well as to tailor physical activity to one’s individual abilities and needs.

I created the workout that follows for a first-time mom who had a somewhat high-risk pregnancy during which she was confined to bed, and unable to exercise for the later stages. Though lengthy and difficult, delivery was normal and not C-section. She experienced a great deal of back and pelvic pain, and some laxity of the knee joint. Her program had to be a gentle re-introduction of activity which emphasized regaining torso strength and postural awareness, as well as strength for everyday tasks such as carrying the baby in a Snugli. The mother was also instructed to do daily Kegels in order to assist with regaining tone of pelvic floor muscles, as well as to go out walking whenever she felt up to it, increasing pace and distance as she felt able.

I relied a fair bit on the Swiss ball and bodyweight-only exercises for the initial stages. Later, dumbbells were included for additional resistance as desired. A bench could be subsituted in certain places but she didn’t have one, so the Swiss ball was a stand-in. This workout is meant to be a collection of ideas aimed at a particular trainee, not set in stone. It may be modified depending on the needs and existing fitness level of the individual trainee.

For example, “week 1″ does not mean “first week after giving birth”, unless you are one of those superwomen who are back in boot camp or board meetings two days after popping out the sprog, and then you probably don’t need my help anyway. Week 1 means the first week you start back with feeling up to organized physical activity and conditioning work. You may find that for the first few weeks, your training goal will be to get an hour of uninterrupted sleep. Go at your own pace, and if you need to take longer with the gentler stuff, by all means do so.

Get outside and walk with the baby as well, whether that’s in a stroller or with the baby in a carrier. As you get back into shape try a bit of running with the stroller, or climbing up some stairs (or a hill) a little more vigorously with the baby carrier. Getting some sunlight is important for helping manage the risk of postpartum depression, as happiness hormones respond to light levels. It helps rehab the low back and improve your cardiovascular fitness. It also often helps the little screamer sleep. Everyone wins.

week 1

To be done every other day.

1. Swiss ball work:
a) sitting on swiss ball, move hips from side to side, repeat 10 times each side
b) sitting on ball, move hips front to back, 10 times each side
c) sitting on ball, leg lifts, 10-20 times each side. This will strengthen the muscles around the knee joint. While sitting, extend one leg out straight in front of you. Lift it up slightly, a few inches, and hold it for 5 seconds, then lower. Do these unweighted, and aim for endurance.
d) lie on floor, face up, feet on ball. Hips should be bent a bit. Squeeze your butt, and lift it off the floor till your whole body is straight like a plank. Hold for 5 seconds, then lower. Do as many as you feel comfortable with.

2. Floor exercises:

a) Quadruped: get on hands and knees on the floor. Slowly lift right arm and left leg off the floor until they are straight in front and behind you (arm and leg are parallel to the floor). Hold for 5 seconds, then lower. Repeat on other side. Do 5-10 each side.

b) Modified plank position: get on to knees and elbows on the floor. Slowly straighten knees until body is straight and rigid, and your weight is resting on your toes and your elbows, as shown. Hold for as long as you can.

week 2

Do this every other day.

1. Swiss ball work: same as week 1.

2. Floor exercises:
a) Quadruped: Do 10-15 each side.
b) Modified plank position: Do 5 times.
c) Pushups from knees: as many as you can do, as shown (not shown in photo: put a towel or mat under your knees). If you cannot do pushups from knees, substitute pushups against the wall. Stand about two feet from a wall, facing the wall. Place palms on wall at chest height. Lean in to the wall to perform the pushup.

d) Calf raises: holding the wall, stand on the edge of the step to your living room. Slide your heels off the step so only your toes are on the step. Lower heels as far as they will go, then stand up on your toes. Lower heels again, and repeat. Do as many as you like.

week 3

Do this every other day.

1. Swiss ball work: same as first week, with one change to exercise d), as follows:
d) lie on back on floor, feet on ball. Squeeze butt and make body straight, like a plank. Then, keeping body rigid, bend knees and roll the ball towards your butt. Straighten out legs again, lower butt to floor. That’s one rep. Try for 10.

2. Floor exercises:
a) Quadruped: Do 10-15 each side.
b) Modified plank position: Now do these while resting on hands, not forearms, like the top position of a pushup. Do 5 times.

c) Pushups from knees: as many as you can do.
d) Calf raises, try them now one-legged.

weeks 4-8

1. Standing warmup:

a) standing pelvic tilt: while standing, place hands on hips and feel where the top of the hipbones are in front. First, tilt hipbones forward and arch lower back, sticking belly out, as far as you can. Then tilt pelvis in the opposite direction, top of hipbones going back, curling pelvis under and trying to bring bellybutton to your spine. 10 times each direction.

b) Shoulder circles: bring shoulders up, forward, down, then back. Repeat 5 times. Then go the other way: down, forward, up, back. Repeat 5 times. This is done without weight. This “scapular clock” can help alleviate “baby carrier back”.

2. Swiss ball wall squats, 3 sets of as many as you like, aiming to work on gradual improvement of depth and stability. Stand facing away from a wall, and place swiss ball between your back and the wall, holding the ball in place by leaning into it. Then, squat down, rolling the ball down the wall. Go only as deep as you feel comfortable with at first. Once you can easily do 3 x 15 with full depth, hold light dumbbells at your sides. More experienced lifters could start with unweighted squatting if they preferred.

3. Standing overhead press, 2 x 15. Holding dumbbells, stand with good posture. Be conscious of keeping abs and lower back tight, like you know someone’s about to punch you in the gut. You don’t need to suck in, just be aware of them and don’t let the midsection sag. Press dumbbells overhead smoothly.

4. One-arm row on Swiss ball, 2 x 15 each side. This is the same as a regular one-arm dumbbell row, except the ball is substituted for a bench.

5. Pushups from knees. 2 sets of as many as you can do. If you start feeling like that’s too easy, try them from your feet.

6. One-legged calf raises, as before, off the step of your living room. 2 sets x 15, hold a dumbbell in one hand for more resistance. Hold the wall with the other hand.

7. Floor exercises:

a) Swiss ball bridge and ball roll, as in week 3. 2 sets, as many as you can do.

b) Quadruped: Do 10-15 each side.

c) Modified plank position: Now do these while resting on hands, not forearms, like the top position of a pushup. Do 5 times.

d) Superman: lie on floor, on your tummy, arms straight above head. Raise legs and arms off the floor at the same time, so you look like Superman flying. Hold as long as you can. Repeat 2-3 times.

After 8 weeks (again, this varies), after having been assured that a base level of conditioning had occurred, I would then move to a more conventional type of weights workout.