Exercise and Pregnancy: Benefits, Challenges and What Nobody Talks About – Dr. Julie Schurr
Exercising pregnant has its own set of goals, challenges and benefits, but it most definitely doesn’t look like your exercise regimen prior to the baby bump. Understanding the why and how modifications to your exercise routine can help keep you safe is important and so rarely discussed.
In our experience, a pregnant woman motivated to stay fit for herself and for her baby can expect positive impacts in her mood, physical strength and endurance and on the development of her child. Clear evidence shows a reduction in certain pregnancy conditions like gestational diabetes and hypertension with regular exercise. Controlling your weight and improving your endurance and core and pelvic floor strength has also shown to lessen the first stage of labor (the cervical dilation phase) and maybe the second stage (the pushing phase).
Labor is aptly named. I remind patients of this during the common struggle with fatigue and exhaustion while in the throes of a long labor- it’s Work! Exercise and the associated mindset of pushing the limits of your physical strength and endurance is a very similar experience to being in labor. That familiarity trains the brain and strengthens your body to endure while in labor. Pregnant women who exercise regularly move, feel and breathe better in labor. And besides, you get the best “prize” in the world at the end that makes it all completely worth it!!
When addressing the common question about the kinds of exercise to do while pregnant, I typically ask about the type of exercise they are currently doing. If you aren’t an active member of a rowing team, now is not the time to join. I’m always excited when a newly pregnant patient is motivated to stay fit when pregnant, but common sense is the rule to avoid injury and potential harm. Here’s a few pearls I share with patients.
- Use the “Talk Test”. In the era of Apple Watches and Fitbit we can monitor just about everything about ourselves while exercising. Breathlessness during exercise is the poor man’s monitor signaling a move towards anaerobic threshold. Your goal in pregnancy is to remain aerobic, meaning all of your tissues are easily perfused with oxygen, and that includes your pregnant uterus, and by proxy, your baby. If you can talk or sing a song while exercising you are aerobic. Looking at your heart rate at the point of breathlessness is interesting as it will decrease as the cardiovascular and respiratory demands rise as your pregnancy advances, and its different for everyone depending on your age and level of physical conditioning prior to pregnancy. In other words, a 20-year-old elite athlete may be breathless at a heart rate of 180bpm in her first trimester and 160 bpm in her third trimester. While a busy 40-year-old executive who exercises just twice weekly becomes breathless at 140bpm in her first trimester and 120bpm at term.
- Cardio is Important. Yes, training your heart and lungs and burning calories is good stuff. If you like running, hit the streets or treadmill. Alternatively, other good cardiovascular options include swimming, rowing, stairs and shadow or bag boxing. The goal is a sustained elevation in heart rate for 30-45 minutes. Cardio trains your heart and your breath and builds endurance; all important when pregnant.
- Strength Training is Key. It is a myth that lifting weights builds bulky muscles. Strength training will tone and define your muscles while making them stronger, but a woman does not look like Arnold Schwarzenegger unless she works out continuously and uses certain supplements. That being said, I typically advise pregnant women to use smaller weights and do more frequent repetitions. This is because during pregnancy our center of gravity is shifted as the pregnancy advances and our core becomes a bit unbalanced placing a lot of strain on the back. Back strain in pregnancy can happen with simple day-to-day activities. Exercise increases the risk. Simply using your body weight for strength training also works well (e.g. planks and push-ups, Pilates and some Yoga) with minimal risk. Strength training also increases your metabolism by increasing your lean muscle mass. This has some long lasting effects and helps you lose your “pregnancy weight” post-delivery.
- Don’t forget to Stretch. The mantra of every personal trainer and physical therapist I’ve ever met. I would interject “Gently and Slowly”. Pregnant joints can be hypermobile and at risk for injury. Thinking “Slow and Gentle” allows you to listen to what your muscles, tendons and joints say. Stop if pain occurs. Classes like Yoga and Pilates are good as long as your instructor can provide you with some modifications. Alternatively, check out the prenatal yoga class given by our very own Christine Kern Steffen, CNM- The Madison Midwives!