Should I be working out while pregnant?

So you’ve found out you’re expecting, and life has become a whirlwind of doctor’s appointments, internet research, and well-meaning people staring at your belly more often than you’d like. First of all, congratulations! It’s going to be crazy, but there are things you can do to help yourself along. One of the major factors in how well your pregnancy goes is maintaining good health and wellness habits, which includes a regular exercise routine catering to your personal level of fitness. While you won’t be trying for the CrossFit Games or a new +100 lbs Deadlift Personal Record over the next few months, you can still maintain most of your current routine with some changes over time. To help you along, we’ll be starting with some general rules for the newly pregnant, and then moving through the trimesters step by step.

Disclaimer: I am not a medical doctor, and my advice should not be considered the advice of a medical doctor. The information below is based on several expert opinions in the medical field via published research, as well as anecdotal (i.e. personal experience) information received from expecting and delivered mothers who are active athletes. Lastly, I base some advice on my own education, research, & experience in the health and fitness field. If there are ever ANY doubts about what you should be doing, for any reason, please consult your caregiver.

The 1st Trimester, or “Holy Crap, I’m Pregnant!”

Once you determine that you’re pregnant, it’s time to start making some changes to your routine to provide the best physical environment for your growing baby. Many women make the mistake of stopping exercise when they become pregnant for fear of damaging the developing embryo, but recent research has suggested that not only is exercise beneficial in general, it also helps lessen the negative side affects of pregnancy while making delivery easier. Seriously, how can you go wrong with that?

“You need to be physically active during pregnancy. It has terrific benefits that are associated with a better pregnancy outcome and even shorter labors. It’s a win-win for baby and for mom.”

-High-risk pregnancy expert Laura Riley, MD, spokeswoman for the American College of Obstetricians and Gynecologists (ACOG), Author of Pregnancy: You and Your Baby.

The general rule you should be following is “maintain what you’ve got” with respect to your current level of activity. The first trimester introduces some specific limitations, but nothing too crazy:

  • Stop smoking, drinking, and doing drugs. (This is here for completeness. You really shouldn’t be smoking or doing drugs anyway, and moderate drinking at most.)
  • Don’t try to hit any Personal Records from here on out. Going for maximum weight lifts, trying to improve your 1.5 mile time, and other huge exertions are not what your developing baby needs right now.
  • Most of your current activities are probably fine to continue, with the exception of any movement or sport that has the potential for high impact to your abdominal region. This means that for the CrossFit mommas, you need to stop doing Wall Balls and Chest-to-Floor Push-ups / Burpees. Basically, don’t slam your stomach into anything.
  • Yous resting heart rate will be about 20 beats higher than normal, so if you normally hover around 80 BPM, you should expect a resting heart rate of 90-100 BPM while pregnant. Your body is producing more blood to feed your baby, and your heart needs to pick up the pace to keep everything flowing correctly.
  • Since your resting heart rate is now so much higher, it is no longer a good measure of the effort you’re putting in while exercising. Instead, you should be measuring effort based on your breathing and perceived exertion. The rule here is, you should be able to hold a light conversation with minimal periods of heavy breathing while exercising.
  • Water is good. Drink a lot of it.
  • Do not, under any controllable circumstances, work out to absolute exhaustion. Always have some gas left in the tank after your workout.
  • You don’t actually need to double down on your calorie intake (i.e. eat for two). Generally speaking, a woman only needs about 300 additional calories per day to support pregnancy, and you should be eating healthy foods to hit the new calorie requirements.

That’s it for the first trimester. It may seem like a long list, but in reality it’s all leading towards the same basic things: protect/strengthen your abdomen, reduce bad habits, and save some energy for the important work of growing the baby.

Physio Note:

During pregnancy your body begins releasing a hormone called relaxin. Just like it sounds, the job of this hormone is to lubricate the joints and make them “relax” more and become easier to open/less stiff. This is intended to help with delivery, as tight hips would make things even more difficult than they already are.

The down side, however is that relaxin causes all of your joints to be better lubricated and thus more prone to injury when going through their full range of motion. This is one of the reasons why your squats are now staying at or above your knees. Closing the knee joint any further could lead to overstress injury, even if you had solid low squat strength before.

The 2nd Trimester, or “Please, No More Nausea!”

As the second trimester rolls around, the restrictions on your exercise increase to further protect the baby and prevent injury or overstress. Again, you’ll see that these rules are all following the same basic themes, but I’ve gone into detail in direct response to questions I get from our pregnant CrossFitters (or their partners). At this juncture, what we’re really trying to avoid is too much pressure or stress on the uterus and supporting structures (like blood supply).

Here is your new list of changes to make:

  • Do not squat lower than 90 degrees (i.e. hips at or above knees).
  • Stop doing anything that forces you to lay on your back. The uterus is now heavy enough to cut off blood supply to the baby. Ab/core targeting exercises are fine, but should be changed to hanging versions (toes to bar, knees to elbows).
  • No inverted exercises like handstand push-ups, handstand holds, or anything that puts you upside down. If you are a practiced gymnast, you can usually get away with these movements for a little longer, but otherwise just stop going upside down.
  • Kettlebell Swings need to be lighter than usual (60% of max or less) and if they become uncomfortable you should switch to light one-handed swings instead.
  • ANY movement that causes abdominal discomfort should be switched out with something that doesn’t. Examples would be changing Box Jumps to Box Step-ups, removing kipping movements, etc..
  • All weighted movements need to have the weight lowered by about 25%.
  • Once your belly extends into the path of the weights on barbell movements, you should switch to equivalent one-handed movements using dumbbells or kettlebells.
  • All Cleans and Snatches should now come from the hang position (i.e. start no lower than your knees) and you should not be catching the movements in a squat position. Essentially, “Hand Power” versions of Clean and Snatch are your new go-to choices for these movements.
  • Start doing Deadlifts with kettlebells, so that the working weight is centered on your body. You can also do light Sumo-stance Deadlifts as long as your belly doesn’t interfere with the movement path.
  • Row, walk, run and jump rope until they become uncomfortable.

These are an extension of the rules in the 1st Trimester, and the biggest rule here is to listen to what your body is telling you. If a movement is uncomfortable, particularly in the abdominal region, you should be substituting for another movement that provides similar benefit, but reduced drawback.

The 3rd Trimester, or “Are We Done Yet?”

Here you are. The 3rd Trimester. The Home Stretch. You’re almost done doing some of the hardest work your body is capable of doing and that’s pretty awesome. We have good news and bad news for your exercise routine.

The good news is that there really aren’t too many further restrictions to add since the 2nd Trimester. You may find yourself needing to reduce your weights a bit more, or spend less time with bouncy movements like running and rope jumping, because they’ve become uncomfortable. That’s all okay and expected. Keep doing the exercises that are comfortable, pay attention to your breathing (remember, you should be able to have a conversation while exercising), and drink plenty of water.

The bad news is that your belly is probably pretty big now! You may notice that many barbell movements are no longer comfortable, and that ab work is iffy at best. It stinks, but until you deliver there isn’t much you can do besides substitute in exercises that fulfill the same needs while minimizing the discomfort. The good news is the fitness industry has been creating exercise routines forever, so you have a lot of options. The upside to the bad news is you’ll get to try exercises you may not have tried before, and maybe even find something you like just as much (or more) than your previous routine. Clouds and silver linings, after all!

Postpartum, or “Gettin’ Back to It!”

Whoa! You had a baby. That is super awesome. No seriously. Reflect on this for a second: you built a person. Good job!

Now that the hard work of being pregnant and giving birth is done, it’s time for the hard work of getting your body back in non-pregnant shape, and ramping back up to your old activity level and capabilities. Just like before, you need to be listening to your body throughout the postpartum stage of child birth. If it doesn’t feel right, then do something different. This will be your guiding star from now on.

Be aware that it may take a few months to get back to where you were way back at the start of the first trimester. Remember, you’ve been making workout changes, restricting your movements, and gradually decreasing your workload for about 9 months, so it isn’t unreasonable to expect it to take 2-4 months to ramp back up again. Don’t let impatience guide you, because you don’t need an injury as your first step on the road to post-baby body.

Initially, you are going to be tired. The effort you put in to grow and deliver the baby is one thing, but caring for a newborn is going to be it’s own effort as well. Keep moving as much as you can, and figure out where in your new life exercise is going to fit best. For the first 3-4 weeks that may be as simple as walking the baby around the house, doing a little stretching/yoga when you find 15 minutes of time, or recruiting your partner to help out while you walk the treadmill for a mile or two. Whatever fits in your schedule, just keep moving. Exercise helps maintain energy, which you’re going to need!

Don’t discount the mental benefits of exercising, either. Over almost a year, the majority of your physical and mental energy has been spent caring for your baby. That isn’t going to change either: now instead of caring for them internally, it changes to external care. Exercising can help you feel the very-necessary amount of self-worth you get from doing something kind for yourself. Keep moving not just because it gives you more energy and makes you physically healthier, but also because it gives you that much needed jolt of “I’m important too”.

As far eating is concerned, you should maintain clean/healthy eating habits, but you will need to keep a higher calorie intake as well. Now, instead of using the extra calories to grow the baby, you’ll be using them to get your body back into shape and produce breast milk. Foods to eat a little extra include healthy unsaturated fats, fruits, and vegetables. Fish oil supplements – a great source of Omega-3 Fatty Acids – are a good supplement on top of your regular daily multivitamin.

Important Note: If you notice that your milk supply starts to decrease before it should, increase your healthy food intake and monitor the supply. You need calories to make breast milk. If you have been restricting your calories (either on purpose or because you’ve had trouble eating), then you need to up the calorie intake to help increase production. Working out postpartum AND breast feeding will both require a higher calorie intake, so adjust accordingly.

Like at any other time, if you experience issues which are not resolved by temporarily decreasing exercise intensity, making healthy adjustments to your diet, or resting a little more, talk to your doctor!