If you are expecting, have recently had a baby, or are trying to conceive, you likely know there are some really strong opinions about exercising during pregnancy out there. The infamous “they” will tell pregnant women how much, how often, how hard, etc. to exercise, but where’s the research and evidence to back any of the hearsay? What is the appropriate exercise and fitness level for pregnant women?
The short answer is – there is no straight answer. We all have different levels of fitness, different physical demands, different hearts and circulatory systems – to give one blanket piece of advice across the board is, in my opinion, misguided.
What is backed by research is the idea of using a scale to determine the level of perceived exertion. I find using a 1-10 scale is easiest to understand and relate to, but others may use another range. This scale allows a pregnant woman to rate her perceived exertion, or the level at how hard she feels she is working. For example, #1 would be the equivalent of kicking it on the coach watching Golden Girls, while #10 is max effort, about to pass out, black out and vomit all over everything and everyone. A pregnant woman should never be a 10, or even a 9 for that matter. In my experience, there’s just no need during this time of your life to ever exert yourself that much. It is instead recommended that an 8 be the max. This equates to adequate levels of oxygen and nutrients delivered to baby and mom while she is able to challenge herself physically and emotionally.
Rather than checking heart rate, which has been a common practice, it has been shown to be more impactful if after exercising, women continue to rate their perceived exertion as it changes day to day, as well as baby’s kick counts. Baby’s level of activity changes throughout the day, and typically well into the third trimester providers will recommend keeping track of baby’s movements. This is something that tells care providers what’s going on without having to hook up the ultrasound machine each week. Baby’s kick count should be 10/hour on average – meaning some hours baby moves like wild, while the next hour baby may be sleeping and moving less.
The other myth that many of my clients hear is that pregnant women shouldn’t workout hard because it will harm them and or their baby. This could be important for some to follow, if your physician has identified yours as a high-risk pregnancy, or if you have certain health concerns that require you to scale back on your exercise routine. Please make sure you discuss your specific exercise questions and concerns with your health care provider prior to exercising, regardless of what stage you are at in pregnancy. However, in many cases that I see with my own clients who have been deemed healthy and able to workout as they’d like, I feel as if that information keeps getting passed down and passed down like your great, great grandmother’s weird jello marshmallow fruit salad. No one really likes it, but we just keep eating it and making it because, I mean, it’s tradition. I am adamant that it’s important for pregnant women to be as strong as they possibly can be leading up to the day of delivery. This varies from woman to woman, which is very important to note. Labor is often considered the hardest, most challenging physical activity of a woman’s life, and is compared to running a marathon for good reason. No one can predict how long or how difficult labor will be, or anything else about a women’s labor, no matter if it’s baby number 1 or 11, so the important thing is to prepare for and train for it just as you would any other major physical event.
Exercise has been shown through research to improve labor outcomes in many degrees. It has been shown to increase the maximum amount of energy a woman can generate, and the amount of oxygen she can use, increase the use of fats as an energy source, reduce insulin resistance, increase metabolic capacity, insulin sensitivity, muscle mass and fat stores, as well as lower laboring time, decrease sensations and perceived difficulty, and train the mind to overcome difficult situations. Wow! And babies of women who exercise don’t have trouble transitioning to life outside the uterus and tend to be alert and easy to care for, according to Dr. James Clapp MD who studies physical activity in prenatal and postpartum women, as well as the babies they deliver.
One last thing to note is that women who are more physically fit before and during pregnancy report an easier transition to motherhood, both physically and emotionally. Just like saying the more you prepare for a marathon the easier that marathon is, and the easier the recovery will be after – the same goes for preparing to give birth and become a new mom.
There are certain movements and exercises pre- and postnatal women should avoid as baby develops, and as mom heals, so it is crucial to work with an expert in the field of women’s health who understands the physiology of pregnancy and a woman’s body so as not to increase risk of injury. And it is equally important that women work and communicate with their care provider throughout the pregnancy and postpartum period on their physical activity, goals, and their emotional needs during and after pregnancy to be sure mom and baby are safe and healthy.
Join me at a special Woodside event, BIRTHFIT KC Power Hour, on Thursday, December 7th at 4:30pm to learn more. Click here to register for this complimentary introductory class.
Chelsea Craig MK, ATC, LAT
Women’s Health Rehabilitation Specialist
Birth and Postpartum Doula
*The views and opinions expressed in this article are those of Chelsea Craig, MK, ATC, LAT, and do not reflect the thoughts, beliefs or policies of Woodside. Please consult your health care provider before starting any exercise or fitness program.*