How should you exercise during pregnancy? The biggest myths unpacked
Hi, my name is Anna!
I teach yoga, strength and movement for Mama’s. I have created this space to help you to recharge, nourish your body and mind and to reconnect with yourself on this crazy journey of motherhood.
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How should you exercise during pregnancy? The biggest myths unpacked
When I was pregnant with my daughter 10 years ago, I had absolutely no idea how to modify my training. I just continued doing all the things I had always been doing; running long distances, high intensity training, power yoga and hitting the gym. My doctors and midwives just said “do what you have always been doing and maybe add some prenatal yoga”, I was never recommended to go and see a women’s health physio, or provided with any specifics on how I should adjust my training.
Now I’m not sitting here playing the victim, those health professionals were doing the best they knew at the time, and pelvic floor and core health are not exactly covered at length in medical or midwifery degrees, if at all. I also didn’t do any of my own research, just placed all the responsibility into the hands of my care providers. However, as medical professionals providing care for pregnant women, I believe they have a responsibility to keep up to date with the research and provide advice based on current evidence and guidelines.
Personal trainers, movement coaches and yoga teachers often don’t have much of a clue in this area either. The trainers at my gym couldn’t provide me with any specific advice, they told me to do what I had been doing but don’t overdo it. I really enjoyed my prenatal yoga classes, but as someone who has always loved hard training and pushing to my limits, the teacher’s advice of “listen to your body” just didn’t resonate with me. I found myself asking “but what does that even mean?”
Postpartum came along, and again I was faced with the question of what to do now with my training? When I found that I couldn’t run or lift weights without leaking I felt like a huge failure. Why was my body doing this to me? What had I done wrong during pregnancy? Should I just push through and eventually it would stop or was this my new normal? I felt so lost.
Now, as a movement teacher specialising in pregnancy and postpartum movement, I am passionate about educating women around these issues so that they can feel confident they are training safely and effectively during these seasons. I wish I could say things had improved drastically over the last 10 years, and whilst awareness and education have definitely come a long way, there is still work to do. I hear from so many women who are still receiving such poor advice around exercise from their health care providers and fitness coaches.
Here is some advice that I have heard commonly over the years (and you have probably heard too!), and they drive me up the wall!!
- Keep doing what you have been doing but don’t add anything new
- Just do gentle walking and prenatal yoga
- Don’t lift anything heavy
These old tips are so vague and inaccurate, they end up confusing people more than guiding them and create unnecessary fear. Let’s break them down…
"Keep doing what you have been doing but don't add anything new"
Alright, there might be some tiny shred of truth here, pregnancy is not the time to start training for that marathon, or to get your first unassisted pull-up, but you absolutely can start a new training program or style of exercise during pregnancy. Pregnancy is also a time when some types of exercise need to be placed on hold or dialled back, so “keep doing what you’ve been doing” is not great advice here, especially if you are a high level athlete, if you train martial arts, contact sports or you are someone who just loves going fucking hard in the gym or on the trails. If you are someone who likes to go for daily walks then no you probably won’t need to stop those, but you might want to consider adding in some strength training and definitely adding some specific pelvic floor and core work. It is so important to actually look at the individual, what they are currently doing, and adjust the training schedule for that person’s needs and goals.
Pregnancy should be viewed as a gradual training deload. Meaning that during the first trimester you can usually keep your training relatively unchanged, although this is so dependent on your symptoms (if you are chucking your guts up everyday you probably won’t feel like going to crossfit!). As your pregnancy progresses, load, intensity, volume and type of training all need to be scaled back to support pelvic floor and core preservation. This can be so challenging, especially if you are used to a certain level of training, and still feel the energy and strength to keep hitting it hard. You will get back to the things you love, and get back there faster if you take the right approach now.
"Just do gentle walking and prenatal yoga"
Prenatal yoga can be an amazing way to keep moving the body during pregnancy, and I am a yoga teacher so clearly I am a big fan! However, not all prenatal yoga is created equal, and only engaging in passive stretching during pregnancy with no strength work can lead to more harm than good.
The hormone relaxin increases during pregnancy, its purpose is to create joint laxity in the pelvis to enable more movement for the baby to pass through. Relaxin is thought to be at least partially responsible for some common aches and pains during pregnancy such as low back pain and pelvic pain. Research has also shown that women who have lower back pain in pregnancy often have weaker hip and back muscles. Continuing to just “stretch it out” often makes symptoms far worse.
I hear from women who are just too afraid to engage in the training they love because of the misinformation or lack of information available on safe exercise during pregnancy. Many health professionals are extremely cautious in the advice they give women for the same reason – fear.
So better just to tell women to “take it easy” or “just do some yoga” during pregnancy and no harm done right? Wrong. Exercise has so many known benefits, and many of these benefits are specific to pregnancy and postpartum and include; lower incidence of excessive weight gain, gestational diabetes, gestational hypertension, preterm birth, caesarean sections, and lower birth weight.
Beyond the physical benefits of exercise, equally if not more important are the mental health benefits. For many women training is also a huge part of self-identity, mood regulation and general wellbeing. For professional female athletes, it might also be their main source of income, and ceasing to engage in their sport may cost them their livelihoods and their careers.
But I digress… coming back to yoga. For women with issues such as lower back pain and pelvic girdle pain, some common yoga poses like forward folding (spinal flexion), single leg work such as standing balances or wide leg poses like straddles can actually exacerbate their symptoms. If you attend a yoga class where the teacher doesn’t have this understanding, and no other options are given, a woman might walk away feeling physically worse than before, feel defeated and confused and maybe even stop exercising altogether.
Prenatal yoga is amazing, and can be so beneficial! But is it the only exercise that should be recommended to women in pregnancy? And should they be told to cease all the other physical activities that they love? Absolutely not.
"Don’t lift anything heavy"
Oh man this one really gets me going. Type ‘how heavy should I lift during pregnancy?’ into google and you will see a range of advice from a number of large health organisations that is based on absolutely NO evidence. Common advice is not to lift anything over 5-10 kg depending on your gestation. Um… ok sure, so if you happen to already have small children whilst you are pregnant, too bad, you won’t be able to pick them up; and forget bringing in the groceries from the car, carrying that loaded washing basket, or picking up the dog food bag.
The fundamental problem with this advice is that most women still have lives to lead that involve lifting things over 5kg, and when they still have to do these tasks but have been told they shouldn’t, there can be overwhelming feelings of guilt that they might be putting their unborn baby at risk. This is so wrong on so many levels.
Miscarriage in Australia occurs in 1 in 4 pregnancies. Yes, it is that high. In 60-70% of cases the cause is a major chromosomal abnormality. Still, women often blame themselves, and look for reasons why. Misinformation like you shouldn’t lift during pregnancy can contribute to these feelings of guilt and shame around a pregnancy loss. There is currently no evidence to suggest that regular moderate-intensity strength training (incorporating weight lifting) contributes to miscarriage.
In later pregnancy, women can be at risk of developing decreased bone density due to the calcium and phosphorus requirements of the baby. As well as dietary changes and supplement support, it is recommended in the literature that women engage in weight-bearing activity to try and mitigate some of these effects. If women feel afraid to engage in strength training during this time due to the advice they have been given, they are at risk of missing out on these amazing benefits for their long term health!
So as you can tell, I am committed to cutting through all the noise and focusing on what the current evidence tells us, how women actually feel in their bodies, and leaving fear and doubt behind when it comes to moving during pregnancy. The benefits for body and mind are just too great for women to be scared to move their bodies.
REFERENCES
Borowski, Lauren E. MD; Barchi, Elizabeth I. MD; Han, Julie S. MD; Friedman, David A. MD; Carter, Cordelia W. MD. Musculoskeletal Considerations for Exercise and Sport: Before, During, and After Pregnancy. Journal of the American Academy of Orthopaedic Surgeons 29(16):p e805-e814, August 15, 2021. | DOI: 10.5435/JAAOS-D-21-00044
Ribeiro, M. M., Andrade, A., & Nunes, I. (2022). Physical exercise in pregnancy: Benefits, risks, and prescription. Journal of perinatal medicine, 50(1), 4-17.
Avery ND, Stocking KD, Tranmer JE, et al. Fetal responses to maternal strength conditioning exercises in late gestation. Can J Appl Physiol1999;24:362–76.doi:10.1139/h99-028
