If you’re thinking about having a baby, proactively preparing your body through exercise can make a big difference. Photo / Meron Tekie Menghistab, the New York Times
Pregnancy can feel like a nine-month feat of strength and stamina, filled with relentless physical challenges, from the extreme fatigue of the first trimester to the breathlessness and back pain of the third.
While regular exercise during pregnancy can help manage these issues, experts say youcan also prepare your body before getting pregnant — in the same way you might train for an athletic event — using exercises that specifically benefit a pregnant body.
“The work of pregnancy, labour, delivery and then post-partum — it’s all one long marathon,” said Maura Shirey, who runs Bodies for Birth, a pre-natal and post-partum fitness programme in Seattle. “If you can dedicate time up front to having a strong foundation, then it’s just going to mean a more energetic, more comfortable, stronger experience,” she said.
Working out regularly beforehand also allows you to continue at a similar clip while you’re pregnant. If you’ve been inactive before pregnancy, your options are more limited because doctors advise against pushing yourself far beyond your typical activity level during pregnancy.
“You’re going to get so much more benefit if you start earlier,” whether that’s six months beforehand or six years, said Michaela Burns, a personal trainer in San Francisco who specialises in pre-natal and post-partum fitness. Plus, she added, once you’re in the thick of pregnancy, “it is really hard to start a routine, especially in your first trimester, when you feel so crummy”.
“Pregnancy is a stress test,” added Dr Cynthia Gyamfi-Bannerman, a high-risk obstetrician in San Diego and a chairwoman on the American College of Obstetricians and Gynaecologists’ committee on exercise during pregnancy. “There are so many complications that can be mitigated by being healthy coming into it.”
Whether you already have an established routine or are starting from square one, here are a few proactive workouts recommended by pre-natal and post-partum fitness specialists.
First, treat any injuries
It’s important to treat any lingering musculoskeletal issues such as sciatica, plantar fasciitis, hip issues or back pain before getting pregnant, said Lisa Schoenholt, the founder of Brooklyn Embodied, a pilates-based pre-natal and post-partum fitness programme.
“If you have an injury or pain, those tend to be exacerbated during pregnancy,” she said, thanks to increased pressure on the spine and hormonal changes (like the release of relaxin, which loosens your muscles, joints and ligaments to help your body stretch).
A physical therapist or exercise physiologist can help address any issues a few months or more before trying to conceive.
Find a cardio workout that works
Doing regular aerobic workouts before becoming pregnant can create a secure foundation for pregnancy, said Catherine Cram, an exercise physiologist based outside Madison, Wisconsin, who trains health professionals in pre-natal fitness.
“The changes of pregnancy, [with respect to the cardiovascular system], are so profound,” she said. Your blood volume increases by 45 per cent, your heart rate increases and you face a risk of gestational high blood pressure. “Exercise really helps with all of those stresses,” she added.
She suggested finding an aerobic activity you enjoy and can do regularly. Walking, running, swimming, biking and dancing are all great options. Strive for roughly 150 minutes of moderate activity per week.
Get to know your pelvic floor
Pregnancy also strains your pelvic floor, the hammock of muscles at the base of your pelvis. Not only are these muscles important for core strength, but they also hold multiple organs in place, including the bladder, bowels, vagina and uterus. When they’re weak, you may experience incontinence or pain.
The solution isn’t to do a hundred kegels a day, said Carrie Pagliano, a pelvic floor physical therapist in Arlington, Virginia. As with any muscle, being able to relax the pelvic floor muscles is as important as being able to engage them, she said, so they are capable of a full range of motion. Learning how to correctly do both before pregnancy can help you manage the challenges ahead.
Try a basic pelvic floor workout to familiarise yourself with your pelvic floor, or visit a pelvic floor physical therapist for a personalised evaluation and programme.
Experts recommend full-body strength-training before pregnancy, but most suggest paying particular attention to a few specific muscle groups that will likely be pushed the hardest.
Core
During pregnancy, your core muscles will need to support a rapidly growing uterus and belly. The deep transverse abdominal muscles that wrap around your lower torso are especially important. When they aren’t strong enough to support the weight you’re carrying in the front of your body, you can experience pain and tightness in your lower back.
An effective way to strengthen the full cylinder of core muscles is to do planks, side planks and pointers three or more days a week, Burns said.
However, core muscles that are too tight can also lead to injury during pregnancy, Schoenholt said, so it’s import to balance strength with flexibility training.
“Your abdominals spread apart and then move back together during pregnancy and post-partum, so we actually want there to be a lot of elasticity,” she said. Breathing exercises can help.
Workouts such as yoga and pilates focus on strengthening the core muscles but also typically include deep breathing exercises, which can help to improve both strength and flexibility in your deep core.
Glutes and legs
During and after pregnancy, your lower-body muscles will be working overtime — not only do they help to bear the extra weight of pregnancy and stabilise your lower back, but post-partum, they are also key to lifting and lowering the baby safely.
Burns recommended doing squats, bridges and deadlifts at least three days a week to strengthen them. “The squat is your favourite friend,” she said. “Body-weight squats are great. Loaded squats are great, with any kind of weight.”
Upper back
During pregnancy, as the breasts and belly expand, gravity pulls the upper body forward. Then, during the post-partum period, holding or breastfeeding a baby can keep you in this slumped position. “There’s a lot of load for a long time,” Burns said.
To counteract this issue and avoid the neck and shoulder pain that can follow, focus on working the upper back muscles, she said.
Rowing movements, chest flys and “anything that can get those shoulder blades pinching back behind you”, she said, will help to develop the upper back and shoulder strength you need.