Working Out, Nutrition During Pregnancy and Beyond: Changes to Consider

Many trainers are not fully educated to work with clients who are pregnant or recently postpartum – this is such an underserved area of personal training clientele. The female body goes through insane changes while pregnant – BUT she can and should continue to strength training! Being aware of the various bodily changes will help both the trainer and client get more out of each session. A lot of women may stop working out because they are scared and simply not educated appropriately as to how much she can and/or should do. They don’t know how high they can get their heart rate and they are worried about harming the baby. I am here to share a ton of information as I recently got my Girls Gone Strong Pre/Post Natal Training Certification. I am going to share BENEFITS of working out while pregnant as well as implications to consider for each trimester and then after birth I will share the timeline for getting back into the swing of TRAINING! Here we go!

Benefits of Strength Training During Pregnancy:

Reduced risk of gestational diabetes, increased muscle mass, better blood sugar balance, decreased risk of low back pain, decreased recovery time postpartum, decrease risk of urinary incontinence, prevention of excess weight gain and more.

That being said, here are some things to keep in mind for each trimester.

Trimester 1: not much has to change AT ALL in the woman’s training. She can carry on all her normal strength and cardio workouts. She may experience, at times, morning sickness, indigestion, breast tenderness, dizzy spells and lightheadedness however but these are all things that the trainer can work around with the client, and try to fit in workouts when she feels her best. The trainer should be understanding and try to accommodate the client as much as possible so that she can work through and around symptoms to maintain strength and fitness.

Trimester 2: Things start to change a little, as she enters the later parts of second trimester she may want to consider removing olympic barbell moves (if she is a level 2 or 3 client and was previously doing these types of moves pre-pregnancy) and as the belly grows, front loaded exercises may become challenging (pushups, planks, front squats). She may also experience round ligament pain, leg cramps, and preeclampsia (sudden onset of very high blood pressure) also becomes a (rare) possibility at 20 weeks. Also at this time it’s important to back off high-impact training and perhaps include extra stability assistance as her balance may become a bit off with the growing belly. For example, using a PVC pipe to aid balance in a Bulgarian split squat or perhaps switching to bilateral strength moves rather than unilateral as needed.

Trimester 3: As the belly continues to grow, she may become quite fatigued and feel off balance even more. She may need to take shorter, more frequent walks rather than 1 long walk (i.e., 45 mins) to aid in pelvic floor recovery, and also resting immediately after workout is beneficial to aid in pelvic floor recovery. She may be more fatigued and also could be experiencing carpal tunnel symptoms as well as struggling to get a good nights rest due to frequent urination and pressure on the bladder. A tip to aid with carpal tunnel or wrist pain could be to avoid wrist extension – so modifying the exercise by placing a mat or folded towel under her palm to avoid too much flexion at the wrist. Also there are beneficial mobility exercises and stretches she could do for her wrists to aid symptoms. Knowing about these possible side effects from pregnancy as well as modifications and mobility exercises to give the client is very helpful.

She can continue to strength train but avoid laying directly on her back, so adding an incline to the bench for a dumbbell bench press would be helpful, keeping her from doing too many position changes while strength training is also helpful (avoid getting up and down on the floor, for example). Also, in this trimester (as well as trimester 2) it’s important that she avoids pushing to 100% effort. She should always save a few reps in the tank and never push to failure when lifting. Of course, every pregnancy is different and the client should listen to her body and do what she can but not push through miserable symptoms. Shortening the duration of the workout, incorporating more mobility type of moves, and reducing the volume (sets and reps and load) will be helpful to allow her to continue to move her body in ways that feel good.

Heart-rate, High Intensity Training (HIT), and High Intensity Interval Training (HIIT):

The client’s training level prior to pregnancy will be a predictor of how high she can keep her heart rate as well as whether or not she should and can participate in High Intensity training (vs. HIIT, which is never advised during pregnancy). Vigorous-intensity cardio (HIT) can be included by women who previously participated in this type of training regularly. This type of client will be better adapted to handle high rates of physical work. Now, HIT is not to be confused with HIIT – HIIT is effort perceived at 9.5 or 10 out of 10. HIIT is not to be done while pregnant. HIT (high intensity training), on the other hand, is activity with effort perceived at 7 or 8.5 on scale of 1-10. This includes moderate to heavy strength training with shorter rest intervals and more sets, hiking, jogging, cycling, etc. It is recommended that the client keep HIT at or below 75 mins per week – in 15-25 minute sessions for 3-5 times per week.

Clients who regularly engaged in strength training and high intensity training for a few times per week for more than 1 year prior to getting pregnant should not exceed 90% of their max heart rate while training. Clients who are more new to strength training should base their effort on a scale of 1-10 and not exceed 8/10 exertion. Women who are more used to pushing themselves hard on the regular may underestimate how hard they are working on a scale of 1-10 so that is why with that type of client (called level 3 client) it’s important to use heart rate as the judging factor of effort.

General timeline for returning to exercise after birth

After birth it’s very important to allow the body to appropriately rest and heal. The three goals for a client post-birth are: rehab and recovery, improve function of the core and pelvic floor, rebuild strength and aerobic capacity.

0-6 weeks: rehab and recover. Perhaps easy gentle walking, around 10 minutes 1-2x per day for the first two weeks, 20 minutes 1-2 x per day in the 3rd and 4th week, and up to 30 minutes 1-2x daily for weeks 5 and 6. For these first 6 weeks it’s very important to rest as much as possible so the body can properly heal and recover. Trying to do too much too fast can slow healing of the pelvic floor muscles and abdominal muscles. Gentle walks are fine as well as pelvic floor strengthening, cat/cow, hip bridges, bird dog and easy bodyweight squats.

7-18 weeks: return to exercise. Now she can get into a true strength routine of 2-3 x per week. These can include exercises to train the entire body both bodyweight and lightly loaded. Walking can increase up to 45 mins per day, and for the second half of this training phase she can begin to incorporate moderate-intensity cardio for 1 session per week, or even a higher intensity cardio for 1 session per week if she is showing signs of progress and no symptoms (up until 13 weeks she should stick to low intensity cardio such as walking).

19-42 weeks: Prime and prepare. This is also the time that high impact activities are OK as long as no symptoms arise (pelvic floor symptoms). She can progress from 2-3 strength sessions per week to more if desired, incorporate 1-2 high-intensity sessions, as much walking as she desires, etc.

Nutritional Needs Throughout Pregnancy

I thought I would touch on this topic just a little – how nutritional needs change throughout pregnancy. For the first trimester there are actually no additional calories needed to help fuel the baby. During the second trimester an additional 340 calories per day is needed (on average), for the third trimester an additional 452 calories per day is needed. During postpartum if she is breastfeeding an extra 500 calories per day, on average, is necessary. These numbers are not set in stone and everyone is different, so perhaps just an extra meal or a couple of extra snacks are needed on top of her normal diet. Try to focus on nutrient dense foods and not “junk and processed” foods though, so high quality proteins, nutrient dense carbohydrates like sprouted grain bread or fruit or sweet potatoes, and healthy fats. Eating a nutritious diet will help prevent gestational diabetes and pregnancy related issues like nausea and constipation.

Weight Gain Guidelines

The ideal weight gain for each woman is based on her pre-pregnancy weight, as well as whether or not she’s carrying one or more fetuses. If the woman has less than 18.5 BMI she should gain around 28-40 pounds. A woman with a BMI between 18.5 and 24.9 should expect to gain around 31-50 pounds, and a woman with a BMI of 30 or more should limit her weight gain to at most 20 pounds. Excess body fat can lead to additional health concerns during and after pregnancy such as high blood pressure, long-term obesity, cesarean section, high birth weight, infections and infant asphyxia. In later phases, too, higher body fat can affect the joints and add more compression to everything inside the abdominal cavity.

Women who maintain or even increase their lean muscle mass during pregnancy are more likely to have healthy insulin responses – and reduce likelihood of gestational diabetes. Exercise (specifically strength training) helps because it transports glucose into cells.

Summary

As stated above, now you know that you can continue to strength train and maintain cardiovascular fitness during pregnancy. Hopefully this information was valuable for you! I am accepting ONLINE clients who wish for me to create a 4-6 week plan of strength training for pregnancy or even postpartum. As always, feel free to reach out to me with questions.