Happy Tuesday friends! I have been spending time this year publishing guides for exercise under different conditions. I am a firm believer that movement is for every body, but most recommendations are based on young, apparently healthy males. Today let’s dive into a group that could really benefit from straight answers.

Medical research did not need to include females until the mid 90s. This covers a lot of exercise related issues as well. And we are just starting to recognize the detriment and attempt to bridge the gaps. Many women aren’t willing to undergo voluntary research during their pregnancies, which makes perfect logical sense. It’s a time when your body is engaged in some serious work and a lot can potentially go sideways.

From an historical standpoint, women always worked (and serious manual labor) during pregnancy. Of course maternal and fetal survival rates were also not great. Post Industrial Revolution, modern medicine developed and started off thinking pregnancy required hospitalization and huge amounts of rest and management. The thinking that pregnant women shouldn’t do anything strenuous has continued to persist despite a ton of evidence to the contrary.

Personal story time. When I went to my OBGYN for confirmation of my pregnancy with my son ten years ago, I asked about strength training advice. Part because I am a good patient and wanted the doctor’s thoughts and part because I wanted to see if the advice would be up to date. I was told to not lift anything over ten pounds under any circumstance. Again, this was ten years ago. And this advice was not in line with American College of Obstetrics and Gynecology (ACOG) recommendations.

Because I am me and had worked with numerous pregnant and post partum women, I knew that. I pushed back and was dismissed. This was the beginning of the end of my time with this OBGYN practice, but that’s a different story. My point is that many women want extra advice during pregnancy as it is a time of heightened fear. Hearing these kinds of things from doctors only exacerbates those anxieties.

ACOG recommendations are actually pretty straightforward. As long as you are healthy pre-pregnancy and things are progressing normally, there isn’t much you can’t or shouldn’t do. If you are a regular exerciser, you are good to continue with your usual as long as you feel good. Slow down or take an extra rest day if dizziness or lightheadedness becomes a common feeling. If you are new to exercise, start slow and build up gradually.

Overheating is a concern, especially in the first trimester, so be sure to exercise in a cool environment. Starting in the second trimester, you’ll want to avoid laying flat on your back during exercises as the uterus can press on the inferior vena cava and effect blood returning to the heart. You’ll obviously want to avoid activity with a high risk of falling, like BMX biking or skydiving, and contact sports. And as pregnancy progresses, you’ll want to have an extra safety measure in place for any exercises that require balance as that may be influenced by a growing tummy.

The bigger thing to know about exercise during pregnancy is when to stop. Dizziness, lightheadedness, or shortness of breath, especially that comes on quickly. Headache or muscle weakness. All of these indicate that your body isn’t getting enough oxygen. Swelling in your lower body can indicate that you aren’t circulating blood fully. Any fluid from the vagina, which can be a sign of ruptured membranes. The last two are rare but definitely stop. Oh, and should be obvious, but definitely make sure you stay hydrated.

If you are post partum, return to exercise will depend on whether you had a vaginal or Cesarean delivery and if your recovery has been normal. Regardless, you are doing nothing but laundry, groceries, and taking care of yourself and a new human for the first six weeks. Childbirth is a huge deal and extremely taxing on the body. At minimum your uterus is healing a dinner plate sized wound from the placental attachment site.

If your doctor clears you for exercise at the six week mark, go slow. If you are new to exercise, start really slow. A walk around the block and a few body weight squats. If you are coming back, start at half to 2/3 of your usual and build back up. Remember that it can take up to two years for the body to fully heal physically so be patient and kind to yourself.

Be prepared for setbacks as well. Nobody talks about these because we all want to be the ones who get back in our pre-pregnancy clothes right away. Minimally you will be tired. Plan for extra rest. If you are breastfeeding, make sure you are taking in enough calories to support lactation. Lactation specialists or nutritionists can help you figure out what that goal should be.  

Things like peeing during squats or lack of coordination will happen. Again, we want to think we will be the exception. Don’t count on it. Make Kegels a part of your workouts and learn to laugh at the weird and gross.

If you are interested, here is the ACOG page with their guidelines. If you are pregnant, plan to be, or are post partum look for a personal trainer in your area that is certified in these areas. Even if you only book a few sessions, they’ll help you learn about your unique responses and boost your confidence.

Until next time, move well friends!

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