Pregnancy is well known to take a toll over your mid-section area, not only the weight added to that part of your body but also the hormonal changes.
Working towards a stronger pelvic floor will result in much less stress avoiding urinary incontinence (Sangsawang B, Sangsawang N., 2016). We are not only talking about static pelvic floor exercises, but functional exercises such as squats (done without additional weights or with additional weights added to your body weight depending on your strength and previous fitness level).
Kegel exercises that are widely promoted to pregnant women first hand work on the ”tightness” of the muscle but not on the functionality of it – you want your pelvic muscle to contract and relax exactly and not remain tight all the time.
The pelvic muscle goes through changes during pregnancy as it expands and stretches in order to accommodate the baby, depending on your level of fitness and how much you have previously worked this muscle it can take you up to one full year after delivery to properly recover, but usually less, if you’re not a beginner (Elenskaia K, Thakar R, Sultan AH, Scheer I, Beggs A., 2011).
Another concern during pregnancy is regarding the workload put on the abdominals and whether one should exercise them or not as it’s widely believed this would provoke a condition called diastasis recti. A 2014 research has found that a 66 to 100% of women will develop some degree of diastasis recti in their third trimester of pregnancy. (Benjamin DR, van de Water AT, Peiris CL., 2014). Studies have found that women who actually work out regularly are at a lower risk for developing such core issues and even if they appear, the postpartum recovery is much faster. Indeed, a study has found that women who did not exercise their strength during pregnancy have had a 2-times higher risk of diastasis recti (Candido, T.Lo, P.A. Janssen, 2005).
In another study regarding diastasis recti, inactive women presented a 90% coincidence of diastasis recti compared to a 12,5% among active women who regularly performed core exercises while pregnant (Chiarello, Cynthia M.; Falzone, Laura A., ; McCaslin, Kristin E. ; Patel, Mita N.; Ulery, Kristen R., 2005). This also means that learning how to properly engage the needed muscles during exercising is key – engaging the tranversus abdominus, the deeper muscles in your lower back and those on the pelvic floor will allow you to prevent the overwork by the rectus abdominus by creating an imaginary belt supporting your midsection and allowing you to recover much faster (Benjamin DR, van de Water AT, Peiris CL., 2013).
Do remember that exercises such as crunches, roll ups (Pilates), planks, can put too much stress on the abdominal muscles and should not be performed especially not after nor during the second trimester.
Exercising during the First Trimester
There should be no major alterations to your usual routine if you are already in the gym – but avoiding jerking movements, bouncing or activities that have higher risk of abdominal injuries. Do not work to exhaustion as you need to control your body temperature and avoid overheating (to be taken into consideration if you live in a southern climate, especially).
An important note to the women that have been into hot-yoga is to avoid it by all means since continuous overheating at this stage can trigger malformations and neural tube defects in the fetus (Justin Chan, Aniket Natekar, Gideon Koren, 2014). If you experience nausea and you find it impossible to continue with your fitness routine, then consider switching to power walking for a period of time that you might find comfortable everywhere from 5 to 30 minutes.
Exercising during the Second Trimester
This is when you should start avoiding laying too much on your back due to your body changes – the baby weight might start pressing on the vena cava (carrying blood from lower extremities to the heart). It is OK to feel a little bit more exhausted and you might need more time to recover between sets of exercises – take your time. The position of your baby also makes things to change. You must listen to your body and learn the cues. Some women can continue with their exercises as planned since they’re more experienced in fitness, others will need to lower their activity as they feel.
Exercising during the Third Trimester
Joints will be overworked, so it is time to indeed take it easier and work more your stability – your hip and lower back might experience more stress now – maintaining a good posture is really important at this point. Never get out of breath and stop when needed. You will find it harder to keep a busy fitness routine, but practising squatting for instance will also prepare you for your birth if you wish to deliver squatting. Never allow yourself to overheat or reach dehydration as these will also provoke the known Braxton Hicks which will drive you crazy thinking you’re starting labor.
All in all, prenatal exercise is about keeping your body flowing with blood, a good heart rate, strong legs and back to carry the new life you’re growing.
If you need more guidance regarding how to work out before pregnancy so you’re able to maintain an active pregnancy, read my previous post on strength training for women before pregnancy.
”Is a 6-week supervised pelvic floor muscle exercise program effective in preventing stress urinary incontinence in late pregnancy in primigravid women?: a randomized controlled trial.”, Sangsawang B, Sangsawang N, 2016.
”The effect of pregnancy and childbirth on pelvic floor muscle function.”, Elenskaia K, Thakar R, Sultan AH, Scheer I, Beggs A., 2011.
”Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.”, Benjamin DR, van de Water AT, Peiris CL, 2013.
”Risk factors for diastasis of the recti abdominis”, G. Candido, T. Lo, Patricia Janssen, 2005.
”The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women”, Chiarello, Cynthia M. PT, PhD; Falzone, Laura A. PT, MS; McCaslin, Kristin E. PT, MS; Patel, Mita N. PT, MS; Ulery, Kristen R. PT, MS, 2005
”Hot yoga and pregnancy”, Justin Chan, Aniket Natekar, MSc, and Gideon Koren, 2014