Does anyone else find themselves captivated and scrolling through the videos of pregnancy announcements? The shocked in-laws, crying soon-to-be uncle, surprised partners who weren’t trying, and relieved couples who have been trying to conceive for years. I’m sure we’ve all seen a video or two of mom being picked up and swung around with a concerned family member in the back yelling “be careful she’s pregnant!”. And while we smile and laugh at the innocence and sincerity of it all, it does stir up the question and concern of what EXACTLY is okay from a movement and exercise standpoint during pregnancy. 

In this blog, we are going to specifically dive into pregnancy, common physiological changes within the pregnant body, and the effect of exercise on pregnancy. We’ll observe contraindications to exercise during pregnancy, and demonstrate common and safe exercises to perform when mamas get the urge to move! 

 

Pregnancy, the Human Body & Exercise

It’s no surprise that the human body changes drastically during pregnancy. Every system of the human body is modified, from the endocrine system to the musculoskeletal system, to our joints becoming more mobile, and everything in between! These changes are normal, needed, valued, and may change the way a pregnant person feels when exercising. Let’s take a further look. 

 

Feeling a little bendy? Want to learn some safe exercises to perform to help with your hypermobility? Check out the above YouTube video to learn more! 

 

Cardiovascular System: 

• Blood volume increases
• Resting heart rate can increase 10-20 beats per minutes
• Cardiac output increases 30-50%
• Blood pressure decreases during the first and second trimester and then returns to non-pregnant levels in third trimester (1).

 

Respiratory System: 

• Elevation of the diaphragm 4 cm
• Angle of rib cage increases
• Oxygen consumption increases 30%
• 5% decrease in total lung capacity (1.) 

 

Endocrine System: 

• Hypercortisolism -increased “stress” hormone in the body  (up to 3x)
• Pituitary gland increases in size
• Fasting glucose drops 10-20% 
• Increased total cholesterol and fat accumulation in second trimester (1.) 

 

Gastrointestinal System:

• Delayed gastric emptying
• Heartburn can be present due to increased gastric acidity
• Nausea and vomiting may be present (1.) 

 

Musculoskeletal System: 

• Increased joint mobility due to hormonal changes
• Normal increase in body mass
• Increased lumbar lordosis and anterior pelvic tilt
• Widening and lengthening of abdominal musculature
• Increased demand on the pelvic floor (2.) 

 

While this is an extensive list of physiological changes that occur during pregnancy, the body is able to adapt appropriately to meet these demands. Let’s talk about why exercise should be encouraged for pregnant individuals and how we should all be encouraging safe movement!

 

LEARN MORE ABOUT OUR [P]REHAB FITNESS HOME EDITION PROGRAM

Looking for a way to continue to move during pregnancy? Our [P]rehab Fitness Home Edition Program could be the perfect fit for you! This 12-week program will help to keep you active with modifications to best support you during your pregnancy! Check with your OBGYN to get started today! 

Exercise During Pregnancy

You heard it here first…well, actually hopefully you’ve heard it many times before, exercise during pregnancy is encouraged! Guidelines state that all women without contraindications should be physically active during pregnancy. This includes women who were previously inactive and those who are currently active. 150 minutes of moderate intensity exercise per week is encouraged, with a combination of varying aerobic exercise and resistance training eliciting the greatest benefits! (3) These benefits include decreased risk of developing gestational diabetes, lower incidence of gestational hypertension, decreased risk of macrosomia and cesarean delivery, lower risk of pre-term delivery, less low back pain, decreased maternal weight gain, increased energy levels, improved mood and quality of life (4).

 

Learn more about our fitness and performance programs as well as our dozens of other programs & workouts that you gain access to by joining our [P]rehab membership! 

 

Sounds like a no brainer, right? And yet, despite the magic of exercise, it is estimated that only 13%-43% of pregnant women meet the set recommendations of 150 minutes of moderate exercise per week. Determined to be the biggest barriers for our mamas are lack of time, fatigue and decreased energy, and not knowing what exercise and how much exercise is safe!(4) Let’s fix this! To all our pregnant mamas out there, find yourself a PT with specialty training in pregnancy and care of the pregnant patient and together let’s exercise our way through a healthy pregnancy. Here are a few of my favorite ones to give my mama’s:

 

 

The goblet squat is certainly one of my “go-to” exercises for mama’s. Not only is it functional, but it’s a great way to work the core muscles and supportive muscles of the pelvic floor!

 

Another great exercise to support core strength and lateral hip musculature to best support that changing pelvis!

 

Another favorite of mine to work on core and lumbar strength as well as hip strength! Avoiding exercises laying completely on ones back can help to limit any heart burn related symptoms!

The hype around exercising during pregnancy is very real. There is also some really amazing research being presented regarding the role that heavy resistance training can play in pregnancy and yes, heavy resistance training is not something that needs to be shied away from while pregnant as long as contraindications are NOT present! To learn more, dive into this awesome podcast below!

 

LISTEN: IS IT SAFE TO EXERCISE DURING PREGNANCY?

 

Let’s dive into some of these contraindications because yes, it is important to note that there are contraindications to exercise within pregnancy. It is encouraged that all mamas check in with their Obstetrician and Gynecologist regarding the status of their pregnancy. 

 

Contraindications (3):

• Uncontrolled gestational diabetes, uncontrolled hypertension or uncontrolled thyroid disease
• Triplets and more
• Ruptured cervix
• Persistent vaginal bleeding
• Placenta previa after 28 weeks
• Pre-eclampsia

 

Relative Contraindications (3):

• Recurrent pregnancy loss
• History of spontaneous preterm birth
• Gestational hypertension
• Twin pregnancy after 28 weeks
• Malnutrition and/or eating disorder

 

 

Let’s Sweat- What to Expect with Exercise during Pregnancy

Grab that belly band and get out the door! Just remember, similar to how your belly band will fit differently from week 20 to week 30 in your pregnancy, exercise will feel different, too! For those who are pregnant, or professionals who are working alongside individuals who are pregnant, it is important to take into consideration how both physiological changes and increased load on the body can alter how exercise feels.

 

LEARN MORE ABOUT OUR [P]REHAB FITNESS HOME EDITION PROGRAM

 

For example, as pregnancy progresses taking deep breaths during aerobic exercise may begin to feel more challenging. Or exercise may have to be completed hours after a meal to reduce sensations of heartburn or nausea. All of this is okay! If a pregnant individual is experiencing any pelvic pain, pelvic heaviness, urinary incontinence with exercise, or bulging sensation within the vaginal opening this may be the body asking for things to be changed up a bit. Modifications to an exercise routine will occur and that is normal. Your body is doing amazing things and to continue to do so, your body needs to stay strong and healthy which working out can help to provide! A PT with specialty training in the management of the pregnant client and training in pelvic health can best direct any exercise modifications that may be needed. 

 

READ: POST PARTUM EXERCISES

Curious as to what exercises are encouraged to perform following pregnancy? Read more in the blog HERE! 

 

Even with needed modifications, exercise should be encouraged to stay a part of the routine. A study that looked at quality of life throughout pregnancy determined that overall quality of life increased from the first to second trimester, and then decreased over the span of the second and third trimester. The study reported that factors strongly associated with improved quality of life during pregnancy were exercise, high exercise adherence, moderate physical activity in the water, adopting low to moderate intensity resistance training, and social support(5). Surprised? Yeah, neither are we!

 

Closing Thoughts

Pregnancy can be a time full of uncertainty, excitement, surprise, happiness, stress, and encouragement. Some of that uncertainty and stress can stem from not knowing what exercise is safe and how much exercise is safe to perform during pregnancy! We can say confidently that 150 minutes per week of moderate intensity exercise is safe, and highly encouraged, as long as there are no notable contraindications. Additionally, those who were able to maintain an exercise routine throughout pregnancy reported improved quality of life in addition to significant health benefits. 

So with that being said, let’s make sure to leave the “surprise” to the pregnancy reveal videos. Because when it comes to exercising during pregnancy, there are no surprises. 

 

References

1. Tan EK, Tan EL. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):791-802. doi:10.1016/j.bpobgyn.2013.08.001

2. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89-94. doi:10.5830/CVJA-2016-021

3. Mottola MF, Davenport MH, Ruchat SM, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52(21):1339-1346. doi:10.1136/bjsports-2018-100056

4. Nelson RK, Hafner SM, Cook AC, et al. Exercise During Pregnancy: What Do OB/GYNs Believe and Practice? A Descriptive Analysis. Womens Health Rep (New Rochelle). 2022;3(1):274-280. Published 2022 Feb 28. doi:10.1089/whr.2021.0132

5. Boutib A, Chergaoui S, Marfak A, Hilali A, Youlyouz-Marfak I. Quality of Life During Pregnancy from 2011 to 2021: Systematic Review. Int J Womens Health. 2022;14:975-1005. Published 2022 Aug 2. doi:10.2147/IJWH.S361643

 

Lyndsay Provencio, PT, DPT

[P]rehab Writer & Content Creator

Dr. Lyndsay Provencio graduated from Colorado State University with a BS in Health and Exercise Science and a concentration in Sports Medicine. After multiple personal sports-related injuries and discovering a passion for healing through movement, Lyndsay attended Creighton University to receive her Doctorate of Physical Therapy. An avid runner herself, she has a particular interest in working with high school, recreational and elite endurance athletes and has undergone specialty training in pelvic floor rehabilitation, postpartum care, and management of the female athlete to better serve her clientele. Through this specialty training, she has acquired a Certificate of Achievement in Pelvic Health Physical Therapy through the American Physical Therapy Association.  Lyndsay now owns her own practice StrongHER in Park City, UT where she specializes in female athletics and care of pregnant and postpartum individuals. Additionally, Lyndsay is BSPTS C2 certified in scoliosis specific exercise and has found a niche working with adolescents with scoliosis to improve overall spinal health. No, you’re not seeing double! Lyndsay is an identical twin to Lauren Lynass, one of our [P]rehab rockstars. A native of Colorado, Lyndsay is an                adventure seeker who loves to hike, camp, and race her twin sister on the mountain trails. When she isn’t exploring Park City’s outdoor playground, you can find her curled up with a cup of tea and a good book. Follow along @strongher_dpt on Instragram!

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.