Training during pregnancy: Yes? No? How?!

Introduction

Women who are active in sports during pregnancy are often criticized by society and lightly condemned for it. The misconception that the unborn child could come to harm is not only wrong, but even the opposite is true!

Numerous top female athletes have recently proven the opposite over and over again. And the world of science also agrees: sports during pregnancy – yes please!

Pregnancy is accompanied by changes in body and mind, which often leads to a decreased quality of life. Common symptoms include nausea and vomiting, sleep disturbances, hormonal fluctuations, anxiety, depression, and fatigue.

Looking at the existing literature, it is apparent that exercise provides an effective and healthy treatment option for many of these symptoms.

Although many authors have looked at the effects of light aerobic endurance training in pregnancy, it is striking that only about 10% of studies have looked at the psychological and physiological effects of strength training.

Accordingly, there are numerous recommendations on endurance training, but few on strength training.

So here we want to give you insights into this small research area, which is not often publicized.

Official recommendations for endurance and strength training

Official guidelines on exercise during pregnancy differ greatly between Europe and Canada or America.

Guidelines in Europe

Women in Europe are advised to be active for 30 minutes at least five days a week. The aim should be a light to moderate intensity, with the talk test as a reference method. I.e. women should still be able to have a conversation whilst exercising.

In Europe, strength training has not yet found its way into the official guidelines for exercise during pregnancy.

• You are expressly warned against jumping, bumping and lifting heavy objects.
• The option to start strength training in the course of pregnancy is also denied, as new sports with unfamiliar movements are discouraged.
• In contrast, recommended activities include sports such as walking, slow cycling, aqua fitness, gymnastics, Pilates, cross-country skiing or pregnancy yoga.

Training recommendations in Canada and America

Recommendations given by the University of Alberta, encourage women to exercise for at least 150 minutes per week at moderate to intense intensity.

• Sports that are recommended include: Walking, running, swimming, cycling and strength training.
• The guidelines point out that any form of exercise contributes to maternal fitness.
• A mix of aerobic exercise and strength training is recommended to optimize maternal and child health.
• It is also mentioned that, until the time of pregnancy, inactive women can safely start various sports. Doing this, at any time during pregnancy, is strongly encouraged to achieve the minimum guidelines of exercise recommendations.
• Pelvic floor exercises can be performed daily to reduce the risk of urinary incontinence. It is recommended to see instruction in proper technique to achieve optimal benefits.
  

A warning is given against sports that can put the fetus in danger through falling (and impact) and/or through the collision with another person (e.g. boxing).

Effect of exercise on the physical health of the mother

Brad Schoenfeld elaborated on the effects of exercise for the pregnant woman and found the following benefits supported by science:

• Improved weight management
• Reduced incidence of gestational diabetes
• Reduced incidence of preeclampsia
• Reduction of back pain
• Positive effect on birth process

Ward-Ritacco et al. discovered that training in pregnant women has also been able to

• Reduce fatigue and
• Increase energy levels

Effect of strength training on the health of the child

The facilitated birth process noted by Clapp also has a positive effect on the child.

Thus, it was shown that the acute stress load of newborns was lower in the sports group (50% vs. 26%).

With regard to strength training, it was shown that women who trained with weights 3-5 times a week gave birth to children with a more favorable body composition.

Thus, they were born with both, more lean mass and more fat mass, than those in the control group. So overall they were heavier and larger.

Children of mothers who participated exclusively in endurance sports were slightly lighter in comparison. However, their body composition was also significantly better than the ones of inactive mothers.

Guidelines for strength training during pregnancy

Pregnant women should always get their doctor’s approval before participating in a strength training program. Provided there are no contraindications, strength training can be a component of a maternal exercise program.

The training goal should be more about maintaining an adequate fitness level and less about optimizing it. Moreover, the training plan should be based on the expectant mother’s current fitness level.

Research therefore suggests that individuals with high exercise volumes can maintain their current activity levels without adverse effects. However, this recommendation should only be adhered to in agreement with the mother’s designated physician.

Experience shows that a three-day week can be used with excellent success. The training should be performed on non-consecutive days to allow sufficient recovery.

In addition, a full-body routine is preferable to a split routine. Ideally, weights should be somewhat reduced, whilst the number of repetitions can be increased. Avoid the Valsalva maneuver, and weight lifting whilst lying straight on your back.

Before the start of training, the following should be taken into consideration:

• Medical history
• Screening questionnaires/ Evaluation of fitness level
  
• Exclude contraindications
• Define and exclude relative contraindications
• Evaluation of the general condition and the training condition
• Assessing one’s own resilience
• Exercise selection

Example training session with useful exercises for pregnant women

When designing a program, special attention should be paid to core muscle training, which can help counteract lumbar strain. Static, endurance-based core exercises are ideal for pregnant women as they have been shown to promote back health while minimizing spinal stress.

Dynamic core exercises like crunches can also help improve core strength, although these movements become more difficult as pregnancy progresses.

Warm up

A good warm-up is very important. This is not the moment to save time. Some exercises that would be suitable are:

• Mini band hip bridge
• Lateral walking with mini band
• Airsquats
• Stick Mobility
• Marching (High Knees)

Upper body

• Press Ups (2×10)
• Triceps Dips (2×10)
• Upright Row (2×10)

Lower body

• Squat – body weight or light weight depending on fitness level (2×15)
• Lunges (2×10 per leg)
• Calf Raises (2×15)

How to arrange breaks depends on the pregnant woman’s individual needs. The workout can be modified or stopped whenever she feels uncomfortable.

Warning signs, that may occur during training, which should always lead to stopping the exercise, are as follows:

• Bleeding
• Dyspnea
• Dizziness
• Severe headache
• Chest pain
• Muscle weakness
• Pain or swelling in the calf
• Premature labor
• Decreased fetal movement
• Amniotic fluid leakage

Final recommendations

Maternal fitness is essential for the physical and mental health of expectant mothers.

After reviewing the literature, it is apparent that exercise (both endurance and strength training) has a number of benefits for both mother and child. It helps to improve well-being and health throughout pregnancy.

Regarding safety, it is worth mentioning that the expectant mother should follow the guidelines in order to do strength training without endangering herself or her child. Before exercising, the mother’s physician should be consulted to exclude any possible contraindications.

Emphasis should be placed on educating mothers well about the benefits of exercise during pregnancy and dispelling long-held myths. Interdisciplinary cooperation between physicians and trainers should be sought.

To gain full benefits of maternal strength training, one should integrate all muscle groups into a full body workout. The deep core muscles, including the pelvic floor, should be trained particularly well.

Overall, it would be desirable to revise official guidelines through further research in the field and to educate pregnant women, as well as the general population, about the benefits of exercise during pregnancy.

You can find more information on the topic of “Women in Sports” in our detailed, free e-book. On more than 30 pages you will also learn how you can best nourish yourself during the different phases of your cycle, for example, and why special sports nutrition is so important.