Call me vain, but a big factor in deciding whether or not I was ready for a second child was deciding if I could put my body through another pregnancy and recovery. I had just spent the last three years working really hard on feeling like myself again. I’m not talking about skinny vs. overweight. I’m talking about feeling confident in my own skin and as though my body belonged to me and not someone else.
I remember vividly not being able to sit comfortably for weeks after delivering my daughter. I remember being terribly disappointed when I realized I wasn’t one of those women whose weight was going to melt away with breastfeeding. Most of all I was shocked that it took years of hard work and diligence before I felt at home in my own body. It took a long time of surrounding myself with motivating and positive people, working out HARD 5 days a week and at times being a bit fanatical about my nutrition (wine excluded of course).
The upswing of this process was that I really fell in love with exercise again. Under the watchful eyes of an impressionable little girl, I learned to love feeling strong and fit over the number of my clothes and the scale. I felt empowered as a mom and more capable in my body. I felt like if I could hold onto that feeling through a second pregnancy, I would be in a better state of mind and wouldn’t put myself last while putting someone else first. I decided I was ok with undertaking this amazing gift again if I could do it differently from my first pregnancy. I wanted to see if challenging myself more physically would make my pregnancy more comfortable and improve my post natal recovery.
I want to be very clear that exercise, especially vigorous exercise, is not for everyone. All women should be evaluated by their practitioners for suitability for an exercise program. I am fortunate to be a healthcare practitioner with a strong background in exercise. I work with amazing coaches and trainers who monitor me closely and I have the luxury and convenience of having my office in a gym. However, if you do decide that you want exercise to be an integral part of your healthy pregnancy, here are some important points to consider.
Who can exercise during pregnancy?
A joint statement from the Canadian Society of Exercise Physiology and the Society of Obstetricians and Gynaecologists of Canada encourages all healthcare providers to support strength and cardiovascular training in pregnancies without complications or contradictory conditions. This includes all levels of current fitness from sedentary to elite athletes.
What are the benefits of exercise during pregnancy?
You may hate the thought of exercise, especially if you are not feeling great, but it is very hard to ignore the benefits of staying active. The Public Health Agency of Canada agrees as does Dr. Michelle Mottola of the Samuel McLaughlin Foundation for Exercise and Pregnancy at the University of Western Ontario. Jointly they cite the following benefits:
Decreased excessive weight gain during pregnancy
Decreased incidence of gestational diabetes
Possible decrease in labour discomfort (I’m banking on this one)
Increased stamina and endurance during the birth
Improved body image and decreased rate of postpartum depression
Increased relaxation and better stress management
Improved recovery following labour and delivery
Improved energy levels
What are the key factors when thinking about starting an exercise program?
If you are new to exercise, there is no reason that you can’t start during pregnancy but it should be gradual. Your first trimester may not be an ideal time to start especially if nausea and excessive fatigue are factors. I would strongly suggest working with a healthcare professional or a prenatal exercise specialist who can guide you towards appropriate exercise, measure your improvement and who can advise you on what is “normal” during pregnancy.
If you are already fit and exercising regularly, it is safe to continue your exercise regime once cleared by your OB-GYN or midwife. Keep in mind that this is not the time to strive for a personal best or train for competition but rather to maintain good levels of aerobic fitness and strength. It is likely going to be necessary to modify your weight, intensity and exercise selection to accommodate the physiologic changes your body experiences. You will also want to reconsider exercises that might result in a loss of balance or fetal trauma. Now is not the time to take up equestrian riding or contact sports.
Regardless of your fitness level, experts agree that adverse pregnancy outcomes and fetal health is not affected by mild to moderate exercise. There is also no evidence that the same level of exercise has an impact on breast milk postpartum.
How should you exercise?
When thinking about how to exercise, the FITT principle is a great way to design your pregnancy program.
F – Frequency:
Ideally you want to aim for 3 – 4 bouts of exercise a week. If you are new to exercise, start with 3 days and only move up when you feel comfortable. Remember that rest days are equally important to allow your muscles time to recover as well as to properly assess how your body responds to your new workout regime.
I – Intensity
New research suggests that temperature is one of the best ways to monitor your intensity but practically this is very hard to measure. Heart rate, although sometimes influenced by other factors, is a much more objective measure of intensity. Using electronic fitness devices like a Fitbit can be helpful to keep track of your intensity.
Healthcare professionals will also use a scale of perceived exertion to measure intensity and suggest that you should not exceed 12 – 14 on the scale.
If both of these options seem too technical, an easy trick is to make sure you can comfortably talk during exercise. If you can’t chat with your workout partner, scale back on your intensity.
T – Time
To achieve health benefits, you should strive for 30 minutes of physical activity. Women who have not previously exercised should start with 15 minutes and increase by 2 minutes per week until they achieve the goal of 30 minutes. What is really cool about this rule is that your minutes can be cumulative instead of continuous. Walking for 5 minutes, 6 times a day, has the same benefits as a 30 minute walk.
T – Type
Women should try to incorporate both aerobic and strength training exercise.
When considering aerobic exercise, aim for low impact, high endurance and if needed non-weight bearing types of exercise. Some great examples are walking, swimming and stationary bike riding. For women who were previously runners, running is still fine provided you slow down and stop should any adverse symptoms arise.
Strengthening is equally important. Aim to use light weights with higher numbers of repetitions to minimize the stress on loose joints (especially into your third trimester). If you are new to strength training, remember that your own body weight is a great tool and you really don’t need heavy weights or equipment. Make sure posture and technique are diligently monitored and avoid any exercise on your back after 16 weeks. Movements should not be bouncy and functional movements should be emphasized over abdominal contractions if there is any splitting of the abdominal muscles (diastasis recti).
When you should stop / contact your healthcare provider?
No matter how committed you are to exercise, your primary concern should always be the health of your baby as well as minimizing any health risk to yourself. Under any of the following conditions it is important to stop exercising immediately and seek out medical attention.
Excessive shortness of breath
Chest pain
Presyncope (light headedness, blurry vision, weakness, feelings of faintness)
Painful uterine contractions
Leakage of amniotic fluid
Vaginal bleeding
Sudden swelling of the hands, face or ankles
Excessive fatigue
Changes in usual fetal movement
Swelling, pain or redness in one leg
Other helpful tips:
Do what you enjoy: If you don’t like what you are doing, the likelihood of you maintaining it as an exercise regime probably isn’t realistic.
Hydrate: The last thing a pregnant bladder wants to hear is drink more water but proper hydration is essential for regulating temperature and muscle recovery.
Seek out an expert: Health and fitness providers specialized in pregnancy have a better understanding of what your body is going through and can more appropriately assign a safe exercise plan.
Dress comfortably: There is nothing worse than exercise clothes that don’t accommodate your growing belly.
Listen to your body: Pregnancy is full of surprises and unusual feelings. If something doesn’t feel right, back off and be safe.
For further resources on exercise during pregnancy, please visit these sites:
http://www.csep.ca/cmfiles/publications/parq/parmed-xpreg.pdf
https://sogc.org/wp-content/uploads/2013/01/129E-JCPG-June2003.pdf
https://www.centre4activeliving.ca/media/filer_public/07/37/07374414-5d09-47a9-85ce-32fe98c1ab62/2011-aug-exercise-pregnancy.pdf
http://www.phac-aspc.gc.ca/hp-gs/guide/04_pa-ap-eng.php
+Melanie Stevens Sutherland, Clinic Director & Senior Orthopaedic and Pelvic Floor Physiotherapist
Melanie is a graduate of McMaster University and brings 20+ years of experience as a senior physiotherapist to Body Co. She has enjoyed a long tenure working with active populations at prestigious sport medicine clinics. Past clients include Provincial, National and Olympic level athletes as well as members of the National Football League, the Canadian Football League, the Ontario Hockey League, the American Hockey League, the National Lacrosse League and Major League Soccer.
Following the birth of her own children, Melanie developed a strong interest in women’s health. She has taken specialized courses in pelvic floor physiotherapy and women’s nutrition. She is passionate about helping women find strength and confidence in their post-natal bodies following pregnancy and delivery.
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