Something was obviously bothering Diane. "I guess I'm going to have to stop working out," she sighed. As her personal trainer, I was stunned at this statement. After all, she had made terrific progress in her training endeavors, and had literally redefined her physique. She paused for a moment and then continued, "I just found out that I'm pregnant..."
Sadly, many women still believe that pregnancy requires a sedentary lifestyle. Even worse, some continue to train while pregnant, without understanding the contraindications for exercise. This can seriously jeopardize their own health and well being, as well as that of their fetus. There are so many misconceptions and lack of information regarding training during pregnancy that many gynecologists are not even sure how to properly counsel their patients on this subject. Yet, when properly implemented, an exercise regimen can provide a multitude of benefits for the pregnant woman, with virtually no downside.
As a personal trainer, perhaps the most frequent complaint that I hear from women is that they cannot lose excess weight gained after pregnancy. During pregnancy, a woman undergoes many physiologic and hormonal changes that can alter her metabolism and body habitus. It is commonplace to gain fifty pounds, post-partum, and most are unprepared to deal with this event.
While it is certainly possible for a woman to reshape her body after pregnancy, the best way to counteract post-partum weight gain is to stay in shape during pregnancy. By remaining dedicated to a workout schedule, a woman can virtually return to her original shape shortly after delivery. In addition to the short-term calorie burning effects associated with an exercise program, a disciplined training program increases muscle mass. This, in turn, elevates the body's resting metabolic rate, thereby helping to burn additional calories on an ongoing basis-even while asleep!
Moreover, adopting a workout routine helps to increase energy levels and reduce the fatigue associated with pregnancy . It is common for a woman to sit around the house all day, feeling unattractive and lethargic as her term progresses. Regular exercise promotes a better sense of well being and helps to improve a woman's self-esteem during this fragile period.
Numerous other exercise-related benefits have been reported, including a lower incidence of back pain, reduced edema, and fewer leg cramps . There also is a positive influence on labor and delivery. Research has shown that women who train during pregnancy experience a shorter active labor and a decreased amount of fetal stress . One study even found that the offspring of women who exercised had significantly lower body fat levels than those who were sedentary-even after a five-year follow-up period!
There are, though, many unique principles to pregnancy training, and extensive care must be taken to ensure a safe, effective workout. The goal of exercise during pregnancy should be to maintain the highest level of fitness consistent with maximum safety. By understanding the basic guidelines of pregnancy training and adopting a dedicated workout program, a woman can reap all the rewards of staying fit during and after pregnancy without risking injury to herself or to her fetus.
Before beginning a routine, it is essential to get a physician's clearance to rule out any possible exercise-related contraindications. Conditions such as hypertension, bleeding, cardiac arrhythmia and other afflictions can be potentially injurious. Even things that might seem innocuous under normal circumstances can be of dire consequence at this delicate time. Therefore, medical clearance is a necessary prerequisite prior to undertaking a training regimen, and follow-up should be obtained on a regular basis to monitor any changes in health. In this case, an ounce of prevention really is worth a pound of cure.
Assuming that there are no contraindications, a woman should plan to exercise at regular intervals. A three-day per week training regimen is ideal, preferably allowing at least one rest day in between workouts. Thus, training on a Monday, Wednesday, Friday or Tuesday, Thursday, Saturday basis will afford maximal effectiveness while allowing adequate rest and recuperation.
As a rule, aerobic classes, especially high-impact and step, are generally not recommended. During pregnancy, hormonal changes relax the connective tissues, which may produce joint instability . Bouncing movements, jumping motions, and rapid changes in direction-all common elements in aerobics classes-place significant stress on the joints and tendons. This will substantially increase the risk of injury to these areas. Moreover, the flow of an aerobic class, which is oriented to a group rather than to the individual, makes it difficult for the pregnant woman to remain in control. It is therefore better to proceed with an individual workout program consisting of cardiovascular activities, stretching, and strength training, whereby proper form and function are maintained at all times.
In choosing an exercise facility, it is imperative that the workout area is well ventilated and air-conditioned. During pregnancy, basal metabolic temperature is increased, which can predispose a woman to overheating-a phenomenon that has been shown to cause neural tube defects . Therefore, a pregnant woman should make sure not exercise in a hot, humid place and take care to monitor changes in body temperature.
The workout should begin with a ten-minute cardiovascular warm-up on a treadmill or stationary bike at a low resistance in order to warm up the muscles. A proper warm-up will help to circulate blood flow throughout the body and thereby decrease the risk of joint injury. The chosen activity should be performed at roughly 50% of maximal heart rate. In order to estimate this number, subtract your age from 220 and multiply by 50%. Thus, a 30 year old woman would have a target heart rate of 95 (220-30=190 x .5=95).
After cardio, it is beneficial to perform about ten minutes of light stretching. Because of connective tissue laxity, care should be taken in the degree of stretching. Stretches should not be taken to point of maximum resistance and should be performed in a relaxed manner that stays within a comfortable zone. Slow, stationary stretching is recommended, and one should be sure to avoid any ballistic, bouncing movements.
Next, a comprehensive weight training session should be undertaken. While there are many ways to approach this endeavor, a total body workout targeting each of the major muscle groups with one exercise is perhaps the best approach. This allows circulation of blood into all areas of the body and maintains the goal of optimal fitness with maximal safety. High repetitions (approximately 12 to 15 per set) are recommended and two to three sets of each exercise should be performed.
During the weight-training phase, it is important to follow certain safety precautions. Weight training should not be performed at maximal intensity of effort - don't struggle to pump out an extra rep. Repetitions should be smooth and controlled and a woman should always maintain basic form. Breathing should be regulated on each repetition and a woman should never hold her breath while lifting. Finally, heart rate should be measured at times of peak activity, keeping maximal heart rate in a comfortable range.
Moreover, due to the physiologic and hormonal changes that occur during pregnancy, there are contraindications for certain exercises. First, exercises that require bending from the waist should be avoided. This can cause dizziness and heartburn in the pregnant woman, as well as placing undue stress on the lumbar spine. Hence, exercises such as stiff-legged deadlifts and bent rows should not be performed.
Second, it is best not to utilize any overhead lifting exercises. Because of the increased lordotic curve associated with pregnancy, overhead exercises can place heighten stress to the lower lumbar area resulting in an increased incidence of lower back pain. Thus, exercises such as the military press and incline chest press are contraindicated.
Lastly, exercises performed in the supine position should be eschewed after the first trimester. Due to a predisposition to decreased blood pressure (hypotension), the pregnant woman is more apt to become light headed and dizzy while lying down. Furthermore, when supine, the fetus tends to press on the vena cava, decreasing venous blood flow and potentially causing harm to the fetus . Thus, movements such as the bench press, crunch, and lying triceps extensions must be dropped at the end of the third month.
After weight training, it is best to finish the workout with a cool down period. The cool down should comprise about ten to fifteen minutes of slow walking or stationary cycling combined with additional gentle stretching movements utilizing the same principles as in the warm-up. This will ensure a gradual stabilization of body temperature and help to flush lactic acid from the muscles.
That's it, a comprehensive routine that is safe and effective! The entire workout will last about an hour to an hour and a half, leaving a woman feeling healthy and invigorated. By following these simple principles, a woman can maintain her shape throughout pregnancy and ultimately look as good or better than before conception!
And by the way, despite her trepidation, I was able to convince Diane that it would be beneficial for her to continue working out-which she did until her eighth month. I am happy to report that she now has a healthy baby boy and was within five pounds of her ideal weight after delivery. She is again back into her training routine, trying next for a baby girl.
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