Pre + Post Natal

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Historically pregnant women were advised not to exercise.  However, this has be deemed overly conservative and instead advice around maximising the health benefits during pregnancy have been developed.  It is, however, important to acknowledge that individuals should seek professional advice before exercising and that there are instances where exercise is not recommended.  The Personal Best team have put together this article with industry recommendations and guidelines for exercising with pregnancy.

There are many benefits to exercising during pregnancy, including improving or maintaining physical fitness, reduced risk of gestational diabetes in obese women, weight management, reduced risk of pre-eclampsia and cesarean deliveries, and enhanced psychologic well-being.  It is recommended that pregnant women who have been cleared to exercise, with no identified risks, take part in moderate intensity exercise.

Examples of moderate-intensity physical activity include:

  • Walking
  • Swimming
  • Stationary cycling
  • Yoga
  • Pilates
  • Strength training
  • Racquet sports
  • Low-impact aerobics

Examples of exercises that should be avoided during pregnancy include:

  • Contact sports
  • Activities with a high risk of falling
  • Scuba diving
  • Hot yoga
  • Sky diving

To assist health and fitness professionals in creating safe and effective exercise programs for pregnant women, the American College of Sports Medicine (2018) has established specific recommendations for the frequency, intensity, time, and type (FITT) of activity that can be used in conjunction with the other guidelines presented in this article. The table below summarizes these recommendations.

FITTAerobicResistanceFlexibility
FrequencyAt least 3-5 days per week2-3 days per week (nonconsecutive)At least 2-3 days per week (daily stretching is most effective)
Intensity

Moderate (3-5.9 METs, RPE of 12-13)

Vigorous intensity for women who were highly active prior to pregnancy (=6 METs, RPE 14-17)

Performed to a point of moderate fatigue with multiple submaximal repetitionsStretch to point of slight discomfort
Time

Work up to 30 min per day (accumulated) of moderate intensity for a total of 150 minutes per week

Vigorous intensity 75 minutes per week

1-3 sets for all major muscle groups depending on level of experience10-30 seconds (static)
TypeA variety of well tolerated weight-bearing and non-weightbearing activitiesA variety of well tolerated free weight, machine, and body weight exercisesTarget each muscle-tendon unit using active, passive, and dynamic forms of stretching

Pregnant women should not exercise if any of the following health conditions are present:

  • Risk factors for pre-term labor
  • Vaginal bleeding
  • Premature rupture of membranes

Fitness professionals should also be familiar with both absolute and relative contraindications to exercise.

Exercise Guidelines for pregnant clients:

  • Do not begin a vigorous exercise program shortly before or during pregnancy.
  • If you have been previously active, continue current program during the first trimester to a maximum of 30 to 40 minutes per day as tolerated.
  • With no previous activity, begin slowly with 15 minutes of low-intensity exercise and gradually increase to 30 minutes.
  • During the second and third trimester, the intensity and duration should be gradually reduced.
    Use the RPE scale rather than heart-rate monitoring.
  • Avoid bouncing while stretching, activities with a high risk of falling, deep knee bends, full sit-ups, double leg raises and straight-leg toe touches.
  • Avoid exercise in the supine position after the first trimester.
  • Avoid motionless postures (e.g., certain yoga positions and the supine position).
  • Avoid exercise in high temperatures and/or high humidity.
  • Modify exercise intensity if post-exercise body temperature exceeds 100° F.
  • Focus on hydration.
  • Utilize extended warm-up and cool-down periods.
  • Walking or running should occur on flat even surfaces.
  • Wear a bra that fits well to support the breasts.
  • Some pregnant women may benefit from a small snack prior to exercise to help avoid hypoglycemia.

Warning signs that warrant stopping an exercise session and physician referral before exercise is resumed:

  • Vaginal bleeding
  • Dizziness
  • Shortness of breath
  • Chest pain
  • Headache
  • Muscle weakness affecting balance
  • Calf pain or swelling
  • Regular painful contractions
  • Amniotic fluid leakage

Postnatal Exercise

Returning to physical activity after pregnancy also has benefits (e.g., improved maternal cardiovascular fitness without affecting milk production or composition of infant growth) and is associated with decreased incidence of postpartum depression. Although some recovery time to regain strength is required, during the initial six weeks following delivery your client could begin to slowly increase physical activity as a means of relaxation, personal time, and regaining a sense of control.  Nursing women should also consider feeding infants prior to exercise to avoid the discomfort associated with engorged breasts.

The following guidelines should be followed with the postnatal client:

  • Get clearance from medical team to exercise.
  • Begin slowly.
  • Start with walking several times per week.
  • Avoid excessive fatigue.
  • Wear a supportive bra.
  • Stop session if unusual pain is experienced.
  • Stop session if vaginal bleeding is more than normal.
  • Drink plenty of water.

We hope that this information is of benefit when exercising whilst pregnant, or after birth.  We recommend speaking to your medical support and an exercise professional, before engaging in exercise.  If you would like to speak to one of the Personal Best personal trainers (PT) about how personal training can help during pre and post natal, then contact us for more information. We have a private personal training studio in Armadale, West Lothian.  We support pre and post natal clients all over West Lothian, including Livingston, Linlithgow, Whitburn, Bathgate and Falkirk. Online personal training support is available for those who struggle to travel to our gym.

To find out more please get in touch, we’d love to hear from you!

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