What do researchers know about exercise and pregnancy? Unfortunately, there is little research to guide specific protocols about safety and best practice in this niche population. In general, studies discuss the values of aerobic exercise during these 40 weeks, but have not made conclusions about other types of activity. However, there are some tips and cues we can take from already existing research, as well as more benefits and direction for postpartum women.
What We Know
There is little confirmed about exercise during pregnancy in the studies out there today. Researchers often combine exercise models in the existing studies, which makes it difficult to draw indications and instructions about resistance training in this group. The other problem with existing research and beliefs around exercising while pregnant is that often there are poor assumptions about what a pregnant woman can handle. In fact, exercise resistance was commonly found to be higher for elderly, frail, and sick individuals. This generally means that dosing of exercise is too low to impact gains in strength. Proper guidance by a medical professional or physical therapist is helpful to ensure you are receiving appropriate levels of exercise and load, while also performing them safely and tracking necessary vitals like heart rate, breathing rate and other data to avoid complications.
Activity vs Inactivity in Pregnancy
One known benefit is that, like in the general population, exercise is helpful and important for maintaining a healthy weight/weight gain as their baby grows. Some other benefits include; reduced blood pressure, prevention and treatment of diabetes, prevention of urinary incontinence, reduced Cesarean delivery, reduced low back and pelvic pain, reduction in postpartum depression and anxiety, improved quality of life, and a positive impact on the health of their unborn child. These benefits may be achieved by participating in various forms of physical activity, including; cardiorespiratory exercise, postural training, strengthening, flexibility training, balance, and pelvic floor muscle endurance exercise. While there are many benefits to physical activity in pregnant individuals, there are also some potential consequences of inactivity during this time. Some of these consequences may include diastasis recti, adverse pregnancy and birth outcomes, as well as short and long term risk for chronic disease in mother and child. Maintaining safe physical activity levels will help with prevention of these conditions/events.
Postpartum Recovery & Exercise
Mothers who have just added a newborn to the mix of their busy families may feel like they have enough to worry about without complicating their lives further with the addition of exercise into their daily routine. Given what is known about exercise, and the benefits it can have, it is important to make physical activity as reachable for them as possible in order to prevent postpartum complications such as; depression and anxiety, weight gain, diastasis recti, and urinary incontinence. There are several important components to consider while structuring an exercise program for postpartum women; structure, barriers, habit stacking, and management of expectations.
How to Structure Your Postpartum Workouts
It is invaluable to promote time management and encourage activity in as small time increments as needed. Sometimes, this may mean anywhere from as little as 5-10 minutes to make exercise achievable. Other strategies to implement may be using tabata style workouts, or circuits using EMOM or “every minute on the minute” timing. Tabata involves alternating between a set period of time of training or “maximum effort” and a time period of rest. These intervals are similar to concepts like HIIT, or “high intensity interval training,” but for the postpartum momma, can and should be performed at appropriate levels of intensity and exertion. For example, a 20 second interval of squats, followed by a 10 second interval of rest, for 3-4 rounds. EMOM involves performing a set number of repetitions of an exercise in the duration of one minute, using whatever time that is remaining once repetitions are complete to rest. For example, performing 8 lunges on each leg and resting for the remainder of the minute prior to starting another 8 lunges upon the start of the next minute for a set number of rounds/minutes.
Pregancy & Postpartum Barriers to Exercise
Some common barriers these women may experience can include time, distraction, and equipment/space. Time management is important and habit stacking is an excellent strategy to combat this barrier. Distractions may also be a limiting factor addressed with habit stacking. Equipment and space restrictions may be addressed with giving spaces in the home like the living room or kitchen dual purpose by placing exercise equipment such as weights, or mats in the area for easy access and convenience of keeping an eye on her baby. It also may be helpful to use various home items as resistance, or using your baby for resistance during some types of exercise.
Habit Stacking
Exercising while doing something that the mother is already in a habit of doing can help save her time and make physical activity more attainable. Some examples include; doing 10 squats while warming up a snack or coffee in the microwave, placing a resistance band near her favorite nursing chair and performing 12 band pulls prior to feeding, doing a set of 10 kegels while changing the baby’s diaper, or getting down on the floor with baby and doing 10 superman holds. Habit stacking is a great way to improve consistency and build a routine of fitness for mothers with newborns.
Make Realistic Expectations
It is important to remind new mothers of the wins they are able to achieve throughout the day, no matter how small. In most cases, a little is better than nothing, and this mindset can help keep postpartum women on track to their goals. It is also helpful to focus on consistency over time, rather than the missed work outs or things that did not get done. With the management of expectations, it is crucial to realize that outcomes will match what they are able to put in. 5 minutes a day is better than nothing, but recognizing changes will be less noticeable than someone who is able to put in more time.
In conclusion…
Staying active during pregnancy and beyond can come with its own challenges. If you are feeling lost or concerned about preventing weakness and other complications during this unique phase of life, seek help from trained healthcare professionals for optimal safety and guidance. The specialized care provided by the physical therapists at Inside Track Physical Therapy and Wellness can help make a significant difference in your plan, education, and execution of physical activity during this time. Our expertise ensures a targeted and subjective approach to promote long term health and wellness.
References
- Santos-Rocha R, Fernandes de Carvalho M, Prior de Freitas J, Wegrzyk J, Szumilewicz A. Active Pregnancy: A Physical Exercise Program Promoting Fitness and Health during Pregnancy-Development and Validation of a Complex Intervention. Int J Environ Res Public Health. 2022;19(8):4902. Published 2022 Apr 18. doi:10.3390/ijerph19084902
- The PT on ICE Daily Show. Episode 1751: HEP for the New Mom. Dr. Heather Salzar, 2024. Accessed September 13, 2024. https://ptonice.libsyn.com/episode-1751-hep-for-the-new-mom
- The PT on ICE Daily Show. Episode 1756: What do we Really Know About Strength Training During Pregnancy? Dr. Christina Prevett, 2024. Accessed on September 13, 2024. https://ptonice.libsyn.com/episode-1756-what-do-we-really-know-about-strength-training-in-pregnancy
