As I sit down to write this, I am currently a mother of a 14 month old and 21 weeks pregnant.

Staying strong during my first pregnancy did take some effort, between the morning sickness that never really went away, the anxiety of 2020 (need I say more?), and preparing for a major life change, my fitness routine looked a little different than I could have hoped. I did, however, manage to stay strong, run (a very slow) half-marathon for 14 weeks and do yoga almost daily. Now, add a toddler and a body that feels barely recovered from the first pregnancy and “effort” seems like a huge understatement.

I know the importance of staying strong during pregnancy. As a pelvic and ortho PT, I know the benefits of exercise far outweigh the risks (in a healthy pregnancy). Moderate exercise shows an increase in fetal growth and decreased risk of gestational diabetes. Keeping the hips and core strong will help with stability of the pelvis, therefore reducing pain that comes from a less stable pelvis. It also reduces constipation, which helps reduce prolapse. So, how much is too much? We’ve all seen videos and images of women 38 weeks pregnant, lifting a barbell or doing a handstand, but is that okay? Should that be praised? Is she putting her baby at risk? Should I be doing more? Is “just listen to your body” good advice? How do I know what my body is trying to tell me?

Generally speaking, pregnancy is not the time to set new fitness goals for yourself, however if you are currently sedentary, it is beneficial to start some light cardio and strengthening such as walking and prenatal yoga. A study that included over 92,000 pregnant women showed no increased risk of miscarriages in women of all activity levels vs sedentary women (Newton and May, 2017).If you are accustomed to more vigorous exercise, you can continue, but the more intense the activity the more important it is to be body aware. “Listen to your body” isn’t always great advice if you are in this group, since we are so accustomed to pushing through our discomfort. Likely if you are doing a very high level of training, it’s good to cut back a bit, especially in the heat. Don’t be afraid to modify, especially in the 2nd half of pregnancy when you may have difficulty with pressure management in the abdomen.

If you are in a healthy pregnancy and have been cleared by your doctor for exercise, here are a few general do’s and don’ts to get you started:

  • Master a great 360 degree breathing pattern, this may include exercises for side body expansion
  • Learn how to engage deep core (get help from a professional if you aren’t sure what this means)
  • Stay strong in the glutes– this includes the back of your hips and the sides of your hips
  • Stay active with a combination of both strength training and cardio
  • Modify exercise if you cannot complete with good form
  • Stay well hydrated and nourished
  • Have someone trained look at your form if you are continuing moderate-strenuous exercise into 2nd and 3rd trimesters
  • Get overheated
  • Perform in deep twists and full inversions
  • Participate in high impact sports
  • Exceed >75% of VO2 max for general population
  • Push through: pain, doming in the abdomen, heaviness in the pelvic floor
  • Do SL activities if you are having SI or pubic pain

Remember, pregnancy and postpartum is just a short period in your life, and pushing too hard can hinder progression towards your long term goals.

It’s just not worth the short term gains. I understand how hard this mentality is for someone who loves fitness, but keep in mind that recovery will be easier if you take the appropriate modifications. If you need more guidance, find a PT or fitness provider that is certified in Pregnancy and Postpartum exercise.

About the Author:

Sara Koehl Physical Therapist Anchor Wellness

Dr. Koehl is a Doctor of Physical Therapy looking to make a difference in the health and well-being of the people in her community. She loves to educate patients to empower them in taking control of their health and reaching their goals including those with acute and chronic orthopedic conditions, pelvic floor dysfunction, and neurological conditions.

She provides patient centered practice with focus on one on one care.