Achieving fitness goals before, during and after pregnancy
A lot goes into developing an exercise prescription surrounding pregnancy, and is most determined by the mother’s individual condition. The American College of Sports Medicine (ACSM) has a set of relative and absolute guidelines for exercise contraindications during pregnancy. Meaning, there are conditional situations where exercise could be safely indicated, and definitive situations where exercise is harmful to the mother and child.
Regular exercise during pregnancy provides much health benefits to the mother and child and reduces the risks associated with sedentary behavior, like preventing gestational weight gain and diabetes mellitus, and decreasing the risk of pre-eclampsia (pregnancy induced hypertension). The physiological response to exercises are more pronounced and acute during pregnancy compared with non-pregnancy. Therefore I ask several questions before prescribing exercises for women who are considering pregnancy.
Is the person pregnant? If a woman is not pregnant and healthy, standard exercise guidelines for strength and conditioning could be initiated with little to no supervision, and is the best case scenario prior to considering pregnancy. Getting into shape is ideally performed before and after pregnancy, and degrees of intensity are adjusted during various stages of pregnancy.
Has there been a pattern or regular exercise or athletic ability prior to pregnancy? If a person has little to no exercise patterns pre-pregnancy, then getting into shape while pregnant should be done under supervision of a professional personal trainer or exercise oriented clinician. During pregnancy, the cardiovascular and respiratory system’s resources are diverted to the fetus, and the capacity for work diminishes, but doesn’t necessarily mean one should avoid intensity altogether. A person who has been regularly exercising, or was exercising with intensive cardiovascular and power routines should be able to maintain a certain level of intensity, so long as new symptoms (refer to ACSM guidelines) are not provoked. This may mean that strength training with weights and barbells could be continued to maintain fitness levels rather than to elevate pre-pregnancy work capacity.
What is a reasonable recovery period for pregnancy workout? When subjecting resistance loads to exceed tissue strength during exercise, you get growth and adaptation. Excessive loads leads to the kind of muscle soreness and pain that is associated with micro-trauma and is typically counterproductive to exercise adaptation. More pain is not always more gain, it just means more requisite recovery periods and less time training. Muscle soreness during pregnancy is not necessarily a bad thing, as long as it is transient during exercise and not to exceed the next 12-24 hours. Soreness lasting more than 24 hours means the body can’t process the lactic acid adequately and is experiencing more micro-trauma than it can handle, and exercise loads need to be adjusted.
Does the fuel source match the fitness demands? Expending energy during pregnancy (and non-pregnancy) will increase the need for fueling the body. The cleaner the fuel source, the more efficient the machine. In practical terms, avoiding excess carbohydrates and processed foods and substituting with nutrient rich whole foods and healthy fats (Omega 3’s, walnuts, chia seeds, salmon). These will provide excellent building blocks for healthy repair and recovery after workouts.
In short, the absence of obstetric or medical complications makes exercise recommendations during pregnancy consistent with recommendations for healthy adults. Exercise prescription for pregnant women should be modified according to symptoms, pain and ability, and is always best to have a team of professionals to consult at all stages of the pregnancy experience.
Dr. Adrian
