My experience with two uneventful pregnancies, where I worked out till the last day, did raise some eyebrows, especially with family and friends, despite the fact that I am a qualified trainer and a certified pre-natal fitness professional.
In India we often approach pregnancy as an “illness” whereas it’s just a “modified state of health”. The old adages are not relevant any more—an expecting mother doesn’t have to blindly double her calorie count and “eat for two” or sit with her feet up all day. In fact, the scientific consensus is that it’s important for pregnant mothers to stay active, and eat nutritionally-conscious balanced meals that are good for both mother and baby.
Pre- and post-natal fitness is a specialized field where the physiological changes in the body through the nine months are of prime importance and training modifications need to be adaptive. According to the American College of Obstetricians and Gynecologists, the average weight gain for a healthy pregnancy is 10-15kg, evenly spread through the three trimesters. The American College of Sports Medicine recommends moderate intensity exercise for 30-45 minutes, three-four times a week. The growing demands of the baby can leave you feeling drained, and you might argue that exercise will worsen that. It does just the opposite. Exercising will help combat morning sickness, fatigue, muscle aches, provide extra oxygen to the baby, and will make you feel mentally strong, among a host of other benefits.
If you have the luxury of planning a pregnancy, this would be a great time to get into the best shape. Work towards developing a strong core, improve your cardiovascular capacity and strengthen your lower back. Research shows that people who exercise regularly conceive faster as exercise is scientifically shown to regulate hormones.
Once you are pregnant, you can safely (assuming you have no complications) continue with your exercise routine, but keep in mind certain guidelines. It’s good to have a qualified pre-natal trainer who can guide you through the modifications for all three trimesters—and of course, you should consult your gynaecologist to prepare an exercise routine that will suit your body.
How to get started
Choose an exercise you are comfortable with. If you have been used to the elliptical machine or treadmill, you can safely continue to train on them. Pregnancy is not the time to start anything new, but if you have been a couch potato, you might want to start some safe, low-impact exercise, like walking or swimming.
Outdoor walks are great as the extra burst of oxygen will be good for you and your baby. Power walks of 30-40 minutes are great for keeping you in shape, and well-conditioned.
During the last two trimesters, the body produces a hormone called relaxin, which relaxes your ligaments as your body is preparing for childbirth. During this time it is important to stretch with caution, as the relaxed ligaments can give you a false sense of increased flexibility and you could overstretch, causing muscle tears and ligament ruptures.
Don’t let your body overheat. This could be harmful for the baby. Gauge the increase in body temperature by noting how soon the body breaks out into a sweat. The increased blood flow and higher metabolic rate that happen when you’re pregnant mean you’ll feel warmer than usual, and more so when you exercise. You may get overheated much faster than you normally would, even before your belly is big. The signs of being overheated are largely individual, but pay attention if you’re sweating a lot or feel uncomfortably warm, nauseated, dizzy, or short of breath. Hydrate regularly before, during and after your workout. This will help to keep the body temperature stable.
Steer clear of high-impact sports and exercise routines like tennis, squash, kickboxing, etc. These could put unnecessary strain on the joints and the sudden stops and starts could increase the risk of injury.
Do not lie on your back for any exercise after the first trimester. The increased pressure on the growing belly will put pressure on an important vein called the vena cava, which will reduce blood to your heart and may diminish blood flow to your brain and uterus, making you dizzy, short of breath, or nauseated. Some women are comfortable in this position well into their pregnancies, but this isn’t necessarily a good gauge of whether blood flow to the uterus is affected. Placing a pillow under your right hip or buttock will allow you to be almost supine without compressing the vena cava.
Pregnancy requires you to eat 300 extra calories a day; if you are exercising, increase that to 400 calories per day. Eat small meals at regular intervals. Do not avoid any food groups. Make sure you have wholegrains, lean proteins, seeds and nuts, low-fat dairy products and vegetables in abundance.
Walking and swimming are safe through all nine months of your pregnancy. But make them a workout. A 40-minute walk could be a power walk for the first 25 minutes and could then end in a leisurely stroll. Make sure you stretch before and after the walk.
Swimming is a great low-impact aerobic workout that is highly recommended during pregnancy. The buoyancy of the water creates the feeling of weightlessness, which is great to take the pressure off the belly and lower back. It is a safe exercise as it does not stress the joints and ligaments, and prevents the body from overheating.
Include resistance training in your routine. Continue lifting light weights, which you can lift comfortably for 10-15 repetitions. Avoid standing for too long when you’re lifting. Sit on an exercise ball for all upper-body exercises. Sitting on the ball takes the pressure off the lower back and helps maintain good posture.
Look after your back and core muscles. The growing belly can take your body out of alignment which, in turn, can put pressure on the lower back. Include exercises like the hip bridge, the cat and camel, and the cross crawl to keep your lower back strong (see boxes).
Make sure you tuck your navel towards your spine through all the exercises. This will help maintain core strength and muscle memory, which is often lost in pregnancy and after delivery.
Stick with your pre-pregnancy fitness schedule, even running if you want. Just get clearance regularly from your doctor and modify the exercises with each trimester. Make sure you include the kegel exercise (also called the pelvic floor exercise)—it’s important to keep the pelvic floor muscle strong to prevent urinary incontinence post delivery. Avoid all inverted yoga poses. It’s important to continue your core exercises: It will not harm the baby; if anything else, good core strength will get muscle tone back in the stomach and take the pressure off the lower back due to the increased lumbar curve.
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Protect your back
Keeping the lower back strong is key during a pregnancy. Here’s how
u Hip bridge
Lie on your back with your feet on the floor and knees up. Keep your hands on your sides and gently lift your hips off the floor till your body is supported on your upper back and shoulders. Slightly squeeze your glutes and hold for 10 seconds and then lower yourself back towards the floor. Do 10 repetitions of this. If you are in your second or third trimester, keep a pillow behind your neck to keep your head higher than your heart so that the blood flow to the heart is not restricted.
u Cat and camel
This is a great exercise to release the pressure the growing baby is putting on the lower back. Get down on all fours, keeping your knees and your hands approximately shoulder-length apart. For the first part of the movement, curl your lower back and look towards your knees. Hold for 5 seconds, then extend the lower back, pushing out your glutes, look towards the ceiling, and hold for 5 seconds. Repeat this sequence 10 times and do it twice a day.
u Cross crawl
This exercise strengthens the lower back and the muscles that run along the spine. Start in the all-fours position, then gently raise the left hand and the right leg so that they are more or less in a straight line with your torso, and hold for 10 seconds. Come back to the all-fours position gently and then repeat with the right hand and the left leg. Aim for 12-15 holds on each side.
This is the first of a two-part series on fitness during and after pregnancy.
Sumaya Dalmia is a wellness consultant, fitness expert and owner of Sumaya, a personal training studio in New Delhi.