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Fitbod’s Guide to Training During and After Pregnancy

Pregnant woman doing bridge march exercise

Pregnancy, although often joyful and exciting, can also be a time of uncertainty. This article, written by Emily Huff, MS, Certified Strength & Conditioning Specialist and Pregnancy & Athleticism Coach, is here to help you navigate fitness during pregnancy. 

Benefits of Prenatal Exercise

Exercising before and during pregnancy is incredibly important. Not just for you, either—exercising during pregnancy is generally good for the health of your child.

Pre-pregnancy exercise can reduce stress, improve sleep, and help build the cardiovascular and muscular health needed to handle the demands of pregnancy. Exercise during pregnancy reduces the risk of gestational diabetes and preeclampsia, helps with healthy weight gain, decreases musculoskeletal aches and pains, improves mental health, may reduce your risk of having a cesarean birth, and might even shorten labor times.

If that’s not enough, research has shown that babies born to mothers who participated in prenatal exercise also experience benefits in utero, at birth, and long-term. Researchers found that children born to women who exercised during pregnancy were leaner (at birth and 5 years old) and performed better on standardized intelligence tests, with significantly greater verbal skills as compared to matched controls.

When Exercise Might Not be Advised or Safe

Although rare, there are certain contraindications to exercising during pregnancy. So, make sure you keep an open and ongoing line of communication with your medical provider. For example, training may not be advised due to a cerclage, placenta previa (after 26 weeks), preeclampsia, or severe anemia.

The American College of Obstetricians and Gynecologists (ACOG) also warns to stop exercising and check in with your doctor if you experience any of the following symptoms: 

  • Feeling dizzy or faint
  • Shortness of breath before starting exercise
  • Chest pain
  • Headache
  • Muscle weakness
  • Calf pain or swelling
  • Regular, painful contractions of the uterus
  • Fluid gushing or leaking from the vagina

While most exercises are okay to continue during pregnancy, you should avoid anything that increases your risk of falling (like skiing, road cycling, or gymnastics) or increases your core temperature (like hot yoga).

Although no specific movement patterns are completely off limits during pregnancy, prolonged periods in a supine position (lying flat on your back) may cause the uterus to flow blood back to the heart, temporarily reducing blood pressure. For this reason, it is advised to keep time spent in the supine position short or just eliminate it altogether if you feel guilty.

Now that we have the serious stuff out of the way—let’s have some fun!

Prenatal Exercise is a MENTALITY Shift

Having worked with pregnant people for the last decade, I can assure you that there is no “one-size-fits-all” approach to prenatal fitness. Every person experiences pregnancy differently and adaptability is key. Some days, you’ll feel exhausted and nauseated—a walk might be all you can muster. On other days, you might be full of energy and zest for all that the future holds—and full workouts will be fun. 

Prenatal exercise is not about breaking personal records, pushing your body to its limits, chasing soreness, or even training for birth. Prenatal exercise is all about setting yourself up for long-term success. You’re getting ready to meet the demands of pregnancy and postpartum recovery, parenthood, and your athletic pursuits. The goal is to grow older in a strong body that can handle the demands of every phase of your life! 

The good news is—it is possible to feel stronger and more confident than ever in your changing body. The way you approach exercise during pregnancy is completely up to you. You will hear a lot of opinions about what is best for you and the baby, but only YOU have full autonomy over your choices and behaviors during this transformative time. 

A defining principle of weight training (and core tenet of Fitbod’s recommended workouts) is progressive overload, or strategically increasing a stimulus (such as weight or reps) over time to elicit adaptation. As a parent you will be training in your daily life, and your stimulus is your growing child. You’ll be hinging, squatting, lunging, pushing and pulling an external load that is wiggling, squirming, and progressively getting heavier. 

All these are reasons to gain muscle strength and endurance but also focus on form, motor control, and listening to your body’s needs.

Foundations of Prenatal Exercise

Although every person’s adventure through pregnancy and parenthood is unique, there are four key foundations that can make prenatal exercise more efficient.

Partners, listen up and follow along—you can benefit from this information as well! 

Foundations of Prenatal Exercise:

  1. Body positioning
  2. Breathing mechanics and pressure management
  3. Pelvic floor motor control and core stability
  4. How and when to scale or modify exercises during pregnancy

These four components build upon each other. Mastering body position allows for optimal breathing dynamics, which impacts pelvic floor motor control and core stability. Once you’ve mastered the first three, knowing when and how to scale or modify your workouts throughout each trimester will become more intuitive.

1. Body Positioning

Our bodies are resilient, adaptable and can function in many positions. There isn’t one universal posture or position that’s best for every person in every situation. However, in the context of breathing mechanics and pelvic floor function, the optimal position is referred to as the “stack” or “core canister.” If you focus on one aspect of fitness during pregnancy, this should be it! 

The stack or core canister is the alignment of your ribcage over your pelvis. If you can find the stack, your ability to connect with your breathing mechanics, core and pelvic floor increase substantially, impacting many facets of both movement and function.

Being “stacked” refers to the position of the entire torso independent of body position. Meaning, a body can be stacked standing, sitting, on all-fours, squatting, lunging, or crawling.

Once the ribcage is stacked over the pelvis, breathing can function optimally. This is important because faulty breathing mechanics may cause pressure management issues, limitations on joint range of motion, and compressive compensatory strategies that can cause muscle and joint aches and pains.

How to Find The Stack

Pelvis Positioning: In the context of breathing mechanics, the lumbar spine is positioned optimally at the midrange of anterior-to-posterior pelvic tilt with the anterior superior iliac crests symmetrical. 

Put another way, imagine the pelvis like a bucket of water, keep the bucket of water level, do not spill forward (anterior tilt) or backward (posterior tilt).

Rib Cage Positioning: The rib cage should sit evenly over the pelvic inlet like a bell. A bell rung upward will cause a rib flare. A bell rung downward will cause a chest collapse. Both misalign the stack, which will impact diaphragm movement and negatively affect breathing, pressure management, and joint range of motion. 

Ribcage position is greatly influenced by breathing mechanics and body position.  

The stack position refers to the orientation of the ribcage and the pelvis as a whole. There are many tasks and exercises that require deviation away from the stack. Important movement patterns, such as rotation, require the ribcage to move independent of the pelvis. 

However, the position of each structure separately, the bucket of water and the bell, are important to maintain regardless of movement pattern.

2. Breathing Mechanics and Pressure Management

On average, humans breathe over 22,000 times a day. The autonomic nervous system controls our rate of breathing, but the position of our core canister can influence our breathing ability. This is why the stacked position is so important. Although breathing is involuntary, purposeful breaths can be used to create expansion, compression, and stability.

Understanding what happens within the torso as you inhale and exhale will help you visualize and connect with the movements. 

Figure 1. Image used with permission from Pelvic Guru®, LLC www.pelvicglobal.com

As you inhale, the thoracic diaphragm descends downward as oxygen fills the lungs and the abdominals relax and gently expand. In order to allow full excursion of the lungs and subsequent diaphragm movement, the pelvic diaphragm also descends upon an inhale. 

As carbon dioxide leaves the body through an exhale, lung volume decreases, the thoracic diaphragm lengthens and relaxes upward, and the pelvic diaphragm ascends.

Try This: Purposeful Breathing Drill

This calming drill is great to do every day, whether you add it to your nightly routine or use it anytime stress or anxiety pops up.

Find a comfortable position (seated or standing) that allows a solid connection in the stacked position, relax the jaw, and let the shoulder blades slide down your back. 

Now, inhale a gentle but long breath through the nose.

  • Feel the ribcage expand front to back, side to side, top to bottom
  • Feel the diaphragm slowly lower down
  • Feel the belly soften and fall forward 
  • Feel your lower belly soften and expand the space between the hip bones
  • Feel a softening and relaxation around the labia, the urethra, the vaginal opening
  • Feel a slight relaxed soft expansion around the anus

Let the exhale happen without any pressure or force

  • Feel the pelvic floor ascend (don’t force it—this isn’t a voluntary contraction)
  • Feel the abdominal wall gently fall backwards
  • Feel the diaphragm ascend upward under the ribcage
  • Feel the ribcage contract slightly side to side and front to back

During the exhale, there are different types and intensities of the exhale which may facilitate different levels of muscular activation and proprioceptive awareness. For example, if you act as if you are blowing through a straw, you might feel the transverse abdominals activate first. On the other hand, if you exhale with a hissing (or “fog the mirror”) breath, the internal and external obliques will activate with greater intensity. 

Although there isn’t a “right” way to breathe, expansive breathing drills may create movement and space in the thorax and pelvic region that can facilitate greater capacity for movement, stability, and management of pressure during pregnancy. 

Managing Pressure

Pressure within the core canister occurs with every movement and breath and creates stability that helps us absorb force. Daily activities such as laughing, yelling, and talking and exercises such as squatting, crunching, and running increase intra-abdominal pressure (IAP). IAP is necessary and functional.

However, during pregnancy there might be vulnerability in the midline and at the pelvic floor where “pressure leaks” may occur. The stacked position, and dynamic breathing mechanics may help manage intra-abdominal pressure (IAP), which may in turn help with issues such as incontinence, prolapse or diastasis recti.

Signs of Mismanaged Pressure During Prenatal and Postpartum Exercise

Mismanaged pressure along the midline may look like doming (or coning) during pregnancy. The linea alba, which is soft tissue that connects the right and left rectus abdominis (the superficial “six-pack” abs) and runs from the bottom of the breast bone down to the pubic bone, stretches and thins during pregnancy to accommodate the growing belly. 

Doming of the midline may occur during everyday tasks like getting out of bed and should not be feared. But, because the linea alba is compromised during pregnancy and there is an increase in IAP, our goal is to limit severe doming or coning during exercise. 

Additionally, feelings of weakness, leakage or pressure in the pelvic floor during exercise can also be symptoms of mismanaged pressure.  The stacked position, dynamic breathing, and pelvic floor and core activation are ways in which you may be able to influence IAP during exercise. 

3. Pelvic Floor Motor Control

Much like breathing, the pelvic floor does not get enough attention when it comes to its function and how it contributes to our overall health. It plays a very important role in many bodily functions, such as organ support, breathing dynamics support, sexual and reproductive health and pleasure, and core stability. Dysfunction of the pelvic floor may cause issues both systemically and locally.

List of signs of pelvic floor dysfunction

The pelvic floor, or pelvic diaphragm, consists of muscles, ligaments, tendons, and nerves that span from anterior to posterior, pubic bone to the tailbone, and medial to lateral from the ischium and pubis (see below) to the midline.

Figure 2. Image used with permission from Pelvic Guru®, LLC www.pelvicglobal.com

Pelvic Floor Motor Control Versus the Kegel

Kegels, or repetitive contractions of the pelvic floor, are not a comprehensive approach to the nuances of complex pelvic floor health. In fact, for many people, the Kegel may be a counterproductive exercise.  

If you experience any signs of dysfunction, seeing a Pelvic Floor Physical Therapist (PFPT) or talking to your OBGYN or uro-gynecologist is recommended before starting pelvic floor exercises. If you need to find a local PFPT, Pelvic Guru provides directories, Origin has locations across the country and provides comprehensive pelvic floor and whole body physical therapy, and Bloom is a great online option.

Barring any significant signs or symptoms of pelvic floor dysfunction, a good approach to pelvic floor training, in context of pregnancy and overall health, is understanding the function and attaining motor control over the muscles of this region. 

Motor control, simply put, is the coordination of the nervous system and muscles. Increased motor control can increase proprioception (think mind-to-muscle connection), which can aid in the ability to purposefully contract and relax a muscle.  Just like any other muscle in the body, the pelvic floor needs strength, endurance, speed, and the agility to fully support the body. It should be both strong enough to offer support and supple enough to relax.  

Put another way, the pelvic floor creates a trampoline effect that helps to absorb and create force with movement and pressure. For example, during a vaginal childbirth, the pelvic floor is not pushing the baby out. Rather, it’s yielding while the uterus contracts, allowing the baby to pass through the cervix and out of the vaginal canal. Although we do want a pelvic floor that is strong, you can see why its ability to relax is also so important. 

How to Practice Motor Control of the Pelvic Floor Muscles

You’ll want to learn motor control of the pelvic floor in conjunction with the breath cycle. This is because, with the stacked torso position and expansive breathing, the pelvic diaphragm descends with an inhale and ascends with an exhale. 

Follow along to see whether you have the ability to contract and relax your pelvic floor muscles and to practice motor control of the pelvic floor.

Find a comfortable position (seated or lying down), stack the ribcage over the pelvis, and relax the jaw and shoulder blades. Then inhale a gentle but extended breath in through the nose:

  • Feel the ribcage expand front to back, side to side, top to bottom
  • Feel the diaphragm slowly lower down
  • Feel the belly soften and fall forward 
  • Feel your lower belly soften and expand the space between the hip bones
  • Feel a softening and relaxation around the labia, the urethra, and vaginal opening
  • Feel a slight relaxed soft expansion around the anus (this is not a contraction!)

Exhale gently but purposefully, as if you were softly blowing through a straw:

  • As the air is exiting your mouth, gently engage your pelvic floor… 
    • Drawing together your sits bones 
    • Decreasing the space between your pubic bone and tailbone
    • Drawing your contracted pelvic floor upward (imagine drinking a smoothie through your vagina)
  • As the pelvic floor engages together and upward, a co-contraction of your lower abdominals (transverse abdominals) will occur.
  • As the abdominals engage, envision your hips drawing together and your pubic bone lifting upward as your abdominal wall falls back and your ribcage gently draws inward. 

Utilizing the Pelvic Floor Muscles During Exercise

If the pelvic floor contracts both together and upward, there is a co-contraction of the transverse abdominals and the multifidus, stabilizing muscles that run up the length of the sacrum and spine. 

This collaborative muscle contraction can provide proximal stability during movement or exercise. Before trying to involve your pelvic floor during every repetition of every exercise, picture this: The tension created in your bicep would differ depending on the weight of the object being picked up. Is it a dumbbell or a heavier object that requires more force production and therefore additional muscle coordination? Similarly, a pelvic floor contraction might be helpful during the midline brace required to do a heavy deadlift but isn’t necessarily needed for every rep of every exercise. Instead, you may only need to focus on maintaining the stack and proper breathing dynamics during exercise, which will ensure the movement of the pelvic floor contributes to the collaborative system that provides stability.

It is important to stress that overly contracted or hypertonic pelvic floor muscles (i.e., muscles that cannot relax) are not helpful and may cause dysfunction. Full and comprehensive motor control of the pelvic floor consists of relaxation AND contraction. While you practice the ability to contract and relax at the level of the pelvic floor, notice if you’re clenching the glute muscles, overly contracting the anus, or not able to relax.  

The key is to not over-emphasize any one component. Rather, you should hone in on your ability to connect to all areas of the pelvic floor in the contraction and relaxation phase. 

4. Exercise Recommendations and Modification through Trimesters

Now that you have a foundational understanding of body position, breathing mechanics and pelvic floor movement, you should have the groundwork to feel confident and strong during your prenatal training. 

Prenatal exercise training should add energy to your life through increases in mood and overall mental health, not detract through exhaustion. The focus should be on motor control, form, maintenance of joint range of motion, and long-term health and wellness. 

Outside of any absolute or relative contraindication to exercise, there are no specific movement patterns that are unequivocally off limits during pregnancy. However, you might need to make some modifications.

List of tips for when to modify a movement pattern

How to Modify or Scale a Movement Pattern

Modify Body Position and Slow Down

Mindlessly exercising or quickly moving through reps often leads to poor form. Take time when exercising to ensure you remain stacked and focused on the muscles supporting your movement patterns.

Example: During the squat are you grounded through your feet (big toe and heel), do you have a good connection to the stack, can you feel the ability to breathe and brace, are you feeling strong through your lower body?

Modify Breathing Strategy and/or Core Activation

Dynamic breathing leverages use of your pelvic floor and core musculature to increase stability during exercise. There are a lot of ways to breathe and brace during movements, and a little experimentation goes a long way in finding which method works best for you.

Example: Exhaling during exertion phase only (example: inhale down in a squat, exhale while driving up from the bottom position)

Example: Inhaling at the top of a rep and exhaling through the entire range of motion (example: inhale at the top of a push up and exhale throughout the downward and upward phase)

Modify Load (weight)

During pregnancy the focus often shifts away from heavy, strength-based repetitions that require breath holding to more hypertrophic loads that allow for greater range of motion, dynamic breathing, and increased neuromuscular connection. If form or range of motion falter or if you see signs of mismanaged pressure, always reduce the load.

Example:  In Fitbod, you can swap in elevated push-ups and planks in the Pregnancy category to reduce load and better manage pressure at the midline. 

Modify Range of Motion

Some movement patterns might cause pain in the pelvic region that hurts regardless of positional, breathe, or load changes. If this is the case, a reduction in range of motion may provide relief and can still be beneficial.

Example: Reduce depth in movement patterns like the squat or lunge.

Swap Exercises

During pregnancy some exercises might not feel good to do at all and that is completely okay. Being in tune with your body is important and making adjustments is often necessary.

Example: Often, traditional abdominal exercises that include crunching become counter-productive as the circumference of the core grows and the rectus abdominis stretches to accommodate the growing baby. You can find anti-rotational exercises like Pallof Press, Racked March, and Elevated Plank in the Pregnancy category as more useful options to work the midline. 

These 15+ Fitbod pregnancy workouts all consist of exercises that are generally safe and comfortable for those who are pregnant. Open these on your phone and save them to your Fitbod Saved Workouts library to use throughout and after your pregnancy. You can also build your own workouts with the exercises in the Fitbod app’s Pregnancy category. Learn more about Fitbod’s pregnancy-specific exercises

List of suggested replacement exercises for prenatal workouts

Modify Training Based on Trimester

0-12 Weeks // First Trimester: Although not always the case, hormonal changes in the first trimester that impact the cardiovascular and respiratory systems can cause a cascade of symptoms such as exhaustion, unbelievable fatigue, nausea, and dizziness or light-headedness. 

Although keeping up with an exercise routine is important long term, if needed scale back on intensity and load to reduce overall nervous system fatigue. Avoid any movements that increase feelings of dizziness, light-headedness, or those with a higher risk of falls. 

13-27 Weeks // Second Trimester: During the second trimester of pregnancy hormonal and biomechanical changes can affect center of gravity, gait mechanics, hip extension and flexion, and balance. Equipment and slight movement adjustments during the second trimester can help prevent problematic movement compensations from arising.

28-40+ Weeks // Third Trimester:  During the third trimester, you might feel fine to continue your workout routine, or you might have to significantly scale back. Some people experience insomnia in the third trimester which can greatly impact energy levels. Continue to move in ways that feel good to your body and make adjustments accordingly. During this final stage of pregnancy, it is especially important to stay in tune with the needs of your body relative to workout intensity, duration, nutrition, hydration, and recovery. Take time during this trimester to add in specific meditative breath work that emphasizes the pelvic floor and jaw, as well as facial relaxation exercises. 

As your due date gets closer think about adding in:

  • Mobility exercises such as Cat Cow, Pelvic Opener, and Pelvic Circles Slide Back (all available in our 20-min Flexibility and Mobility Pregnancy Workout)
  • Modifications to make squatting more comfortable, such as the Heels Up Goblet Squat or TRX Squat to deload body weight 
  • Small box step ups
  • Stairs or walking instead of high-impact cardio

0-12 Weeks Postpartum // Fourth Trimester: 

For the first twelve weeks postpartum, your body is going through a time of tremendous healing and your activity will depend greatly on your labor and delivery experience as well as your support system. Rest and bonding with your baby should take precedent. 

Regardless of the type of delivery, a doctor’s clearance at 6 weeks postpartum does not justify jumping back into pre-pregnancy exercise loads or intensities. Over a span of forty weeks your body grew a human being and went through a great transformation. Take time to honor your body and slowly reintroduce strategic exercise. Below are general recommendations that do not take into consideration your unique circumstances. If you have any questions about your specific needs, you can email [email protected] with questions or concerns. 

0-2 Weeks Postpartum: 

  • Rest, sleep, hydration and nourishing foods
  • Daily tasks to care for yourself and your baby

2-6 Weeks Postpartum: 

  • Continue to focus on rest
  • Test out comprehensive pelvic floor and core activation in association with the breath
  • Start with short walks around the house or neighborhood and build from there based on how you feel
  • Add in moving mobility such as Cat Cow and Overhead PVC Shoulder Stretch
  • Very gentle exercises such as Side Plank Clam Lifts, Single Leg Kickbacks, TRX Squats, and Racked March (with little or no weight) for balance

6-12 Weeks Postpartum:

  • Continue to move in ways that feel good to your healing process and slowly start to increase duration, frequency, or intensity of exercise
  • Start a weight training (weights) program 
    • Keep load light and move with intention
    • Focus on form, the stack, dynamic breathing, and connecting to your muscles 
    • Move in dynamic ways that include squatting, lunging, hinging, pushing, pulling, rotation and anti-rotational movement patterns
  • Following 6-8 weeks of strength training, and before running or doing high-impact plyometrics, slowly add back movements that test impact on your core and pelvic floor, such as Box Squats and Mountain Climbers.

Taking the time to exercise with intention during and after pregnancy sets the stage to feel stronger and more confident in your body for the rest of your life! If you have any questions about exercising during  pregnancy or the postpartum period, reach out to Fitbod’s trainers at [email protected] or Coach Emily Huff at [email protected]. We are here to support you in your fitness and wellness goals over a lifetime!

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