Pregnancy Fitness: What's the point?

This is something I've been thinking about a lot during my pregnancy, and ever since I started training preggo women.

Normally fitness is about some kind of performance or aesthetic goal for most people. It's also about health, (although that's not usually what gets someone off their bum and into the gym).

We want bigger muscles, a rounder bum, less body fat, we want to look good naked, run further or for longer, to lift heavier weights, to get stronger or faster.

For the most part, these aren't reasonable goals during pregnancy. Most women are going to lose strength and performance, get a bit slower, probably a bit fatter and lose a bit of fitness. That's probably normal, but not hugely motivating. Our goal isn't to see results, but to slow down this degeneration, limit fat gain - not massively motivating.

Also, you'll be able to do less and less as the pregnancy progresses, which is frustrating, and requires more knowledge and tools. And a flexible mindset. Ugh. But what are we actually trying to achieve? I think we should be trying to maintain 3 major components of fitness:

1. Strength and muscle mass 2. Cardiovascular fitness 3. Mobility and flexibility

At the very least we will want to maintain these 3, although you probably can improve 2 and 3, which we'll discuss.

STRENGTH AND MUSCLE MASS

Why is this important?

For most women, especially around the time that they start having babies muscle mass isn't something that comes high on their list of priorities. They equate muscle mass to looking like this:

When it actually might make them look like this:

Increased muscle mass does a few things:

1. It increases our metabolism, making it easier to lose fat and/or maintain a healthy weight

2. It increases our insulin sensitivity, making it easier to control blood sugar levels

3. It's what gives shape to the body - defined arms/shoulders/abs, a peachy bum, "sculpted" legs, "toned" whatever... this all comes from where and how much muscle mass you have (and how much fat you have covering it).

4. It will help you stay strong, which is important as a mum, and as a heavily pregnant lady (typing this at 39.5 weeks pregnant, I can confirm, lest you have forgotten/haven't been through it yet, that this shit is heavy. It's hard to carry around all day. The stronger you are, the easier it will be).

When we lose strength and muscle mass we may:

1. Become more prone to injury and aches and pains (back, hips, knees etc).

2. Our metabolic rate will be lower after birth (muscle is an "expensive" tissue... it costs a lot of calories per hour to maintain. So when we have more of it, we burn more calories, also at rest. When we have less of it, we burn less calories.) This can lead to weight gain, or struggling to get the weight off after birth, or that feeling that lots of mums have, that they are "back to their pre-pregnancy weight" but still feel a little squidgy (if you've lost 3kg of muscle, but you're back to the same weight, guess what's replaced it?)

3. We may struggle to carry the extra weight during pregnancy and then the baby, as we may be weaker.

So how do we maintain strength and/or muscle mass during pregnancy?

This is a tricky one (I have more positive answers for the other two, I promise).

We can follow a prenatal strength programme during pregnancy. Most women will, however find, that they will lose some (or a lot) of muscle mass during pregnancy. For those of us who were doing strength training before pregnancy, most of us will find that we just cannot lift the weight that we did before, or anything close to it. We will observe drastic decreases in strength. Some women do seem to be able to weight train until late in pregnancy, and as long as they are following safe strength training guidelines for pregnancy, I can't really argue with it. But most women find that this is not the case.

There is usually a decline in strength in the first trimester, which seems to plateau throughout the second, then another decline in the third when you're carrying around a whole lot of weight and the abdominal canister is fully stretched out.

If you weren't strength training before pregnancy and start during the first few months, you may experience a slight increase in strength levels before it starts to level off and then decline.

It seems that pregnancy hormones contribute to this decline in strength/muscle mass - in the same way that a non-pregnant woman will struggle to build significant muscle mass because of high levels of oestrogen/progesterone and low levels of testosterone (something like 10 times less than men's levels), a pregnant woman will have an even greater uphill battle.

Ultimately, however, the body also needs to soften, open and release tension in order to birth a baby. We do need some strength and muscle mass, but we also need to be able to soften and relax - it is a tricky balance to hit, and we do want a balance between the two.

The bottom line here is that MOST women are probably going to lose both muscle mass and strength. BUT by doing careful strength training we can slow this process down and maintain a fair bit of muscle mass. It is hard to train with such a meh goal in mind, but ultimately it will help improve function, prevent aches and pains, help keep us mobile and avoid muscular imbalances and help us get back in shape postpartum.

CARDIOVASCULAR FITNESS

Why is CV fitness important?

CV fitness is important for a whole bunch of reasons, it's often the focus of female fitness, while other (arguably more important) goals like strength are overlooked. It is the focus of national guidelines (i.e. 150 minutes of CV fitness weekly).

I'll save the rant on why strength training is potentially more important for another post.

CV fitness is, though, important throughout the lifespan, and particularly during pregnancy for the following reasons:

1. Improved function of the heart, lungs, blood and blood vessels

2. Increased blood glucose uptake into muscles

3. Lowers risk of heart disease, stroke, diabetes (type II) etc

4. Improves mood and reduces stress

5. Reduces back pain (all exercise and movement does this)

6. Lowers "bad" cholesterol and triglycerides

(Even though you're probably better off trying to achieve it through well programmed strength training + HIT instead of steady state cardio, but that's a topic for another post).

Specifically during pregnancy:

1. Lowers risk of gestational diabetes

2. Prevents excessive weight (read: FAT) gain

3. Increases blood flow to extremities which can have far-reaching effects including improved healing of soft tissue and less swelling

4. Increases stamina (which you will need during birth).

In a non pregnant woman looking to achieve aesthetic, performance and health goals, I would highly recommend starting with strength and HIT, and NOT steady-state cardio. HOWEVER, for a pregnant woman, I would say that it should be a high priority - it's less of a stress on the body and easier to recover from.

Something that is often understated is that pregnancy alone is a huge strain on your cardiovascular system. Over 9 months you will have between 10 and 14 kilos more of lean body mass (the baby and surrounding tissues) that YOUR heart and lungs have to support. The body will produce 40% more blood (taking your blood volume from 4 litres to 6 litres) and when combined with cardiovascular (aerobic) exercise this can massively INCREASE cardiac output and overall CV fitness. It doesn't feel like that when you're lugging the damn thing around all day, but if programmed right, you can massively increase CV fitness levels (endurance, stamina).

Check out this video on underfill for more on this topic.

I've also talked a lot about this book, which details a lot of the benefits of aerobic training throughout pregnancy.

What kind of training should you do during pregnancy?

Low-impact, steady-state. Swimming is a great example (it has the added bonus of putting you belly-down, which can be very good for optimal foetal positioning). Spending some time on a cross-trainer can be great too - though I opted for swimming because water + Israeli summer + the opportunity to get off my feet! Walking often doesn't get your heart rate quite high enough to reap benefits (and again, it's heavy on the hips later on during pregnancy), but you could whack on an incline on the treadmill.

I have always hailed the benefits of HIT or High Intensity Interval Training for better results - basically getting your heart rate really high for short periods of time (5-20 minutes). Check out this post.

But during pregnancy, this becomes difficult, and we're not sure of the effects of a very high heart rate on the foetus.

Instead we may want to get our heart rate up to a moderate level (130-150 bpm) for 20-40 minutes 2-3 times a week.

For those of you who were doing this sort of training before pregnancy, you are likely to at least maintain your fitness level (though it won't feel that way when you are carrying around 9 months worth of pregnancy).

For women like me, who were only doing strength and HIT (or who weren't doing any sort of steady-state cardio before), you will likely IMPROVE your performance.

Personally, I experienced an improvement until the start of the third trimester (by improvement I mean that I could either swim further, or faster) by swimming twice a week and then maintained that level right up until the end with just one swim sesh a week.

I documented this on Instagram.

Please check out the full posts on IG

extra 14 kg of lean body mass

MOBILITY

Mobility is often overlooked in pregnancy (I think I've said that about all 3 now!). But I think it's probably the most important component of fitness to maintain during pregnancy

What is mobility?

I think of mobility in 2 ways:

1. The full range of motion in all your joints (can you get into a deep squat? Can you touch the floor? Can you get your hands directly overhead?)

2. Being mobile. Having the ability to get up and down off the floor, from a chair, in and out of the car. This involves having pain-free movement though the entire range of motion, but also strength through that range of motion

This doesn't mean that we have to become gumbi people who are crazy flexible. We just want to be able to utilize the full range of motion of our joints without pain.

This is likely to prevent injury and aches and pains, promote good posture and prevent muscular imbalances.

It also keeps you independent - being able to play with your kids on the floor, or get up on your own from a bean bag (without someone pulling you up) - even getting out of bed can be super hard when you are about to pop and have to climb over a pregnancy pillow.

For those of you who are hoping to have an active birth, mobility is super important. Being able to do things like deep squats, or being able to hang out on all fours for a while will make it much easier to be active during labour. I've seen lots of women who cannot do a lot of the movements and positions that are suggested in this book when they are NOT labouring (and a lot who can't do them when not pregnant). If this is the case there is little chance you will be able to do this while labouring. It's important to practice these movements throughout your pregnancy and feel strong in these positions.

Finally, moving the hips and spine can help get your baby into a good position for labour and birth. Spinning babies talks about this a lot, about how to flip a breach baby, or get him or her more centred in the pelvis.

Ultimately, we want to:

• feel better,

• be healthier,

• maintain (as much) fitness (as possible),

• avoid injury and aches and pains

• support birth and

• recover quicker afterwards.

EVERYTHING we do during pregnancy should be focused towards these goals. It's not a time when we're trying to maintain (or improve) our 1RM or 5K run time, or run a marathon. (Although, as discussed, improvement may be a reasonable goal in some areas under the right conditions).

Even if in the long term your performance goals do look like this (which is totally legitimate), or if our goals are mainly aesthetic (also legitimate), trying to achieve them in the short-term (during pregnancy) will probably set us back in the long-term. Aiming to achieve the fitness goals listed above will serve you in the long term, whatever you eventually hope to get from your fitness regime.

I think that these 3 components of fitness combined with the MINIMUM EFFECTIVE DOSE that I mentioned in this post are essential to achieve these goals.