Anyone who has ever been pregnant can attest to the fact that those nine months take a toll on your body. But science is confirming yet again just how much. A study out of Duke University, published in Science Advances in June, looked at the effects of challenging races (like the Ironman and Tour de France) on elite athletes, and concluded that pregnancy is just like running one of those.
It makes sense, says Bess Carter, NASM-CPT, a partner with Academy Sports + Outdoors. "Pregnancy is the pinnacle of physical exertion that the body can handle when it comes to endurance," says Carter, who didn't work on the study.
At the same time, those nine months are marked by major, taxing physical changes. Debora Sedaghat, D.O., an OB-GYN at Fountain Valley Regional Hospital and Medical Center in Fountain Valley, California, points out that during pregnancy, all the body's systems go through "drastic shifts and changes to accommodate the changes of pregnancy," Dr. Sedaghat, who also didn't work on the study, adds, "Your heart has to work hard, and your whole system has to work hard to accommodate, and this is all without doing anything other than being pregnant."
That said, anyone who is trying to conceive can benefit from prepping their body for the physical toll of pregnancy—before, during, and after.
How to Train Before Getting Pregnant
In addition to prepping your body for carrying a growing baby for nine months, moving more may benefit your fertility. "It has been shown again and again that activity not only helps enhance preconception, ovulation, and helps with getting pregnant," says Dr. Sedaghat. Here's how you can optimize your pre-conceptual exercise plan.
Focus on strength training. "Strength training the whole body for not just pregnancy but also motherhood is extremely helpful, so functional movements that mimic moves you may do as a mom, such as a crib reach, baby lift, and car seat carry, will best prepare you," says Carter. What's more, keeping your muscles strong will help your body support the weight gain and may help make recovery post-birth easier, she says.
Make sure you're getting aerobic exercise in, too. Whether you're trying to conceive or not, it's wise to get your heart rate up for at least 30 minutes at least three times a week, but this is something Abby Phon, CHHC, AADP, IAHC, a certified holistic health and wellness coach, advises women make sure to do in the lead-up to pregnancy. "Your heart will need to pump up to 40 percent more blood through your body during pregnancy, so making sure it's in tip-top shape before you begin is a good idea."
Switch up intensity. Kelsey Miller, CSCS, NSCA-CPT, with Biola University in Southern California recommends trying interval training—in which you'll work hard then rest for the same period of time or slightly longer (think spin class)—twice a week. Then do a less intense but longer workout once a week. "Aim for at least 30 minutes of continuous activity that causes your heart rate to stay elevated," she says.
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Work on your pelvic floor muscles. When we hear pelvic floor muscles, we think of Kegels, but Jenny Arrington, a yoga teacher and wellness advisor at the Kellogg School of Management at Northwestern University in Chicago, recommends doing more to prep your pelvic floor—a group of muscles that support the bladder, uterus, and bowel. "Proper preparation can help avoid urinary or fecal incontinence after the baby arrives," says Arrington. "I often cue students to think of holding gas, urine, and lifting all the muscles in between. For women, the best way to really understand how to engage and strengthen all the muscles of the pelvic floor is to use a weighted egg. The egg is inserted into the vagina and in order to hold it there, the pelvic floor muscles have to engage. This is the best way to sense how deep these muscles are and how broad their reach is."
Consider hiring a personal trainer. Carter recommends looking for a certified personal trainer who has a pre- and post-natal fitness certification—especially if you are a novice at the gym. That way, you'll "ensure you are performing moves correctly with the proper form and alignment."
How to Train During Pregnancy
As you continue to workout throughout your pregnancy, you'll do well to continually adapt to the ever-evolving, physical demands of those nine months, says Brianna Battles, CSCS, founder of Pregnancy & Postpartum Athleticism. "It's a time to be mindful of the changes to your body and how your exercise influences your expanding abdominal wall and pressure on your pelvic floor."
Keep up what you were doing before pregnancy. Dr. Sedaghat encourages her patients to continue whatever exercise regimen they've been doing before pregnancy. "If a patient doesn’t have a very active lifestyle, I encourage them to start by walking, even just 30 minutes a day to get them moving," she says. "Being active during pregnancy can make it easier, including during the birth."
Prepare for birth by cultivating hip strength, mobility, and flexibility. To power up your ability to squat (which can be a wonderful position to push the baby out), and to boost your hip flexibility and mobility, try the yoga pose Malasana, recommends Arrington. Start by standing with the feet a little wider than the hips and the toes turned out about 45 degrees. Slowly bend the knees, lowering the hips into a deep squat while the feet remain flat on the floor. "If bending the knees fully isn't possible at first, one could use a block or bolster under the hips for extra support," she says. "The key here is to continue to press down into the feet to activate the glutes and hip muscles, thus strengthening the muscles while lengthening."
Don't underestimate breathing techniques. The lungs get increasingly compressed as the baby grows, so knowing how to breathe fully is key. "Not only will it help keep her nervous system calm during labor, but it will help keep her blood properly oxygenated, thus giving her more strength and endurance," she notes. One two-step practice she recommends: "Close the eyes and exhale, knitting the ribs together, drawing the navel back towards the spine as far as possible. When you think you're done exhaling, squeeze the core muscles together around the spine a little more, and you'll find there was more air in there. Then, all you have to do is relax all your core muscles and a big inhale will swoosh in without any effort. It may feel like the fullest, deepest breath you've had in months."
After you feel comfortable with this exercise, try a calming breath practice to soothe the nervous system: "Close off the right nostril with your right thumb. Breathing just through your left nostril, count your deepest inhale, then constrict your throat gently to slow down the exhale to double that count. So if you inhale for a count of 4, you'd exhale for a count of 8. This is a practice to get really familiar with while pregnant so it's easily accessible as a go-to tool during labor."
How to Train After Giving Birth
Every woman's body and postpartum recovery is different, but in general, Dr. Sedaghat encourages "some level of activity, but not full force with exercising until six weeks for vaginal births and eight weeks for C-sections." Still, it's not enough to hear "you're cleared," Battles says. She advocates seeking out more "feedback on the status of your healing body from both pregnancy and delivery, regardless of how Baby came out. You need more information and context on your readiness from the inside out, literally." Here's how Battles and other experts recommend acquiring that information.
Work with a postnatal certified trainer. "[He or she] can help you get back into exercising at the right pace, ensuring they are helping you with your core and pelvic floor exercises first to establish that again, since that area was most affected during pregnancy and is likely weakest," says Carter. And if you're dealing with diastasis recti—a condition that can occur during pregnancy in which the large abdominal muscles separate—a certified trainer who specializes in postnatal exercise can help you rehab those areas.
See a pelvic floor physical therapist. Ann Udofia, PT, DPT, co-founder of Body Connect Health & Wellness in Washington, D.C., recommends every new mom visit a pelvic floor PT. "It doesn't necessarily mean they need extensive therapy done, but pregnancy, the birthing experience, and postpartum recovery is really just a powerful transformative experience in any person's life," Udofia notes. "Understanding how to safely and effectively take care of yourself and understanding the resources you have available to you are important."