Safely Navigating Exercise During Pregnancy

Googling it, I found so much conflicting information. There was even people saying it’s bad to exercise during pregnancy! 🫠

It was frustrating and that frustration led me on the path that I’m on now. I sought out education and now I want to help other women because while there is more useful information out there, there are so many women who don’t know what to do.

Spoiler alert, exercise is NOT something to be avoided during pregnancy. In fact, it can be a huge benefit to you and your baby.

DISCLAIMER!

If you have health issues or pregnancy complications where your doctor has advised you to not exercise during your pregnancy, don’t do it! In this article, you’ll learn what “red flags” to look for and be aware of in this article if you do have any concerns.

Please make sure to get clearance from you doctor before starting a new exercise program. 😉

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Your #1 priority when approaching exercise during pregnancy is to make sure you and your baby are safe.

You need to be aware of signs, symptoms, red flags, and contraindications for exercise.

We’ll discuss each of those lights and more:

• Green Light: When Are You Okay to Exercise During Pregnancy?
• Yellow Light: When Should You Proceed with Caution with Exercise During Pregnancy?
• Red Light: When Should You Stop Exercising During Pregnancy?
• 3 Activities to Avoid During Pregnancy
• Use the Perceived Effort Scale

Green Light: When Are You Okay to Exercise During Pregnancy?

There are the certain signs and boxes to tick that means you have the green light to exercise:

• You’ve met with your doctor and they’ve cleared you for exercise
• You aren’t showing signs or symptoms of:
  • pain
  • pelvic floor dysfunction
  • nausea (excessive)
  • vaginal bleeding
  • dizziness
  • any other red flags that are concerning to you
• You’re exercise feels good and is nourishing your body
• Avoid exercises that are contraindicated in pregnancy (you’ll learn more about his in the section on activities to avoid during pregnancy)

Yellow Light: When Should You Proceed with Caution with Exercise During Pregnancy?

This is our yellow light. When I say proceed with caution, I mean that you need to keep a close eye on the symptoms and modify the exercises as needed.

5 Indications to Proceed with Caution:

1. Something Seems “Off” During Your Workout

Proceed with caution, pause, or modify the exercise if you feel any of the following during your workout:

• Pain in the front or back of the pelvis. This could feel achy, sharp, radiating, or like a burning sensation.
• Aches and pains that feel worse than the normal mild pain that comes with exertion. (ex. wrist, knee, shoulder pain)
• Feeling very out of breath during exercise.
• Extremely fatigued.

You might be thinking, Christy, I feel tired, out of breath, and achy all the time during pregnancy. How do I know what’s normal?

You know your body best. Listen to it. Before you start your workout, do can do a small meditation to help you be aware of how your body is feeling. Where is there tightness, aches, or pain, etc.

I know this can sound hippie dippie to some, but I promise you that it works.

Keep a close eye on any of these symptoms and make sure they don’t escalate to something more serious.

Pause, take a break, modify the exercise, or skip it if you’re unsure.

2. You’ve Been Diagnosed with Pelvic Organ Prolapse

Pelvic organ prolapse is a condition where the pelvic organs descent toward or through the opening in the vagina. This needs to be diagnosed by your doctor.

Her are the symptoms to watch out for:

• Incontinence (lack of control over urination or defecation)
• Low back or pelvic pain
• Feeling of excessive downward pressure in your pelvic floor, heaviness in perineum (the area between the anus and vulva), or feeling like something is bulging, dragging, or falling out.

If you notice any of these symptoms, try modifying the load (decrease the weights), intensity or range of motion. If that doesn’t help and symptoms get worse, stop the exercise and talk to your doctor.

3. You Experience Urinary Incontinence

This one is SO common during pregnancy and postpartum, but it is NOT normal.

Urinary incontinence is the involuntary leaking of urine. It can be a sign of pelvic floor dysfunction or a sign that you’re not handling intra-abdominal pressure well.

Leaking normally happens during moments of strain or excessive pressure like when you’re laughing, sneezing, coughing, or performing a strenuous activity.

If this is happening to you, I recommend you see a pelvic health physiotherapist. You can make modifications to your workouts or wear a pad and proceed as normal, it’s up to you.

You do not and should not have to live with incontinence.

4. You Observe Abdominal Wall “Doming” or Bulging, or Have Concerns About Diastasis Recti

Diastasis Recti (DR) is the widening of the linea alba (in purple below). It’s the connective tissue that links the 2 sides of the rectus abdominis muscles (the “6-pack abs”).

DR is normal and expected during pregnancy. As your baby grows, your belly expands to make room.

Everyone will have some degree of DR by the end of pregnancy. It’s unavoidable.

For some, it will resolve itself on its own during postpartum recovery. Some cases might be more severe which will make postpartum recovery a little bit more difficult.

Be cautious with exercises that:

• Cause doming or bulging of the linea alba
• Feel like too much for your core to handle

If you have problems with DR, chat with your doctor or a pelvic health physiotherapist about it. Also, as a side note, it’s never too late to fix your DR. Even if you had a baby 20 years ago. 😉

5. You’ve Been Diagnosed with a Relative Contraindication to Exercise

Relative contraindications to strength training during pregnancy include:

• Mild preeclampsia
• Mild respiratory disorders
• Mild congenital or acquired heart disease
• Well controlled type 1 diabetes
• Placenta previa after 28 weeks
• Untreated thyroid disease
• Severe eating disorder
• Moderate to heavy smoking
• Multiple nutrient deficiencies and/or chronic undernutrition

If any of the above relates to you, it doesn’t automatically mean you shouldn’t exercise, it means that you should discuss strength training with your doctor to make sure it’s safe for you.

If you’re given the greenlight, you should still be cautious and listen to your body. You might need to make modifications to exercises.

Here are some common symptoms and what you can do to modify.

8 Ways to Modify an Exercise to Reduce Symptoms

If you’re doing an exercise and start experiencing symptoms like incontinence, heaviness or dragging in the perineum, or doming/bulging of the linea alba, here are 8 ways you can modify the exercise that should reduce or eliminate any symptoms or discomfort:

1. Decrease the weight. You might be able to manage any intra-abdominal pressure better by using a lighter load.
2. Experiment with different sets and rep ranges. Reducing the number of sets or reps could help reduce any symptoms because you’re less fatigued.
3. Decrease the range of motion. Working in a smaller range of motion might help you have more control over the movement and your body.
4. Change the position of the load. For example, if you’re holding a kettlebell, try holding it toward the floor, closer to your chest, on one side, or holding 2 smaller kettlebells. Do whatever feels the most comfortable.
5. Try a different breathing strategy. Try exhaling on exertion, inhaling on exertion, or try to breath normally without thinking about it too much and see what happens. Experiment to find what works best.
6. Try different exercise techniques. Try a narrower or wider squat stance. Turn your toes out or more forward. A more upright or forward leaning torso and more or less ankle dorsiflexion.
7. Do what you can to feel safer. For example, squat to a box to remove a balance issue. Holding onto something when you are doing a lunge, etc.
8. Make sure you aren’t creating excessive intra-abdominal pressure. Avoid “gripping” your upper abs, or bearing down on your pelvic floor during a movement. You should be able to breathe normally and have a conversation while strength training. If you feel pressure on your pelvic floor, think about “drawing up” through the pelvic floor may help redistribute some of the pressure.

Red Light: When Should You Stop Exercising During Pregnancy?

These red light signs to stop exercising might be things you notice or ones that your doctor will need or evaluate.

Stop if You Experience Any of the Following Red Light Symptoms

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

Stop if Your Doctor Has Diagnosed You with One or More Absolute Contraindications

There are also absolute contraindications to exercise during pregnancy. These would need to be diagnosed by your doctor, and they mean strength training is definitely not safe.

It’s so important to get checked by your doctor before you start an exercise program to be sure you don’t have any of these absolute contraindications. Some of these might develop over pregnancy so be sure to attend all of your prenatal appointments and discuss any concerns you have. If something doesn’t feel right, talk to you doctor!!

3 Activities to Avoid During Pregnancy:

Okay, now that we’ve gone through the green light, yellow light, and red light symptoms, let’s get into some specific activities you should avoid during pregnancy.

This sounds like such a downer, but there are literally hundreds of exercises that are okay to do during pregnancy. You still have so many options.

There are some exercises or activities that you should modify or avoid completely to keep yourself and your baby safe.

1. Avoid High-Risk Activities During Pregnancy

These activities might put yourself or baby at high-risk:

• Contact sports that might put the baby at risk of trauma (e.g., hockey, boxing, volleyball, soccer, football, basketball, hockey)
• Activities with a high risk of falling (e.g., horseback riding, skiing / snowboarding, water skiing, skating, surfing, off-road cycling, gymnastics)
• Olympic lifts (the snatch and the clean and jerk, in which the bar could collide with the belly)
• Exercising at altitudes greater than 8200 feet (2500 meters) if you don’t live at that altitude
• Activities done in high temperatures (hot yoga)
• Scuba diving

2. Modify or Avoid Exercises that Cause or Make Symptoms Worse

These activities aren’t completely off-limits, but they come with a higher risk than reward:

• Plyometrics / Heavy Lifting: Exercises that cause you to leak urine or give the sensation of heaviness or dragging in your perineum. This varies from woman to woman, but some find that jumping exercises, running, heavy lifting can cause these symptoms. However, some women don’t have any problem with these activities. So again, listen to your body.
• Exercises that cause or aggravate existing pain, aside from mild musculoskeletal pain that may be expected from certain exercises.
• Exercises that cause your abdominal wall to bulge, especially along the midline. There’s a wide range of exercises that may cause bulging, and what causes it for one woman may not be an issue at all or another. Planks and push-ups are common culprits.
• Prolonged exercise on your back in the later stages of pregnancy, especially if it makes you feel lightheaded, nauseous, or tingly.
• Exercises performed at such a high intensity so you aren’t able speak comfortably.

The good news is there are lots of tweaks or modifications you can make that can help alleviate symptoms like these like we learned in the section above (8 Ways to Modify an Exercise to Reduce Symptoms).

However, if a modification doesn’t help reduce your symptoms, it’s probably safest to switch to a different movement. Like I said, there are lots of other options that are effective and will keep you and your baby safe.

3. Avoid Valsalva Maneuver / Unintentional Breather Patterns

The valsalva maneuver is a breathing technique used when lifting heavy weights. Here’s how it works: the lifter closes their airway while attempting to forcefully exhale. Prior to closing their airway, most lifters also take a large breath of air. The reason heavy lifters do this is so they can increase their intra-abdominal pressure, which increases the rigidity of their core which helps support the spine and improve their power and stability.

Pregnant women should also avoid unintentional breathing pattern during straining or lifting.

There is a lot of conflicting advice on whether it’s okay to use during pregnancy, but based on the research I’ve read and heard from professionals in the field, I recommend avoiding it.

We don’t have the evidence that it’s safe during pregnancy and we also know that it can put extra pressure on the abdominal wall and pelvic floor muscles which are 2 areas that are already strained and weakened by pregnancy.

Plus, the technique is generally used when a person is lifting close to their one-rep max, which isn’t recommended during pregnancy anyway.

Trust me, a weak pelvic floor is not fun! Peeing your pants everytime you sneeze or laugh too hard is not fun. 😬

The Perceived Effort Scale

I’m going to end with this. Throughout the article I’ve talked about listening to your body and really tuning into it. The perceived effort scale will help you do this.

What is it?

I’ve been using the perceived effort scale with my clients ever since I first became a personal trainer. It’s a method to measure how hard you’re working based on how you feel. Kind of like when you are in labor or at the doctor for pain and they ask you on a scale of 1 to 10 where your pain is at.

Why use it?

It’s important to be cognizant of your intensity when working out during pregnancy. That includes the intensity of load (how heavy you’re lifting) and the intensity of effort (how hard you’re working).

There are risks of overdoing it during pregnancy. Putting too much pressure on your core or pelvic floor, getting your heart rate up too high, etc.

Using this scale is a great way to easily make sure you’re staying within a safe range.

How does it work?

You can use this during strength and cardio sessions. The scale ranges from 1 to 10.

The highest your effort should ever be during pregnancy is 8.5 out of 10.

Most HIIT classes / workouts are designed to take your intensity to a 9 or higher. Be aware of this and be sure to modify or skip these workouts/exercises. When the instructor is yelling at you to go harder or longer, listen to your body, not them. 😉

Okay, here is the scale!

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ANDDDD, if you’ve made it to the end of this article, I’d like to reward you with some free workouts for each trimester. ☺️

I also have a free workout guide for pregnancy and postpartum and beyond that is made for the busy mom. It includes over 60 workouts that are 10-30 minutes and can be done at home.

Sign up up here to receive that. ⬇️ ⬇️ ⬇️

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Here are your workouts!! ⬇️ ⬇️ ⬇️

1st Trimester

30 Minute Full Body Bodyweight Workout

Complete 4 to 5 rounds of the following full-body circuit. Rest only as needed between exercises and 30 to 90 seconds between circuits.

1. Perform 8–10 push-ups (make them incline push-ups if needed).

2. Perform 10–12 bodyweight squats.

3. Perform a side plank for three sets of 10 seconds each side (reset every 10 sec).

4. Perform 10 bodyweight lateral step-ups each side.

5. Perform 8 dead bugs each side.

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30 Minute Full Body Bodyweight Workout

Complete 4 to 5 rounds of the following full-body circuit. Rest only as needed between exercises and 30 to 90 seconds between circuits.

1. Perform 10 dumbbell one-arm overhead presses each side.

2. Perform 10 dumbbell split squats each side.

3. Perform 10 one-arm dumbbell rows each side.

4. Perform a suitcase carry with your dumbbells for 15-30 seconds each side.

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2nd Trimester

30 Minute Full Body Bodyweight Workout

Complete 4 to 5 rounds of the following full-body circuit. Rest as needed between exercises and 60 to 90 seconds between circuits.

1. Perform 10 bodyweight split squats each side.

2. Perform a side plank for three sets of 10 seconds each side (reset every 10 sec).

3. Perform 15 bodyweight hip thrusts.

4. Perform 10 incline slow mountain climbers each side.

5. Perform 15 side-lying knee abductions on each side.

30 Minute Full Body Dumbbell Workout

Complete 4 to 5 rounds of the following full-body circuit. Rest as needed between exercises and 60 to 90 seconds between circuits.

1. Perform 8–10 dumbbell Romanian deadlifts.

2. Perform 8–10 dumbbell bent-over rows.

3. Perform 8–10 dumbbell lateral step-ups each side.

4. Perform 8–10 dumbbell biceps curls to overhead presses.

5. Perform a one-armed suitcase carry with your dumbbells for 15 steps each side.

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3rd Trimester

30 Minute Full Body Bodyweight Workout

Complete 4 to 5 rounds of the following full-body circuit. Rest as needed between exercises and 60 to 90 seconds between circuits.

1. Perform 10–12 bodyweight squats.

2. Perform 6–8 incline slow mountain climbers each side.

3. Perform 10 side-lying knee abductions each side.

4. Perform 10–12 bodyweight hip thrusts.

5. Perform a side plank for three sets of 10 seconds each side (reset every 10 sec, elevate hands or elbow if necessary).

30 Minute Full Body Dumbbell Workout

Complete 3 to 5 rounds of the following full-body circuit. Rest as needed between exercises and 60 to 90 seconds between circuits.

1. Perform 6–8 offset goblet squats each side.

2. Perform 12 dumbbell biceps curls.

3. Perform 8–10 seated overhead presses.

4. Perform 10–12 bodyweight hip thrusts.

5. Perform 12 triceps kickbacks.

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Enjoy!

EMAIL ME if you have any questions.

If you want to learn more about 1:1 coaching, click here.

Again, sign up here to get access to the full guide. ⬇️ ⬇️ ⬇️