Pre- and Post-Natal Exercise – the Do's and Don’ts
This fitness blog looks at progressing from Level 2 gym instructor to the specialist Level 3 award in Designing Pre- and Post-Natal Exercise Programmes.
Pregnant women who follow a fitness regime devised by their personal trainer will notice several benefits, including:
- Improved circulation, for both mother and baby
- Reduction in leg cramps, swelling, blood pooling and water retention
- Less muscular and gastro-intestinal discomfort
- Reduction of lower back pain
- Offset of postural imbalances, such as lordosis (curvature of the lower spine) and kyphosis (rounded upper back), which can occur in pregnancy
Exercising in pregnancy can also lead to:
- Reduction of weight gain during pregnancy
- Easier, shorter labour
- Reduced pain during labour
- Quicker postnatal recovery
- Better self image for the mother
Dos and don’ts for exercising during pregnancy
There are a number of dos and don’ts that a personal trainer should be aware of when devising an exercise programme for a pregnant client.
A personal trainer should approach each individual’s programme with an open mind and focus on objectives other than performance. These might include developing an improved sense of well-being, physical capacity and productivity.
The total volume of activity should be sufficient for the client to develop a sense of achievement and well-being. Usually this will be around 20 minutes of moderate activity, working at three or four on the modified RPE (Rate of Perceived Exertion) scale. As a general rule, if it feels good, it’s probably OK and expectant mothers should be able to apply common sense to regulate their exercise and listen to what their body tells them it is capable of doing.
It’s important for the fitness instructor to keep an eye on the details, for example ensuring that:
- The client is hydrated and not overheating
- She has appropriate rest periods
- She is wearing comfortable, loose clothing
- She is eating well and regularly
- Any discomfort is immediately noted and the exercise stopped
- She avoids exercising in hot or humid conditions.
Essentially, the personal trainer should pay as much attention to the pregnancy as they do to the training session. If there are any problems in the pregnancy or the client is especially fatigued, stop the exercise immediately.
After the first trimester, the client should not exercise in the supine position (lying on their back) as this will put pressure on the vena cava, restricting blood flow to the heart, which is dangerous for both mother and baby.
If the client doesn’t already exercise regularly, pregnancy is not the right time to start, but if she is used to following a programme with her fitness instructor, then there’s no reason she can’t continue to exercise under these guidelines.
Guidelines for aerobic sessions during pregnancy
The basic guidelines are three to five sessions a week, working at a 40%-70% VO2 match or HRR (Heart Rate Reserve) under the supervision of a personal trainer. The client’s age will define the heartbeat rate she should work to, as follows:
- Under 20 = 140-155 beats per minute
- 20-29 years old = 135-150 bpm
- 30 – 39 years old = 130-145 bpm
- Over 40 = 125-140 bpm
Cardio-vascular exercise should be low impact: around 20 to 30 minutes per session of cycling, swimming, walking or low-impact aerobics. As women advance into their pregnancy, they will find it difficult to cycle or use a rowing machine. In later stages, the cross trainer is also not advised.
Resistance training during pregnancy
For resistance training, the guidelines are two to three times a week; 15-20 reps on a low weight. One to two sets per exercise and eight to 10 exercises in a circuit format. Pelvic floor exercises are beneficial but sit ups and crunches should be confined to the first trimester.
The personal trainer should ensure that all work is performed on a stable base, avoiding the use of equipment such as Swiss balls. Correct posture is especially important during pregnancy and isometric work should be minimised.
The client should also be advised not to lift weights above her head as it will raise blood pressure, which can have a tendency to increase in pregnancy.
Flexibility training during pregnancy
The recommendations for working on flexibility are two to three times a week, to a position of mild discomfort, holding for eight to 10 seconds.
The personal trainer should devise warm up exercises that use controlled dynamic movements and mobilise the joints. All stretching should be done from a stable base and clients should rise and change between movements slowly to avoid dizziness. During pregnancy, the joints will have increased flexibility as relaxin is released and so PNF and developmental stretching should be avoided as they could lead to unwanted hypermobility.
Exercising during the trimesters of pregnancy
As long as the client feels comfortable and is supervised by a fitness instructor, she can continue with aerobic activity during the first trimester. In the second trimester, she should switch to low-impact activity such as walking and cross-trainers, aqua classes and so forth. The client should also increase her food intake by around 150 calories when exercising because of insulin resistance. In the third trimester, clients can continue with low-impact work such as walking and swimming, reducing exercise time to 15-20 minutes and increasing food intake to around 300 calories.
Resistance training can continue as long as the personal trainer watches the client for fatigue and low blood pressure, which can cause fainting. In the first trimester, the fitness instructor can include training to offset future postural adaptations. In the second and third trimester, the client’s changing shape will dictate what equipment can be used. By the third trimester, clients should avoid overhead work, working in the supine position and holding their breath.
Flexibility training in the first trimester can continue as normal. Dynamic flexibility is encouraged in the second and third trimester, mostly maintenance-based static training for flexibility.
We hope you have found this fitness blog useful and welcome your comments below. Please find more information on Pre and Post Natal Programme Design here.