• Coach Lauren

Fitness During Pregnancy

Updated: Jun 16


With the recent announcement that John & Ashley are expecting (TWINS!!), my personal passion for educating & supporting moms as they exercise through pregnancy & postpartum, and the large number of moms in our gym, I thought this would be a good time to talk about fitness, CrossFit® and pregnancy!

{Image: Roseann Dennery}

Is high-intensity exercise like CrossFit® during pregnancy safe? It depends. Using this checklist as her guide, this type of fitness could be safe for a woman to perform during pregnancy. Each step of the list flows into the next, and all must be in place!

Top 5 Essentials For CrossFit® (or any exercise) During Pregnancy:

1. Have a good team: your healthcare provider, a woman’s health physical therapist (pelvic floor physical therapist) and fitness coach. I hope you have access to a great healthcare provider that treats you as an individual, not as a textbook. Good obstetric care is critical for a healthy & strong pregnancy. Your provider will (should!) follow the American Congress of Obstetricians & Gynecologists (ACOG) guidelines, or you can research them on your own, plus they are outlined later in this post.

Most women have the healthcare provider piece of their pregnancy team in place early on. It’s the women’s health PT ( pelvic floor PT) that many aren’t even aware of as an option to have on their team. Maybe someday maternal care in the USA will routinely include a connection to a women’s health physical therapist by the third trimester, if not sooner! Right now this is a little known gem, but can make a huge difference in a woman’s recovery from childbirth. Search by state to find a practitioner through Herman & Wallace or by zip code. Local Phoenix recommendations include Tara Sullivan, PT, DPT, PRPC or Sarah Backus through Honor Health, or Kim Bryant, PT, DPT. This PT will be especially important when you want to return to exercise postpartum, and in training your core & pelvic floor awareness.

What can be even harder to find is a fitness professional who is actually trained in pregnancy and postpartum exercise, not just speaking from personal experience or making generic modifications. (I don’t entirely blame them for not being trained, because there aren’t many good training programs for pregnancy/postpartum exercise out there!) At the very least your fitness coach should educate you about the relationship of your pelvic floor & core (and the symptoms of dysfunction), teach you a breathing strategy to coordinate your core & pelvic floor, and recommend you to see a women’s health PT.

Having this team monitor your pregnancy and your body’s response to exercise (CrossFit) and pregnancy will help make sure the whole process is done safely.

2. A balanced mindset: Often there have been two main schools of thought that are loudly promoted when it comes to pregnancy exercise-- The first: only perform gentle exercises (so CrossFit is out!) or the second: prove that you can perform heavy lifting and high intensity exercise throughout your entire pregnancy (So CrossFit® & marathon running are IN!) Pregnancy exercise should be balanced in the middle of that. If you only perform gentle exercises, you neglect cardio & strength. But pushing too much, too intense & too heavy increases the risk of core and pelvic floor dysfunction which can cause permanent damage to your body. Always consider the risk. vs. reward. You do not have something to prove & you have to think about the big picture.

What you need to know:

  • Set your ego aside! “Pushing through doesn’t make you tough, it makes you careless.” -- Brianna Battles

  • Pregnancy and postpartum limitations are temporary; damage to your body can be forever!

  • “True strength is in training smart and training with patience!” -- Get Mom Strong

  • You will feel like yourself again!

  • Your body will likely change. It is beautiful, you are beautiful.

3. Listen to your body: This recommendation is great if you know what you’re listening for, and once you hear it if you do something about it. Beside’s the ACOG’s warning signs (detailed later in the blog), here is what else you are “listening” for-

Monitor for signs & symptoms of dysfunction:

  • Leaking urine unintentionally when you jump, sneeze or run (etc)

  • Vaginal bleeding or increased discharge

  • Feeling like you’re sitting on a ball

  • A pulling or heavy feeling in the pelvis

  • A bulge or cone (football shaped) protrusion down the middle of the belly

If you experience any of these symptoms, seek guidance from your healthcare team- which

hopefully includes a women’s health PT! And don't push through symptoms - put in the work to fix the cause.

Pay attention to your breathing and heart-rate: Let your intensity be guided by your ability to breathe and talk. During pregnancy your heart rate is already slightly higher (even at rest) due to the increase of blood volume. You may become short of breath more easily because of increased pressure of the uterus on the diaphragm & increased need for oxygen in other areas of the body. That’s ok! This is a natural way for your body to regulate the intensity of your exercise. If you find yourself pushing to the point where you can’t maintain a conversation, take a rest until your heart rate has settled back down, or modify the exercise to decrease the intensity.

And also consider your general fatigue, discomfort, nausea, etc. It’s ok if this pregnancy season means fewer days at the gym. Your body is doing an incredible WOD just to grow this baby!! Don’t discredit that, you wonder woman!

4. Connect your core: The muscles of your core are like a canister; the diaphragm (helps you breath!) is at the top and pelvic floor (supports all your organs, controls bowel/bladder movements, performs sexually, etc) across the bottom. The front of your core includes the rectus abdominous (the famous-- or elusive-- “6-pack abs”) and underneath that the transverse abdominous (“inner corset”) which reaches around to your spine. There are also other muscles (such as spinal erectors & multifidous) that attach to the spine and pelvis. You have to think of these muscles as a team, not focus on one individually.

To do this, consider your--

Alignment:

- Stack your ribs over your hips

- Untuck your bum

- Aim for this posture in all movements and activities of daily living

Breathing:



- Inhale through the nose (umbrella breath- into the belly & lower ribcage, not chest)

- Engage (lift pelvic floor, pull hip bones together) then exhale upon exertion (the hard part of the movement)

>>> Think “Blow before you go” (Julie Wiebe's Piston Science)

- This breathing pattern supports your core & pelvic floor muscles that are experiencing change in inter-abdominal pressure, general weakness due to stretching & increased load to accommodate the growing fetus.

- No breath holding! Especially in heavy lifting we use breath holding to stabilize for heavy lifting (and often start a habit of using it for all lifting, including picking small household items off the ground!) This strategy has it’s place but usually not during pregnancy & postpartum.

Core Awareness: Diastasis recti abdominous (DRA) is a natural & essential occurrence in most pregnancies, where the abdominal muscles separate to accommodate the growing belly. It only becomes a problem when they muscles stay separated or the fascia doesn’t regain density after the baby is born. Using good form (alignment) and breathing through all activities of daily living and exercise can reduce the severity of DRA during pregnancy and help it heal postpartum. In general it is recommended to avoid traditional ab work (sit-ups, toes-to-bar, knees-to-elbows, hollow rocks, & often kipping movements, etc) during pregnancy and until you have progressed postpartum. “A functionally strong and connected core is essential for overall health!” (source)

Modify to accommodate the belly: As your belly grows, performing barbell lifts will become more challenging because the belly will get in the way! It is not recommended to just move the barbell around the belly, because that usually sacrifices your alignment and definitely sacrifices your technique. Rather than train improper movement patterns, it is recommended to switch to dumbbells or kettlebells. This also lightens the load which is another way to help maintain the proper alignment and breathing strategy.

{Image author's own}

High impact exercises: Exercises such as running, double-unders & box jumps take extra

consideration because they increase the risk to the core & pelvic floor.

5. Exercise in a way you love! Aside from the contraindicated exercises listed by the ACOG, move and exercise in a way that you enjoy, that prepares you for the demands of motherhood, is convenient, and that feels good to you. If that exercise is CrossFit® and you can perform it with the above considerations, then go for it! The goal of exercising during pregnancy becomes functional strength. It wouldn’t make sense for a momma (with a normal, healthy pregnancy) to stop exercising altogether, because she needs to be strong for the demands of motherhood alone! Carrying, laboring & delivering the baby and caring for any other kid(s) in the meantime means lots of lifting, pushing, pulling, & moving. We need to prepare her body for those tasks. Pregnancy exercise should include a mix of relaxation (mindfulness or meditation), strength & cardio.

The vast majority of information a woman receives about exercise and pregnancy is vague blanket statements and generic suggestions. I want my coaching and Chuckwalla CrossFit to be a voice of informative education about pregnancy (& postpartum) exercise and to give each mom an individualized strategy for her CrossFit® (exercise) routine.

“When women are educated about their pelvic floor and core,

they are empowered to make the right decisions

for their body and to monitor how their body is coping!”

-- Heresphere

The way a woman’s body was created to adapt to growing, carrying, laboring, delivering, and nourishing another life is incredible. Her body is powerful and undergoes profound anatomic and physiological changes to accomplish this. Pregnancy does not make her fragile. Outside of a high-risk pregnancy, extreme pregnancy discomfort (such as hyperemis gravidarum) or a pregnancy with multiples, most women are empowered and surprised by how many things they can still do during pregnancy. And they are also surprised by how breathless and tired they feel after doing simple tasks that they didn’t used to think twice about. Pregnancy is a strange blend of feeling strong and weak all at the same time. If a woman’s body changes to accommodate pregnancy, then she should respect that and change her exercise as well.

The relationship of a healthy, normal pregnancy and exercise has been found to have a high benefit to risk ratio. ACOG does counsel you to consult first with your medical provider, but outside of a few complications, exercise is very safe during pregnancy, especially when you remain under good obstetric care, and in fact provides enough benefit that it is strongly encouraged! These benefits include:

  • fewer pregnancy discomforts

  • decreased risk of gestational diabetes, preeclampsia, and cesarean delivery

  • healthier weight gain during pregnancy

  • prepare for the physical demand of labor & delivery

  • improved overall fitness as well as a stronger heart & blood vessels

Clinical experience also shows that women who exercise during pregnancy seem to have a quicker recovery postpartum. Besides the physical benefits, there are many psychological benefits as well, because for many women exercise places them in a social community, improves their mood, sleep & body image, and helps decrease any anxiety. Research also shows that babies of women who exercise have fewer obstetrical complications during labor, increased blood volume, more oxygen present, less likelihood of cord entanglement, “normal” heart rate reactions and less meconium present.

We have established that (in most cases) a pregnant woman CAN (should!) exercise. What exercises should she do? Is high-intensity exercise like CrossFit® safe? The ACOG only lists a few basic precautions for exercise: stay hydrated, wear a supportive sports bra, avoid overheating, and minimize standing still or lying on your back. And they only give a very generic list of exercises to avoid, such as exercises with a high risk of falling or impact (i.e. contact sports, skiing). The only other guidance they offer is a list of warning signs that would indicate you need to stop exercising immediately:

  • Bleeding from the vagina

  • 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 leaking from the vagina

In fact if you experience any of these symptoms, call your healthcare team or 911 immediately.

The ACOG guidelines for exercising during pregnancy are probably similar to what you might hear from your healthcare provider and they are a great starting point. From there many blanket statements are often thrown around such as, “Continue the exercise you were doing before pregnancy.” “Listen to your body.” “Don’t do crunches.” “Only walk and do gentle stretches.” There is often confusion about what exercises can be done during pregnancy and these statements do not consider the individual and her body’s response to pregnancy and exercise and they don’t offer any education for the woman to determine for herself HOW to exercise during pregnancy.

After CrossFitting through my own pregnancy and delivering our baby boy in May of 2016, I have been studying to learn the answer to, “HOW should a woman exercise during pregnancy (and postpartum)?” There are a small number of professionals, such as fitness coaches and women’s health physical therapists, who are working to bridge the gap (often literally! Diastasis joke...) when it comes to exercise and pregnancy. Through this study I have found a strategy for exercising during pregnancy & postpartum that helps prevent, minimize, or heal pelvic floor & core dysfunction. This strategy will allow a woman to be educated about her core & pelvic floor and to determine if CrossFit® (or any other exercise) is safe for you.

So, the long answer, is still that usually high-intesnity exercise like CrossFit® is safe during pregnancy. But it depends. The way you exercise will look a little different during each phase of your pregnancy, depending on how your body is responding to pregnancy. Use the 5 essentials above to determine what, how and when to modify. Don’t compare your journey or abilities to the pregnant mom next to you in the gym. She has a different body, different pregnancy, different stressors, and different genetics.

This strategy is a starting point to educate a woman about her body and the effects of exercise and allow her to make the best decision for her pregnancy. We can do our best to exercise safely & control what we can, but there are a lot of other factors that play a role into our body’s response to pregnancy & exercise. Plus only so much research has been (can be) done on pregnancy in general, so the information is always improving. A lot of time can be spent learning about the relationship of the core & pelvic floor, pregnancy, postpartum & exercise. This blog was already more like a research paper and way longer than I intended (nerd alert!) And of course there are extended discussions about running during pregnancy, breaking the strategy down by trimester, why breath holding is not a good strategy (for pregnancy & postpartum), and returning to exercise after the baby is born!

Author's Note:

My goal is to keep an open mind and always be learning and sharing what I know! I am happy to discuss any this with you! And maybe someday I’ll get around to more blogs about these topics...I can only do so much during naptime!! Feel free to reach out to me through Chuckwalla Fitness or email me!

To stay up to date on the best information regarding pregnancy & exercise, follow some of my favorite sources:

Be inspired by some of my favorite CrossFit® athletes and their pregnancy & postpartum CrossFit journey:

{Meghan Leatherman, source}

**This blog post is not a substitute for medical treatment. Refer first to the guidelines of your health care team and the ACOG recommendations.

#crossfit #pregnancy #pelvicfloor #diastasisawareness #mom #baby #phoenix #postpartum

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