Wednesday, 15 November 2017

Pregnancy and exercise

Pregnancy and exercise

Having had two kids and been extremely active through both pregnancies, I believe very firmly in remaining active during pregnancy. However, what I learnt through these pregnancies, and in the years that followed, is that appropriate training is critical.

During both of my pregnancies, I smashed out the group fitness classes, right up until a few days before each birth. This didn’t do any damage, however on reflection, I WISH I had known more about proper strength training, pelvic floor training and pilates.

I had two very healthy pregnancies, gaining around 9-10kg during both. I’m always keen to push the boundaries and pregnancy was no exception. During my second pregnancy I developed pubis symphysis, which was an extremely painful condition in the pubic bone. This continues to cause me problems 7 years on. Had I engaged in more controlled strength training and a proper pilates program, I have no doubt I could have reduced the severity of this condition. Instead, I karate kicked my way through combat classes until the end of my third trimester, ignoring the pain and the warning signs.

So, here are my learnings, not just from reflecting on my own mistakes, but also through my experience as a pre- and post-natal trainer along with some of my own cool research and chats with some of my favourite referral partners.

It’s ok to continue training. In fact, it is strongly recommended!
Aside from the obvious morning sickness that may keep you bedridden, and the fatigue that hits hard during the first trimester, please continue to exercise. Just going for walks won’t cut it.

What I failed to recognise was the postural challenges I would experience when my little critters came out. Nobody told me I would need to be able to nurse them for 30-45 minutes at a time – PER BOOB – and that this required strong back, neck and arm muscles. I didn’t know I would be doing heavily modified deadlifts throughout my entire pregnancy.

I also didn’t realise that when your baby is upset, there may be nights where you need to rock them for hours. Literally – HOURS. Had I known this fun fact I can guarantee I would have been busting my hump doing squats to get me ready for the leg strength required here.
My superstar client, Jen, who has continued to
work with me, even on her crappiest of days,
because she knows it's worth it in the long run!
This is our modified squat to allow for her
beautiful belly and to keep her extra safe

And don’t even get me started on the sheer strength in your arms required to carry bub, all the while doing housework, preparing dinner, or running errands when you absolutely cannot put them down.
I pretty much carried Sam non-stop for the
first 18 months of his life. I used an ergo-baby
most of the time, as did the carers in the creche
he went to so I could teach classes. YOU
Arm strength would have been useful. 

Do all of these activities on less than three hours of broken sleep when your central nervous system is in overdrive and I can guarantee you that a solid strength foundation is certainly an advantage.

Kirsty Bright, my absolute favourite Physio when it comes to anything relating to Women’s Health says:

“The official position on exercise during pregnancy was stated in the ACOG (American College of Obstetricians and Gynaecologists) in 2002, stating that 30 minutes or more of moderate intensity exercise on most, if not all, days is recommended for all pregnant women in the absence of medical or obstetric complications.

“Following medical review, exercise may still be recommended in women in the presence of medical or obstetric complications. It further states that exercise can be safe and beneficial in previously sedentary individuals.

“As a physiotherapist that works in women’s health, I believe it is also essential that women start undertaking pelvic floor strength exercises through pregnancy both to avoid potential episodes of incontinence through pregnancy, and to be ready for post natal recovery and return to activity.

“Starting pelvic floor exercises early gives you a better chance for successful return to activity, exercise and good pelvic health  after bub. Happy pregnancy and happy exercising!”

These are the practical reasons. However, what about recovery post birth?

I have trained women shortly after birth who maintained exercise throughout their pregnancy, and those who haven’t. I can state with absolute certainty that the recovery, both physically and emotionally, is without doubt quicker and more enjoyable if an active pregnancy was maintained.

Finally, the other really important reason to remain active is weight gain. Why put on an extraordinary amount of weight if it isn’t necessary? I struggled with post-natal depression after both children were born. Had I also needed to lose a bunch of unnecessary pregnancy weight, I firmly believe this depression would have been a far darker experience.

David Oxenham, Director of Tribe Chiropractic states:

“As a Chiropractor, postural strength/endurance is paramount throughout pregnancy. I find that my patients who fall pregnant, and who are already training in the gym and continue to train throughout their pregnancy, find their birthing process easier.

“Being under the guidance of a qualified trainer is an essential ingredient as modification of the program is adapted to the changes seen in the gestational Mum. Strong Mum, strong Bub!”

So, what are the actual dos and don’ts of exercising during pregnancy?

Lifting weights? Yes. Unless you have been advised by your medical professional to not lift any weights, please continue to maintain a healthy weights training program.

This needs to be carefully monitored by an adequately qualified Personal Trainer or Strength Coach. Someone who understands the changes that need to be made at each point during your pregnancy and can explain why. Squats, deadlifts and bench are the foundation of all strength training and can be continued, albeit heavily modified throughout.

Towards the end, your squat may resemble a one-inch maneuver onto a very high box, simply engaging gluts and pelvic floor. But this is better than nothing! Your deads may be just the bar lifting a couple of inches off some very high racks – but again, you are engaging the back muscles, gluts and hamstrings – all of which need to be strong for labour and recovery post-birth.
Keeping the butt cheeks firm and strong :)

If your health professional disagrees, always ask why and make educated decisions. Challenge them if you feel intuitively that their advice seems restrictive. Some days, lifting weights may be the last thing you feel like doing, but those happy endorphins will keep the energy levels up and the sleep deep (or as deep as it can be with a baby kicking you in the ribs while you sleep!).

Cardio? Yes, go for it. Back when I was preggers, it was advised that keeping the heart rate around the 70%-75% of your max is a great place to sit. This is something I completely disregarded during my pregnancy as I was teaching high intensity group fitness classes and my obstetrician was ok with it.

However, the guidelines have since changed, and it is ok to lift your intensity and get that heart rate up. Just be aware of how you are feeling and be mindful of not overheating. Otherwise, there is no need to change the activity or intensity you were doing prior to falling pregnant.

Unless you were running prior to pregnancy. I wouldn’t start a running program during pregnancy. Walking and cycling are great options here as they work comfortably around that growing belly.

Pilates/Yoga? Yes. Please do this. This is one of my greatest regrets. Whilst I have been able to repair the damage post-child birth and post-hysterectomy, those few early weeks after bub came out could have been a lot more pleasant! Do engage in these classes with someone who has experience with pregnancy though!

Will exercise make birth easier? Some say yes, some say no. My birth was pretty rough with my first child, so I felt pretty ripped off as I was convinced it was going to be a breeze due to my fitness level.

It wasn’t.

Twenty-six hours later and my body wasn’t doing what it was meant to do.
What I do believe though, is that my recovery was short and pleasant, and my pre-baby body bounced back quite quickly. I was back teaching classes 11 days after the birth of my first child.

With my second labour, I was fit and strong, and wanting to avoid the lengthy labour experience from the first time around. I spent a lot of my labour being active; running up and down stairs outside the hospital in between contractions. The labour was quick and the recovery was even quicker.

Again, give yourself the best possible chance of a happy, easy and quick recovery so you can enjoy that beautiful baby.

I spoke to Trish Cummings about the benefits of exercise during pregnancy from her experience. Trish helps women through their pregnancy and labour with hypnobirthing techniques, so she is exposed to a LOT of pregnant women during the pregnancy, during the birth and for a period of time after. Trish says:

"During pregnancy there are soooo many things to consider. One of the most important factors is taking care of yourself. Most of us know the importance of eating well and keeping active, however what about your mindset and how you're feeling?

“Babies are capable of feeling too, so ensure you take time out for yourself to relax and breathe. When you relax and breathe, so does your baby. Calm mum equals calm baby! So, practice, practice, practice and when it comes time for labour and birth, you'll be ready both physically and emotionally."


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