Training Considerations During Pregnancy: Part 5 Exercise Selection Considerations
Exercise Programming and Pregnancy
Selecting the correct sports exercises while pregnant is crucial. All programs designed for pregnant women should include low impact aerobic activities to increase cardiovascular and vascular density development. These aerobic exercises will increase stroke volume and haemoglobin concentrations.
It is important to avoid near maximal activities as they may restrict blood flow to the foetus and thus can cause foetal distress. Maximal activities may also magnify the mother’s feelings of fatigue, as her energy supply is unable to match demand.
Trainers should avoid using recumbent bikes, as this may cause the foetus to push on the inferior vena cava. This pressure on the inferior vena cava can restrict venous return of de-oxygenated blood and thus increase oxygen demand by the muscles as the strain to sustain activity. As a result, the mother’s heart rate will increase and thus increase the demand for oxygen from her heart at a time of decreased oxygen supply. This may cause a potentially serious cardiac event.
Trainers should also be especially conscious to avoid any exercise that may cause abdominal trauma, as this will obviously increase the risk of foetal trauma.
As previously discussed high impact activities should be avoided as they dramatically increase the risk of musculoskeletal injury.
Exercise should cease if any of the following signs or symptoms present themselves:
Syncope (light-headedness or fainting)
Disorientation
Vaginal bleeding
Lower abdominal pain or cramping
Headaches
Palpitations
Blurred vision
Trainers need to be aware that during pregnancy there is a decreased availability of oxygen for aerobic exercise. To this end, a segregated training program may be advisable to ensure that the mother does not become over loaded and to allow adequate recovery time for all physiological systems.
Importantly, pregnant women should be advised against exercise in hot or humid conditions, or in similar stressful environments. They should be advised to wear loose fitting clothing to assist with heat dissipation.
Timeframes for progression and exercise selection
0-12 WEEKS
Programs should consist of exercises to develop cardiovascular ability, joint stability, core stability, proprioception and gait ability and flexibility
12-18 WEEKS
Maintain stability exercises concentrating on hip and shoulder stability, maintain cardiovascular ability
18-32 WEEKS
Decrease any resistance training due to increases in relaxin, cardiovascular should be partial to non-weight bearing, greater focus on core stability and maintaining flexibility.
32 WEEKS-Birth
Exercise should be programmed individually based on the ability and desires of the expectant mother:
Aerobic:
Approximately 2-3 sessions per week
Intensity 60-70% MHR and RPE
Duration 15-30 minutes
Resistance:
Approximately 2-3 sessions per week
Intensity no more than 70% 1RM, decreasing load as pregnancy progresses
Rep range above 10
2-3 sets
Core training:
Performed between sets
Low RPE
Slow and controlled movements
General program considerations
Maintain adequate hydration at all times
Maintain healthy pregnancy weight gains (1-2kg 1st trimester, 0.4kg per week for total of 10-12kg)
Ensure additional nutrient requirements are met
Have a prolonged cool down after all aerobic sessions
Do not start resistance training after week 12 if not already started
Have extended warm up and cool down
Avoid Valsalva breathing
Avoid complex compound or plyometric type exercises
Be aware of continued joint laxity throughout pregnancy due to hormonal change
Account for a raise of heart rate of about 7 bpm in the first weeks of pregnancy
Avoid exercise in the supine position after week 16
Do not train in extreme environmental conditions