The Definitive Do's and Dont's of Exercise While Pregnant & Postpartum

Exercise-pregnant-postpartum

Pregnancy is one of life’s greatest turning points.  Until it happens, every moment in your life has been about you and your survival.  Then, with one subtle and profound realization, a seismic shift happens and your focus shifts to someone else.

But what about you, mom?  It’s critically important for everyone that you feel healthy, happy and strong so your little one can feel the same.  So, how should you take care of yourself? Despite being as natural and common as anything in human history, there is likely no point in your life more riddled with confusion, self-doubt and insecurity than experiencing pregnant and postpartum life for the first time.

There’s so much advice riddled with conflicting information. While everyone else seems cool and in control,  you quietly (and not sometimes not so quietly) tie yourself in knots from the inside out.

We asked two physical therapists, (Dr. Carrie Pagliano and Dr. Juan Michelle Martin) about the keys to exercise while pregnant and postpartum.

Brass Tacks: Should You Exercise Pregnant or Postpartum?

So let’s get right to it.  Should you exercise while pregnant or postpartum? “The answer to every question is: it depends…” Dr. Pagliano explains.

“There is so much information nowadays and it’s more confusing than ever.  The honest answer is really that everyone is different but no studies, nothing ever written (outside of a legitimate medical risk recognized by a doctor) has shown that exercising while pregnant has negative effects.”

In fact, the American College of Obstetricians and Gynecologists even recommends it!  “Pregnancy is recognised as a unique time for behaviour modification and is no longer considered a condition for confinement,” they say. “It is currently recognised that habits adopted during pregnancy could affect a woman's health for the rest of her life.”

“Once upon a time women were told to rest,” says Dr. Martin.  “But the truth is movement is great for the pregnant woman and the baby.


“Whatever Beyonce did,” Dr. Martin explains, “probably won’t work for you because you aren’t the same person and you didn’t have the same pregnancy.


“It still holds the same benefits as it does for those who are not pregnant including: maintaining good cardiovascular health and endurance, increasing strength (which you will need to lift that car seat) and stabilizing weight or weight gain, because there will be some weight gain during pregnancy.”

What about postpartum?

According to Dr. Martin, “Everyone is so consumed with getting my pre-baby body back so what should I do?”  But once again, it depends.

“What did you do during pregnancy?”

“What method did you give birth by?  If you had a C-section you’ll have different healing times than a natural birth.  You gotta give yourself time to heal.” Both doctors advised that if you’re an active person there is no reason you need to stop being active.  They just advise caution, not over-doing it, and paying attention to you.

“Whatever Beyonce did,” Dr. Martin explains, “probably won’t work for you because you aren’t the same person and you didn’t have the same pregnancy.  So talk to your doctor and a women’s health specialist about your specific situation.” But she stressed that there is nothing wrong or dangerous with exercise itself.

Both Dr. Pagliano and Dr. Martin emphasized being open with your doctor about your life during and after pregnancy.  If you’ve been an active person your whole life. then there’s no reason you should have to give that up after you have a child.  And your doctor should know that and recognize it.

If they advise you against something like exercising (assuming there are no pre-existing or identified conditions outside of pregnancy), it might be a sign to find a doctor more align with your lifestyle.

Sadly, this happens all the time with patient/doctor interactions of all kinds.  Doctors should know and take into account your expectations post-recovery. If you’re an active healthy person there’s no reason to expect to sacrifice that long-term just because of your pregnancy.  

Expecting the lowest level of recovery is a negative indication of a doctor’s fluency in modern research.


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Pre-Pregnancy Warning Signs: 

“Even before you’re pregnant,” advises Dr. Martin, “there are a few warning signs that might get exacerbated during pregnancy.”

Incontinence or Constipation

Both Dr. Pagliano and Dr. Martin stressed repeatedly how critical it was to understand this warning sign.  Though it can be a personal and embarrassing topic, the inability to control your bladder is something to be taken very seriously.  If you find yourself accidentally urinating while running or jumping rope it’s NEVER okay to dismiss as a quirky trait.  It’s a warning sign of pelvic dysfunction to be taken care of.
 

Injuries

If you’ve had any kind of injury to the pelvic region (hips, sciatic pain or back pain) there’s no reason to be worried; but it is reason to be aware and smart that these pains might get worse during pregnancy.  No need to push through these things; instead you need to adjust what you’re doing.
 

Pain in the pelvic region

Again, though it might seem obvious to the outsider, it’s critically important that you tell your doctor everything.  Do you have pain in any part of your pelvic region? Burning while urinating? Pain during sex? If it’s not a big deal, your doctor will tell you.  But what they don’t know they can’t help with. Oversharing is caring in this regard.
 

General Pelvic Dysfunction Screen

Dr. Martin strongly recommends having your doctor run you through a General Pelvic Dysfunction Screen.  Even if you “fail” some element of the screen, it’s not a full stop. It’s just a good thing to be aware of and address before you enter the stress of pregnancy.

 

Exercising While Pregnant

Once you’re pregnant, the game has clearly changed.  If you’re experiencing morning sickness, it’s fine to take the day off (you’ll likely want to anyway). When you’re feeling good, it’s a great idea to use exercise as a chance to cultivate a sense of awareness of your body.  Watch out for these signs:

Leakage

Once again, any type of incontinence is not okay or a normal part of pregnancy.  It might be common, but it’s not normal. Just because someone you know had it is not a reason to dismiss it.

How to Fix it:

“What we’re finding is that kegels don’t work all the time because lack of strength is not the problem.  The issue isn’t underactive pelvic floor, it’s overactive. So during jumps or running, there’s no give. The problem can often be breath control and relaxation.”  For this, Dr. Pagliano recommends check out a women’s health specialist for your specific needs.
 

Gas Control

A loss of gas control can also be one of the warning signs.  With any kind of inversion (common in many yoga poses) this can happen.

How to Fix it:

Largely it comes down to pressure control.  You’re going to experience internal pressure from that extra person you’ve got.  Start with alignment. Avoid hyperextension (tilting the front of your pelvis down) and breathholding which can add to the internal pressure in your body.

Laying On Your Back

This is important to keep in mind while exercising.  “Laying on your back causes and increase stress on your heart and vascular system,” warns Dr. Martin.  Considering this system is already under stress from a child, you’ll need to be extra careful about how much you tax it.

How to Fix it:

Just be aware of how you’re feeling.  As mentioned before, exercising can be great for your overall health, especially when pregnant.  But you’ll have to learn to focus more on how you’re feeling and then how much you’re striving.

Warning Signs While Postpartum

Let’s fast forward a little.  You’ve given birth (hooray!) your doctor has cleared you (hooray!) and you’re ready to start exercising again (triple hooray!); what about postpartum?  What should you be focusing on and being aware of now?

You guessed it: Leakage.

Even though all the reasons from before still apply, it’s worth mentioning again.  For clarity: it’s never okay to uncontrollably urinate and can be a sign that you have trauma to your pelvic floor.  Considering you just gave birth, that’s not hard to imagine. If you find yourself struggling with this, even though it can be embarrassing, it’s vitally important to discuss this with a doctor.  

How to fix it:

Once again we recommend finding a women’s health specialist in your area to help you.

Abs “peaking” at the center or belly button pushing out excessively.

Diastasis Recti is often warned about but in reality is extremely rare.  “Your belly button pushing out like a turkey timer can be a sign you’ve developed a hernia,” warned Dr. Pagliano.  

“Neither of these issues are devastating or life changing per se, but they are important warning signs every postpartum woman needs to be aware of.”

How to fix it:

The most important step towards fixing this issue is learning breath control.  Focusing and “belly breathing” by using your diaphragm and pelvic floor are critical not only for good health but also for improving any exercise.

The Comeback: Exercise After Birth.

So you’ve gotten the OK from your doctor!  Great! Let’s be very honest here: it’s not like things will be the same as they were before you were pregnant.  

“Being cautious is important.  But trial and error is okay too,” said Dr. Pagliano.  “Learn to trust your instincts.”

“When you’re going back postpartum,” she explained, “You’re not gonna pick up where you left off.  Start easy. But as far as should or shouldn’t I? Start with something you feel is safe, and build from there.”

“If you weren’t doing anything before: don’t overdo it,” warns Dr. Martin.  “Remember, the type of birth you had determines how soon you can get back.”

“Everyone is just so different that there are no hard and fast rules.  As long as they’re feeling good that’s fine.”

“Sadly,” she explained, “the one thing I commonly see is moms who feel the pressure to start right where they left off.”  

Taking your time seems like obvious advice from the outsider but, when you’re dealing with women who have been active their entire lives, slowing down and taking it easy can be a tough pill to swallow.  

Wrapping It Up

OK - so bottom line: exercising while pregnant is not only NOT DANGEROUS but it’s encouraged. You’re gonna need all the strength you can muster and studies have shown that the shape you go into giving birth seriously affects healing time.  But it’s absolutely critical that you take advice tailored to you, from your doctor, and not from the myriad information you’ve heard about or from others.  

Exercise during your pregnancy is a wonderful time to learn more about yourself and stay in tune with yourself.  You’re gonna have plenty of time to focus on someone else soon, so don’t forget take care of yourself.

Andrew Killion5 Comments