Your Pregnant PT: Why you Should Exercise During Pregnancy!

I am excited to announce that as of February 2016, I will be joining ranks with the majority of my patients and becoming a mommy! For the past 6 months I have had the “pleasure” of experiencing that pregnancy roller coaster that everyone has been telling me about – the morning sickness, fatigue, crankiness, and general “ugh” feeling has prompted me to evaluate in a new and highly personal light all the advice and treatment I have given to my pregnant clients over the years, in a very good and healthy way! Through this new first-hand lens, I want to share some knowledge and research with you in a brief format, because it is often hard to sort through on the internet, and you won’t likley hear it from your doctor. I hope you find this helpful, and if you have any questions let me know – I guarantee you aren’t the only one wondering!

I want to start with the most general, and most important topic – the argument for continued  exercise throughout pregnancy. I am all the more passionate now about this, albeit with a new sensitivity to how difficult it can be. For about 12 weeks I DID NOT FEEL LIKE IT. My stomach was in knots all the time. The thought of eating was repulsive and yet the only relief came when something was in my mouth. I was exhausted, and frankly just wanted to sit on the couch and nap.

But I didn’t. Thanks to all of you, my accountability crew, I was able to say to myself, “practice what you preach!” and thanks to my running partner Leslie, God bless her, who walked when I needed to walk and encouraged me constantly to get up at 6:30am and just get’er done. I also think constantly about all the research I’ve read and cited time and again, which so clearly shows the great benefits for both mom AND baby when exercise is made a priority – not just in the 1st and 2nd trimester, but all the way through to delivery.

So I have done my best to keep it up. I really couldn’t run due to nausea for about 6 weeks, but by week 16 I was back to jogging 4 miles and lifting weights twice a week. My OB told me I wouldn’t want to jog after week 14, but I actually found it easier at week 22 than I did at week 8, and I am SO glad I pushed through – doing what my body said was good, until gradually it all felt good again. I also have been very aware of my changing ability to tolerate abdominal and core work, convicting me on the need for more education for pregnant women on how to recongize when strength training is appropriate, and when you need to modify.

So why?? Why is am I such a stickler on this?
Well let’s talk about the science and research that we all should know to help us get over that mountain of “I don’t feel like it, and gosh darn it I’m pregnant so I don’t have to!!”
Multiple studies have demonstrated a plethura of benefits for mom, including:

  • Less weightgain

  • Reduced leg cramps

  • Reduced aches and pains

  • Increased energy

  • Decreased depression

  • Decreased risk of gestational diabetes

  • Easier, shorter, less complicated labor

  • Less need for medication and induction of labor

  • Quicker recovery after delivery

If that’s not enough, there are benefits for your BABY, including:
– lower body fat ratio (BMI) at birth and up to 6 months after
– better heart rate response to stress (which helps him tolerate labor better)

Dr. James Clapp III, MD is a physician and OBGYN who has conducted a wealth of research over the past 40 years (since 1976) on exercise and pregnancy. In his book he outlines the result of years of research looking closely at the impact of not only light exercise but vigorous, strenuous exercise on both mother and baby. Some of the highlights of his discoveries are:
– assuming a normal low risk pregnancy women who have been participating in vigorous weight bearing exercise before pregnancy can safely continue to do so throughout pregnancy
– there is NO increased risk of miscarriage, preterm labor, placenta previa, placenta separation, or hypertension (preeclampsia) in exercisers vs. non-exercisers
– exercisers experience a lower rate of gestational diabetes and premature “water-breaking”
– average 7lbs less weight gain for mom, with the most impact seen in the last half of the pregnancy
– Back pain in exercisers is around 10%, versus more than 40% in non-exercisers (controls)
– 35% decrease in need for pain relief, 75% decrease in maternal exhaustion, and 50% decrease in need for artificial rupture of membranes (induction)
–  75% reduction in need for forceps and C-Section collectively
– 55% reduction in need for episiotomy
– >65% of exercising women delivered in <4hrs, with active labor averaging 10-14 hours for controls, and less than 10 hours for exercisers

I have to mention two important points Dr. Clapp makes in his assessment of his own research. First, the women he studied were not just “walking 30 minutes a day”. The current recommendation of theAmerican Congress of Obstetricians and Gynecologists is that women with normal low risk pregnancies should perform moderate intensity exercise at least 30 minutes, 5 days a week. The women Dr. Clapp observed were performing more like 30-90 minutes 4-5 times weekly of moderate to high intensity weight bearing exercise, at 65-90% max capacity. In addition, Clapp and others have found that it is safe for women to START an exercise program during pregnancy, but for those who don’t start until they are already pregnant, you need a little higher criteria to reap the benefits. Clapp draws this line at a minimum of days a week, 40 minutes or more of moderate to high intensity. “Starting regular, moderate-intensity exercise during pregnancy will limit weight gain and fat deposition but only if a woman exercises more than 3 hours a week.”

We should also note here that “moderate intensity” is identified using Rate of Perceived Exertion during your workout – not your heartrate or the speed you’re running or what you did in your last 4 workouts. Moderate intensity means you feel like you are working fairly hard, but you are still able to breathe evenly and carry on a conversation. (For information on when you should stop exercise, click here.)
Second, mommas who stopped exercising late in pregnancy did not experience some of the benefits listed – especially decreased labor times and complications and improved fetal outcomes. They were no worse off, but their numbers matched the control group. Dr. Clapp notes that in his studies, when women stopped exercising in the third trimester, baby fattened up considerably, yielding a larger baby, with higher body fat %.
The last thing I want to mention is that some studies indicate a possible increase in risk for adverse events if a pregnant woman consistently exercises at 90% max capacity or above. If you are an elite athlete performing at high intensity during pregnancy, you may want to find an OBGYN who is experienced with this and will advise you on what to track to ensure you are not putting baby under too much stress.
But for most of us, we are just trying to motivate ourselves to get out there and break a sweat, and justify to ourselves and our skeptics why that is safe and important both for our own wellbeing and for baby. Dr. Clapp and many researchers since have given us ample data to do that, and I hope you will take it to heart. If you have any questions about how or why to exercise during or after your pregnancy, THIS is what I do, and it is my passion. I love empowering women to manage and improve their health through natural exercise and treatment, so if you ever need me, just call!
Have a blessed and healthy week!

Your Pregnant PT,
Sheri DeSchaaf, DPT