What I wish I had known about pre and post partum fitness!
When I fell pregnant with Olivier I had zero idea about exercise for preganancy. I was very fit going into pregnancy and was doing crossfit 5 days week but I didn’t really know what was ok and what wasn’t. I saw lots of “fit mums” on social media still deadlifting and doing crazy workouts and I thought yep that’s me because I’m so fit before pregnancy :)
Well I was wrong….
I never imagined I would end up doing no deadlifting, I never imagined I would struggle with a simple push up and I NEVER imagined my nausea would stop me right in my tracks. The biggest shock for me though was how heavy I got and how hard it was to just walk around doing daily tasks!
Pregnancy tends to make ligaments more flexible in preparation for birth and the shear weight of the placenta and baby on the pelvic floor muscles means you might feel ok at the time but post partum can be a whole different story!
I had the pleasure of interviewing Jess, creator of moofitmoofit. Jess is in her third trimester of pregnancy at the time of this article and I can tell you she looks amazing and fit!
So here are some top 4 facts, tips and truths about pregnancy and post partum fitness that Jess helped clarify:
Get clearance post partum to do any physical activity:
“The weight from baby alone during pregnancy adds pressure to pelvic floor along with the hormonal changes that soften the muscles and ligaments causing them to stretch. Labour and delivery both complicated or uncomplicated and regardless of whether your birth was vaginal (assisted or non-assisted) or via C-section (major abdominal surgery) all add additional risk factors and independent healing factors to consider for postpartum recovery.
Either way it’s important to understand your body takes time to heal after pregnancy and birth for any woman regardless of their pregnancy, type of birth, age or fitness status. Just because you may be symptom free doesn’t mean everything is ok with your postural alignment, pelvic floor and core.
It’s very common to see your midwife or obstetrician 6 weeks after your birth and for you to be cleared to exercise or resume having sex again but unfortunately you have not been properly assessed to see if it is in fact SAFE for you to do so! A women’s health physiotherapist will take a thorough and detailed medical history covering things related to your gynaecological history, obstetric history, surgical history, bladder and bowel function, fluid and fibre intake, lifestyle factors as well as sexual function. Then with your consent may be required to do an internal assessment or use ultrasound to determine the function of your pelvic floor and core. They can also assess if you have any abdominal separation and ensure you have the correct breathing patterns connecting to the pelvic floor as well as assess your movement and postural alignment.”
See a physiotherapist during pregnancy :
“It can be as equally important to see a women’s health physiotherapist during pregnancy. Again, having that proper feedback on whether you have good postural alignment, breathing patterns and pelvic floor activation can help with common symptoms during pregnancy. Sch as lower back pain, incontinence (any leaking of urine or faeces), misalignment, pressure or heaviness in the pelvic floor, pain during sex, haemorrhoids or difficulty emptying the bladder and bowels. In fact, even if your not pregnant or postpartum it may be beneficial to see a women’s health physiotherapist particularly if you are lifting weights, running or training hard just to see how your pelvic floor and core are functioning. You don’t need to have symptoms to make an appointment and the feedback you may receive can be beneficial long term”
Be realistic about recovery from pregnancy
“I feel like the term “bounce back” carries negative connotations and assumes that there is something wrong with the body you have now. Your body is not and will not be the same. Your body changed because you carried and birthed a tiny little human. This doesn’t mean you can’t aim to lose weight, gain muscle or look a certain way after birth. But it’s important to work on your functionality first and build a strong foundation from the inside out. There should be no rush to return exercise and its important to focus on Spending time with your baby, your family and giving your body time to heal.
If you tore a knee ligament you would be told you had at least a 9 to 12-month recovery ahead of you and that you would need to work with allied health professionals to achieve a good recovery. Why is the expectation of birth recovery any different to this? Knowing what to do in those early weeks and seeing a women’s health physiotherapist can certainly help you achieve an optimal recovery. Key things to consider whether you are early postpartum or if it’s been several years since you birthed are postural alignment, the pelvic floor and connection breath and doing exercises that promote healing and recovery not potentially hinder it. If you are unsure of what to do, where to start or when to start its best to see a women’s health physiotherapist or a certified pre and post-natal coach to help you design a program that is suitable and individualised for your recovery.”
Be aware of signs and symptoms of issues during exercise
“Some research has shown that a woman is safe to lie on her back as long as, she doesn’t experience any signs or symptoms from doing so. This is a great example of where guidelines are great but it’s important to know what symptoms to look out for when exercising. Considering that the time frames are broad between guidelines and each woman is an individual, using common sense and looking for signs and symptoms that a certain position or exercise may be impacting her health is more important than a hard and fast rule.
Signs and symptoms from laying on your back during late pregnancy include feeling uncomfortable, pain, numbness, tingly sensations, dizziness, feeling lightheaded or out of breath. If you experience any of these symptoms you can first try to modify the exercise and/or exercise position or simply stop”
And the myths around pregnancy, fitness and lactation? Here are some common myths clarified!:
Your heart rate can’t go over 140bpm whilst exercising during pregnancy
Truth: A good way to measure and monitor intensity is to use the Borg scale Rate of perceived exertion scale (RPE). The scale allows individuals to subjectively rate their level of exertion during exercise or exercise testing. An appropriate scale during pregnancy would be working at around a score of 12-14 which means the exercise is somewhat hard, but you are still able to maintain talking throughout. To view the whole chart and gain further understanding of how exertion is measured please see the following link ( https://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm). In simpler terms simply a “talk test” where you can maintain conversation without becoming out of breath is an ideal exercise intensity level.
You can’t lift anything heavy whilst pregnant
Truth: If you can safely lift weight and you feel strong, capable, comfortable and don’t experience any symptoms associated with lifting then there should be no reason to avoid lifting the weight. Some symptoms to watch out for may include low back pain, downward pressure on the pelvic floor, pain in the abdominal or pelvic region, urinary incontinence or the feeling of bulging or something falling out of the vagina. If you experience any of these please stop and seek assessment from a women’s health physiotherapist.
Exercising whilst breastfeeding will dry up your milk
Truth: The current evidence shows that moderate to vigorous intensity physical activity and sports will NOT negatively affect your breast milk volume, composition or affect infant growth AS LONG as you have: Adequate nutritional intake (Not eating in large calorie deficit) and Adequate fluid intake.
In fact studies have shown that lactation promotes weight loss to an extent but that once lactation is established, women can restrict energy intake by 2092 kJ/day and exercise four times a week to lose up to 5kg/week without affecting infant growth
So what are some good take home messages for pregnancy fitness and guidelines?
The current Australian guidelines as per Sports Medicine Australia are as follows
For Women who were not active prior to pregnancy – 150 minutes per week or 30 minutes per day commencing at low intensity and working towards a moderate intensity on most days of the week. This might include activates like walking, cycling, swimming or strength training.
For women who were previously active prior to pregnancy and are experiencing an uncomplicated pregnancy physical activity 150- 300 minutes per week and 30-60 minutes per of moderate to vigorous activity day most days of the week. Exercise is encouraged to be continued until it becomes uncomfortable to do so or unless advised by your healthcare practitioner.
The current guidelines for strength training during pregnancy recommended by sports medicine Australia are:
Frequency: minimum 2 sessions per week.
Intensity: Sub-maximal intensity using own body weight, light weights and/or resistance bands (exhale on effort).
Type: Work all large muscle groups
Programming: 1 set of 12-15 repetitions of up to 8-10 exercises.
So what is a good final tip for women around health, fitness and going into pregnancy? Jess leaves us with so me great insight:
“Prepare for your postpartum recovery whilst trying to conceive and during pregnancy! This will significantly help your recovery post-partum. You can do this by ensuring you have proper postural alignment and core and pelvic floor connection. If you are unsure of how to achieve this, please see a women’s health physiotherapist. Try and maintain a healthy weight range and eat foods to nourish your body and work with your physiotherapist or a certified pre and post-natal coach to develop a pregnancy safe workout plan that is individualised and customised throughout your pregnancy and beyond”
This is such a huge topic! You can read the full interview here: Full Interview Moofit Moofit
For additional info and links:
To learn more about Jess and Moofit: Moofit Moofit
Exercise and breastfeeding (2012) Association, A. B. Retrieved June 25, 2018, from https://www.breastfeeding.asn.au/bfinfo/exercise-and-breastfeeding
Lovelady, C. (2011). Balancing exercise and food intake with lactation to promote post-partum weight loss. Proceedings of the Nutrition Society, 70(2), 181–184. https://doi.org/10.1017/S002966511100005X
https://www.physicalactivityaustralia.org.au/pregnancy-and-exercise/
https://sma.org.au/sma-site-content/uploads/2017/08/SMA-Position-Statement-Exercise-Pregnancy.pdf
https://www.racgp.org.au/afp/2014/august/exercise-in-pregnancy/