What are safe exercises during pregnancy? Does it matter if I am rather active to begin with? Will exercising increase my chances of miscarriage? Should I do kegels? What are kegels, actually? The questions can go on and on… and who can you trust to give you the right answer, anyway?
On top of monitoring what goes into and onto your body during pregnancy, you are also wondering about how to move your body. And if you can, or maybe even should, maintain your previous physical activity levels or if this could potentially harm your developing baby or your pregnant body.
Let’s see what evidence is out there on physical activity during pregnancy and postpartum. First, we’ll start with an overview of the physiological changes of pregnancy and birth and then try to answer that question about ab exercises during pregnancy, and many more.
Your body’s transformation through pregnancy and birth
Before diving into physical activity it is important to highlight the physiological changes that occur during pregnancy and postpartum.
Pregnancy brings about significant physiological changes, including weight gain, ligaments loosening/becoming stretchier, postural changes, and shifts in the center of gravity. That bowling bowl on your belly does change things throughout your entire body.
Here's some numbers
ABS
The abdominal musculature is stretched to 115% of its resting length by 38 weeks of pregnancy to accommodate a growing baby.
Heart
Cardiac output increases by 30-50% by mid-pregnancy along with a 10-20% in baseline oxygen consumption resulting in a decreased amount of available oxygen for aerobic activities.
Pelvic floor
The pelvic floor musculature is stretched to 250% of its resting length during delivery – typically requiring several months for optimal recovery.
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Many postpartum women experience musculoskeletal pain, urinary incontinence, abdominal separation, and pelvic organ prolapse. However, while these issues may be common, they are not normal. For many women who were unaware of how to use pelvic floor muscles prior to delivery, or for those who have had multiple babies without adequate rehabilitation and recovery, it can be very difficult to self-train these muscles.
Most importantly, addressing these issues early with pelvic floor rehabilitation can prevent long-term dysfunction and support a safe return to sport. Studies have shown that more than one-third of postpartum runners experience pain and urinary incontinence when they begin running again. And some women may be off to a good start, but find these issues occurring much later on after they have given birth. These findings emphasize the need for early and guided rehabilitation to address potential dysfunctions in pelvic floor and abdominal muscles.
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Recommendations continue to evolve – and as with much research focused on “women only problems” there is little evidence being generated – yet, the research that we have does show significant benefits for staying active during pregnancy and postpartum regardless of your prior fitness or training status.
So, can I do ab exercises during pregnancy?
Because of the changes happening in a pregnant body certain adaptations to strength, endurance, and postural control exercises should be considered. Our physical therapist and personal trainer cover these in our courses. However, the outdated advice to limit heart rates below 140 bpm and avoid lifting more than 25 pounds has been debunked.
The American College of Gynecology recommends, “30 minutes or more of moderate exercise a day on most, if not all, days of the week [for pregnant women in the absence of either medical or obstetric complications].”
Physical activity during pregnancy is known to reduce the risk of several conditions, including gestational diabetes, pre-eclampsia, hypertension, depression, and both prenatal and postpartum incontinence.
And, exercising during pregnancy does not increase the risk of adverse outcomes such as low birth weight, miscarriage, or perinatal mortality.
Women should be encouraged to continue physical activity- or ab exercises during pregnancy, if that’s your thing.
Should I exercises after birth?
International guidelines state that, “Postpartum physical activity can improve mood, maintain cardiorespiratory fitness, improve weight control, promote weight loss, and reduce depression and anxiety.” But what kind of physical activity?
The six-week postpartum check-up is commonly viewed as the green light to resume normal activities. However, emerging evidence suggests that some exercises and physical activity can and should begin immediately postpartum.
Waiting until the six-week mark to begin rehabilitation can actually compromise a safe return to activity, as many women are left to navigate this phase alone.
What exercises should begin immediately after birth?
Pelvic floor contractions, sometimes referred to as kegels are the only exercise that is safe to start postpartum. However, contractions are the opposite of relaxation and both aspects of muscle control and required for pelvic floor health. Diaphragmatic breathing, or 360 breathing, is crucial for the coordination of pelvic floor contraction and relaxation. This is the real basis for healing and movement and is taught in all of our courses.
How do I do a pelvic floor contraction?
What about running?
Running, for example, places significant demands on the pelvic floor musculature, requiring both strength and endurance. High-impact activities, like running, have been found to increase the risk of pelvic floor dysfunction by 5-fold as compared to low-impact exercise. This means that it is not only the time since birth that counts, but also an assessment of physical readiness, potentially around three months postpartum. Yet, while there is no peer-reviewed return to sport protocol for postpartum women, 75% of postpartum runners are running within 8 weeks of delivery and more than 1 in 3 experience pain as well as some form of incontinence upon their return.
If you are an athlete and want to get back to running or strength training, we have the online course to get you there, step by step and safely: Exercise & you!
Verdict: You can do ab exercises during pregnancy and beyond
Regardless of the physical and mental benefits of staying active, it is crucial for women to continue to do activities that they enjoy while pregnant and during the postpartum period. If that is ab exercises for you, keep them up! Making time to maintain these habits will help you stay connected with your body which can often feel foreign and give you little pockets of “me-time” during a period where you might feel that your primary purpose is as a life-support machine.
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