Webinar: Active During Pregnancy

Webinar

This panel discussion featured facilitator Tarja Owens, Naomi Sturdy of Elements Yoga, Yvonne Byrne former Mayo Ladies Goalkeeper and Sinead Brophy of FFS Gyms.

The webinar provided insight from current mums, mums to be and experts working in the fitness industry with pregnant women. All views presented were the individual speakers opinions and anyone looking for advice or to be active during pregnancy is encouraged to seek  medical advice.

Watch the webinar HERE.

Sinead -  Questions & Answers about Exercise and Movement during Pregnancy

•       Your expertise is more focused on strength training during pregnancy. Why would you recommend this for pregnant women?  

Exercise during pregnancy has been shown to have lots of benefits  (see below)

Our bodies change significantly during pregnancy, our centre of gravity moves forward and our bodyweight increases by approximately 10kg  - in our pregnancy training we focus on strengthening the upper back, posterior chain, pelvic floor muscles and core to help support those changes

Furthermore labour can be a marathon event, that requires fitness and endurance -studies have shown that women with high aerobic fitness during third trimester had a reduced 2nd stage labour by 2 hours.

Finally, it helps to prepare you for all of the movement that you are going to be doing as a new parent - lifting the baby in and out of the cot or up off the floor, feeding baby, carry car seats/buggies, putting them in and out of the car. 

•       What are the benefits of strength training during pregnancy? 

Prenatal physical activity should be considered a front-line therapy for reducing the risk of pregnancy complications and enhancing maternal physical and mental health. - 2019 Canadian Guideline 

Improves sleep, posture, mental wellbeing, and energy levels

Supports bone mineral density, balance and coordination as well as strength

Help reduce labour time, c-sections, risk of gestational diabetes, preeclampsia and high blood pressure

Critically, these benefits occur without increasing the risk of having a small baby, preterm birth or a miscarriage.

Specifically for strength training: 

• Support, strength, PF strength progression

2014 Paper - Supervised resistance training twice a week vs a home-based programme - indicate that supervised, moderate-to-vigorous resistance exercise does not jeopardize the health status of healthy pregnant women or the fetus during pregnancy, but instead appears to be an appropriate form of exercise in healthy pregnancy

•       What does a typical work-out look like? 

PF Breathing - connection breath, kegels

Warm up - Mobility + Activation + PR 

Strength block - EMOM or supersets of two strength exercise - rep range - break

Cardio - Aerobic block or Moderate Intensity Interval training

Cool Down - HR Down

•       What type of women come in to you? Mainly those who have already been going to the gym or those completely new to weight training? 

We have a mix. 

Our existing members have the option of continuing with normal classes or choosing SGPT or 1:1 PT. All of our coaches are well versed in pregnancy training and alternates. Alts up on the board for all classes and note on profiles for coaches to see - discretion is key but also safety.

Classes then are a mix of current members and new members - our Online Training has opened us up to people outside of Dublin which is great.

•       Can women take up strength training no matter what stage of pregnancy they are in? 

Yes,  

• You start slowly and build it up. 
• cleared by their GP. 
• always recommend people to work with a trainer who is Qualified in Prenatal trainer 
• Our small group training is max 4 people, which allows us to give to personalised attention and adaptations
• Everything can be regressed - goblet squat to sit to stand
• Example - client started training with me online at 20 weeks pregnant.

Further information

Benefits of Exercise:

Most recent research papers that I have read state the following:

• Exercise during pregnancy is recommended for all women without contraindications regardless of background or exercise level (Mottola, 2019 Canadian Guide to Exercise during Pregnancy)
• Higher levels of aerobic fitness in the third trimester are linked to a 2hour reduction of time in the 2nd phase of labour (Kardel et al, 2009)
• Exercise during pregnancy is linked to a reduction in overall labour time, particularly phase 1 and phase 2 (Rodríguez-Blanque R, 2019)
• Exercise during pregnancy has been linked to a reduction in the risk of gestational diabetes, preeclempsia, large weight babies, plus improvement in pelvic floor stretngth, blood glucose levels, mental health and sleep (Mottola, 2019 Canadian Guide to Exercise during Pregnancy)
• Physical Activity during pregnancy has not been linked to miscarriage, stillbirth, preterm labour or low birth-weight (Mottola, 2019 Canadian Guide to Exercise during Pregnancy)
• A mix of exercise is recommended : aerobic and resistance training as well as stretching and yoga (Mottola, 2019 Canadian Guide to Exercise during Pregnancy)
• Supervised moderate-vigorous resistance training has been shown to not jeopardise the health of mother or baby but appears to be an appropriate form of exercise during pregnancy (Petrov et al, 2014)
• 150mins of moderate exercise, ideally broken over 3 days, is the baseline recommendation for exercise to be beneficial (Mottola, 2019 Canadian Guide to Exercise during Pregnancy)

When to stop exercising  (Source: Mottola, 2019)

• Persistent excessive shortness of breath that does not resolve on rest.
• Severe chest pain.
• Regular and painful uterine contractions.
• Vaginal bleeding.
• Persistent loss of fluid from the vagina indicating rupture of the membranes.
• Persistent dizziness or faintness that does not resolve on rest

Safety Precautions for prenatal activity (Source: Mottola, 2019)

• Avoid physical activity in excessive heat, especially with high
• Humidity.
• Avoid activities which involve physical contact or danger of falling.
• Avoid scuba diving.
• Lowlander women (ie, living below 2500m) should avoid physical activity at high altitude (>2500m).
• Those considering physical activity above those altitudes should seek supervision from an obstetric care provider with knowledge of the impact of high altitude on maternal and fetal outcomes.
• Those considering athletic competition or exercising significantly above the recommended guidelines should seek supervision from an obstetric care provider with knowledge of the impact of high-intensity physical activity on maternal and fetal outcomes.
• Maintain adequate nutrition and hydration—drink water before, during and after physical activity.
• Know the reasons to stop physical activity and consult a qualified healthcare provider immediately if they occur

Contraindications to Exercise - When not to exercise

Relative Contraindications to be discussed with your GP or Consultant

Based on recent research by British Journal of Sports Medicine (2020), it is suggested that not all relative contraindications require a complete stop of physical activity, but adjustments and reduction in intensity may be necessary. However, please speak to your healthcare provider.

Absolute contraindication - moderate-vigorous activity not suitable 

• Severe acquired or congenital heart disease with exercise intolerance
• Severe pre-eclampsia
• Cervical insufficiency
• Placental abruption
• Vasa previa
• Intrauterine growth restriction (IUGR)
• Severe respiratory disorders
• Uncontrolled type 1 diabetes
• Active preterm labour