Pregnancy is a very special time in a woman's life. Lifestyle changes are influenced by many variables that include both psychological and physiological spheres. Obviously, there are many changes taking place in the female body and over the years studies on this subject have gradually improved, especially regarding the behavior to be maintained during pregnancy. An example of this is the recommendations regarding pregnancy workout and post-natal periods: in the mid-1980s, for fear of harming the fetus, the pregnant woman often heard her doctor advise her not to perform any kind of pregnancy workout.
In addition to the joint changes mentioned above, there is increased extensibility of the connective tissue overall. Pregnancy workout is always recommended, but this must be balanced with the need to maintain joint stability and prevent over-stretching when performing mobility and flexibility exercises.
Body adaptations during pregnancy workout
During the 240 days of a normal pregnancy, the body is subjected to many changes, the most immediate is that of weight gain, which leads to a series of other transformations that affect the musculoskeletal system both during activity and at rest:
- Increase in lumbar lordosis, which causes 50% of pregnant women to experience lower back pain.
- An anterior shift in the distribution of body weight, which leads to an imbalanced posture and causes a reduction in balance and proprioception, which is why activities with a risk of falling are not recommended (horseback riding, skiing, etc..).
- Up to 100% increase in the forces acting on the joints of the lower body (hips and knees) during resistance exercise, this can increase the risk of arthritis or damage joints that are already less stable due to increased levels of relaxin hormone. There is no clear evidence in the literature about the increase in musculoskeletal injuries during pregnancy workout, but it is prudent to consider these factors when drawing up a pregnancy workout program.
In addition to the joint changes mentioned above, there is increased extensibility of the connective tissue overall. Pregnancy workout is always recommended, but this must be balanced with the need to maintain joint stability and prevent over-stretching when performing pregnancy workout such as mobility and flexibility exercises.
Cardiovascular adaptations are very important:
- Between the second and fifth weeks, the resting heart rate and heart rate during submaximal exercise, increases by about 8 beats per minute, this continues to rise through pregnancy, and is almost doubled at the end of gestation.
- Between the tenth and twentieth weeks, there is an increase in volaemia, i.e. the total amount of blood in the circulatory system (blood circulating in vessels and organs).
- Within the fifth week, there is an increase in the resting cardiac output due to the increase in volaemia, heart rate and systolic output. It is recalled that cardiac output is commonly considered to be the volume of blood that the ventricles can expel every minute through the aorta (left ventricle).
- Despite the decrease in diastolic blood pressure, systolic pressure remains stable due to the decrease in peripheral vascular resistance.
This brief overview shows how variable the cardiovascular system is during pregnancy, likewise, the heart rate of the pregnant woman is not particularly stable, both in the short and long term, it is therefore not recommended to use the HR as a method of monitoring the intensity of training performed (fetal HR may also be detected and confound the readings of a Heart Rate Monitor). The American College of Sport Medicine recommends using the Borg 6-20 or CR10 rate of perceived exertion scale as an monitoring tool.
The cardiovascular system undergoes changes both mechanically (because the rib cage undergoes a temporary remodeling) and physiologically (bringing the respiratory rate at rest of a pregnant woman to a level that would normally be seen during aerobic conditioning).
5 benefits and 3 indicators of correct pregnancy workout
When considering pregnancy workout, fears are lurking and a mother-to-be may care more about risks than benefits. What is certain is that training during pregnancy brings certain benefits against uncertain risks, even in pregnant women with obstetric or other problems, under theadvice/ supervision of the doctor.
Among the main benefits of training in pregnancy are to be found:
- weight control.
- Reduction of low back pain.
- Improvement of glycemic control with a consequent reduction of the incidence of gestational diabetes, especially in obese women.
- Increased muscle strength and endurance.
- Greater chance of having a shorter birth.
Although there are no absolute contraindications, there are some indications of parameters to be kept under control during pregnancy workout sessions.
- Temperature: Temperature increases are generally manageable if they are not excessive. Usually the fetus has a temperature 1 ° C higher than that of the mother, it is recommended not to exceed 39 °C especially in the first 45-60 days. During pregnancy workout such as aerobic exercise the temperature of the pregnant woman's body increases by 1.5 degrees in the first 30 minutes, to reach a plateau in the next 30 ', generally this is well below the recommended limit.
- Blood flow: in the past there were fears of a selective redistribution of blood flow during pregnancy workout , and that this could interfere with the transport of transplacental oxygen and carbon dioxide, thus reducing the availability of nutrients to the fetus. Now it is known that there are no negative effects caused by exercise related to this problem, if a woman wants to completely obviate this possibility, activities in water eliminate any possibility thanks to a centripetal distribution of blood.
- Birth weight: it is often feared that pregnancy workout may result in a lower weight of the fetus at birth. This concern has been disproved both by the scientific evidence and in practice, with anecdotal examples provided by the children of professional athletes who have continued to train during gestation. The problem of birth weight can be caused by the mother's diet if she does not consume all the necessary nutrients, if she does not have sufficient calories in her diet, or if she begins to do sports without changing her diet.
Naturally, exercises in a supine position are not recommended, the obvious exception being for surface swimming, in which the body is supported by water without the full effects of gravity acting on the abdomen.
The ACOG - American Congress of Obstetrincians and Gynecologists has compiled a list of warning signs indicating that exercise should be stopped and medical advice sought during pregnancy:
- Vaginal bleeding
- Dyspnea (shortness of breath) at rest or with minimal effort
- Dizziness
- Headache
- Chest Pain
- Muscle weakness
- Calf pain or swelling
- An abnormal decrease in fetal movement
- Loss of amniotic fluid
Two useful indicators for training during pregnancy
The Canadian Society for Exercise Physiology has created a questionnaire (PARmed-X for Pregnancy) that can be used as a guide for choosing the physical activity to practice during the gestation period.
Unfortunately, there are no pre-established workouts that give indications on what to do every week or every month of pregnancy, but you can follow the guidelines of the ACOG regarding physical activity.
Duration and frequency of workout
As far as sedentary people are concerned, it is recommended not to exceed 30' of training each day. The recommended training intensity is 60-70% HRmax or 50-60% VO2max. Using the Borg scale, as suggested above, the perceived intensity should be 12-14.
Type of training
It would be appropriate to do both aerobic and strength training. As for the latter, the guidelines recommend circuits of 10-12 repetitions each, performed with moderate loads.
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