How to Modify Exercise During Pregnancy

It can be hard to know what exercises are “safe” vs “not safe” to do during pregnancy. This blog post helps break down how to modify exercise during pregnancy by trimester.

Here are a few things you need to know about training during pregnancy.

Exercise is both safe and beneficial for mom and baby, unless your doctor directs you otherwise for a medical reason (like placenta previa). As a matter of fact, exercise is one of the best ways to manage pain & stay comfortable during pregnancy.

Here are some general themes you should understand about exercise during pregnancy. After I go over these, I will give a breakdown of mindset and modifications for each trimester.

• Learn how to coordinate your core, pelvic floor, and ribcage with your breath - this is one of the most important thing you can learn about fitness during pregnancy. You want your rib cage, core and pelvic floor to expand on the inhale and you want them to engage/contract on the exhale. You’ll use your exhale to create stability and manage intrabdominal pressure during exercise. This will help you protect your core & pelvic floor during pregnancy. Think of “hugging the baby” with your abdominal muscles as you exhale to engage your deep core/TVAs.
  
  Breathing is also one of the ways you will learn to lengthen your pelvic floor, which will help you during labor & delivery. Your pelvic floor does not push your baby out, your uterus does!! Your pelvic floor needs to lengthen & get out of the way!

• Strength training should be a priority - a pregnancy hormone called relaxin increases joint laxity during pregnancy. This can cause instability & weakness, especially around the pelvis. Strength training can help you find/maintain stability in your joints, which in turn will help manage those common pregnancy aches & pains. Strength training should be a priority during pregnancy!

• risk vs reward - when you’re wondering if an exercise is “safe” during pregnancy, I encourage you to stop and think about the risk vs reward. What’s the risk to your core & pelvic floor? What’s the reward? Is there another exercise you can perform that has the same stimulus, but less impact to your core and pelvic floor? But the most important thing to know is that it is YOUR CHOICE. Your coach should be there to support you, not make decisions about your body.

• running during pregnancy - running during pregnancy is safe, and for many people it is a priority. If it is a priority for you, monitor your pelvic health symptoms. Look out for signs you’re putting too much stress on your pelvic floor (leaking, pelvic pain, bulging feeling, pelvic heaviness, low back pain, etc.) and adjust accordingly (slower, shorter). If running is not a priority for you, I suggest finding another form of cardio that has a lower impact to your pelvic floor (biking, swimming, brisk walking, etc).

• coning/doming - one of the best indicators that you are not managing pressure well during pregnancy is if you observe coning/doming. This is when the connective tissue down the center of your abs start to look like a speed bump or a tent. This is a sign that you are not managing pressure well and you need to either adjust your strategy (like adjust positioning or use an exhale to find a better core brace), or modify/swap out the movement.
  
  For some people, this doesn’t start to present itself until the second trimester when their belly really starts to pop. For others (like me!) it starts showing up in the first trimester. Here are some photos of what coning/doming looks like from my first trimester of pregnancy:

Trimester One Modifications

The first trimester can be challenging for some due to nausea and fatigue. You might be too tired or sick to get intentional movement in, and that’s okay! But for those of you who feel good & keep working out, there are not many exercise modifications that need to be made during the first trimester. This is because many of the musculoskeletal changes caused by pregnancy haven’t started yet. You may notice, however, you’re more winded and have a higher heart rate, so you might need more rest during workouts.

The first trimester is a great time to scale back on your intensity and set the tone for the rest of your pregnancy. Slow your movements down and focus on form & breathing coordination. Keep your intensity at 70-80%. This will help make sure you can focus on control and form.

The first trimester is also a great time to increase hip, thoracic, spinal, and rib cage mobility. Mobility in these areas are typically the most difficult to maintain during pregnancy as your body changes, so the more mobility you can start with the better. Use positional breathing & mobility exercises to encourage movement in these areas. Mobility & breathing are also great movements to incorporate if you’re too fatigued or nauseous for full workouts.

Trimester Two Modifications

Some people feel like they get a second wind during the second trimester! They have more energy & feel ready to focus more on fitness. Unfortunately for some, the nausea and fatigue remain and they might still struggle with routine fitness. The important thing is to just do what you can and not compare yourself to anyone else.

The second trimester is your time to maintain or even increase strength and work on hip mobility/stability to help prevent those common pregnancy aches and pains. Your goal is to keep moving & stay comfortable. Keep intensity around 70-80% and continue to focus on form and breathing during movements.

You might need to start modifying core exercises. Core exercises are important to keep doing during pregnancy, but you might have to change the type. Things like crunches, planks, and even pull-ups are notorious for putting a lot of pressure on the already stretched front of your abs. It can be helpful to avoid flexion exercises or challenging hanging exercises (like crunches and pull-ups), elevate movements like planks and push-ups, and choose more rotation, anti-rotation, and lateral flexion core-focused exercises.

It also might start to get more difficult to press weight overhead without arching through your low back and flaring your ribs. This also puts added stress on the front of your core. It can be helpful to perform pressing exercises in a seated or half kneeling position so you can better control spinal position & pressure.

As your body changes during the second trimester, it also becomes more important to monitor for pelvic heaviness, bulging, leaking, or pressure during or after exercise - these are signs you need to adjust pressure management strategy or modify/swap out a movement.

The second trimester is also a good time to eliminate movements that put a lot of added pressure and stress on your pelvic floor like box jumps, jump roping, sprinting, and other high-impact exercises. If running is a top priority to you, keep running, but also pay attention to your pelvic health. Adjust distance & speed, as necessary, to keep you feeling good.

Lastly - really start to focus on feeling the pelvic floor relax & lengthen on the inhale. End workouts with breathing exercises designed to relax your pelvic floor. It’s important to be connected to your core & pelvic floor during pregnancy so it’s easier to find postpartum.

Trimester Three Modifications

I like to think of the third trimester as a deload period. You want to drop your intensity to 50-70% and start to focus more on birth/labor prep, movement that feels good, and staying comfortable. You’ll likely naturally feel your energy levels decrease as you approach labor. Exercise should be a tool to help you feel good, not something you’re forcing yourself to slog through during the third trimester.

Continue to monitor for pelvic health symptoms and coning/doming with exercise. Adjust or eliminate movements as necessary. It’s also important to continue to work on hip mobility & stability. This will help you prepare for all of the movements the pelvis needs to make during labor as well as keep you comfortable.

You might find that you need to adjust foot positioning or stance during movements like squats and deadlifts. It might feel better to point your feet out or widen your stance. Similarly, it might be helpful to change from barbells to free weights, to accommodate your changing belly.

It’s okay to perform exercises on your back as long as you don’t get light-headed or dizzy. It can start to get difficult to get up and down from a lying position, however, so it can be helpful to switch supine exercises (like bench press) to seated or incline bench positions.

As you approach your due date, you might need more rest days, more rest during workouts, or to decrease intensity of your workouts. All are completely normal and I encourage you to listen to what your body is telling you. If it’s begging you for rest, take the day off.

More Resources

I hope you found this post helpful & you feel more prepared for exercise during pregnancy.

If you want more specific support for exercise during pregnancy, check out the my Functional Empowered Fitness membership where I have pregnancy & postpartum programs you can switch seamlessly between. They’ll help you feel strong, comfortable, and prepared for birth and then recover postpartum. Check out more information here.

If this blog post was helpful to you, but you want it in a condensed form to reference during pregnancy, download my “Pregnancy Exercise Guide” below.