Experts recommend that pregnant women exercise at a moderate intensity, and that the length of their training sessions not exceed an hour (Illustration photo: Mladen Zivkovic, Shutterstock, NTB scanpix)
What’s the best way for pregnant women to exercise?
ASK A RESEARCHER: Only 15 per cent of all pregnant Norwegian women exercise, according research. At the same time, the health benefits of training during pregnancy have been well documented.
Exercise during pregnancy — and after giving birth — is good for both the mother and child. Pregnant women who exercise also have an easier, safer pregnancy, and have greater self-confidence and mental strength.
Nevertheless, a study by the Norwegian National Advisory Unit on Women’s Health shows that up to 85 per cent of pregnant Norwegian women do not exercise.
Experts think one reason for this statistic is that many pregnant women are uncertain about what they should do, how much they can exercise, and what types of exercise are suitable.
Midwives and doctors need more expertise
“I think part of the reason why pregnant women don’t exercise is that professionals don’t give them advice about physical activity, and that physical activity isn’t discussed during follow-up visits throughout the pregnancy,” says Katrine M. Owe, a researcher at the Norwegian National Advisory Unit on Women’s Health.
Owe is one of the researchers behind the study and believes that many midwives and other health professionals still don’t know enough about the health benefits of exercise for pregnant women and what recommendations they should make.
Owe teaches midwives, doctors and other health professionals about advising pregnant women on exercise. Her experience is that many health professionals suggest that women take it easy rather than exercise.
“These recommendations are based on ignorance. We know that everyone — even women who don’t exercise before becoming pregnant — reap great health benefits from exercising. At the same time, many women believe that they have to push really hard if they are going to exercise. You don't have to run to keep fit. Light weight training, walking, swimming and cycling are all good alternatives,” says Owe.
Uncertain and insecure
Her experience is that many pregnant women find it frightening when their heart rate increases and that they are afraid of doing something wrong when they exercise.
That’s also the experience of Simone Holbø, who is a physiotherapist, writer and entrepreneur who has co-authored a book called “Frisk Graviditet” - Healthy Pregnancy.
“For eight years, we have advised and guided pregnant women during and after giving birth, and have seen huge health benefits for women who exercise. We offer classes where women train using large fitness balls, among other things, to make the workout fun, cool and tough. In addition to getting in better shape, women build networks,” Holbø says.
Avoid a high heart rate
At the same time, both Owe and Holbø advise pregnant women not to exercise too hard. Studies suggest that women should keep their heart rate below 90 per cent of maximum. That means you should be able to say one sentence, take a breath, and say a new one.
If your heart rate is over 90 per cent of its maximum, you will only be able to say short sentences and will have to concentrate vigorously to keep the intensity up.
“There aren’t many studies on pregnant women who exercise at a high heart rate, simply because it’s not always ethically possible to carry out these studies. Some studies suggest that the flow of blood to the uterus and foetus is reduced when the mother’s heart rate is high, which can affect the heart rate of the foetus,” says Owe.
She and Holbø consequently recommend that pregnant women exercise at a moderate intensity and that the session last no more than an hour.
Holbø’s book also suggests:
- Don’t train if you have pain. Roughly 50 per cent of pregnant women experience lower back or pelvic joint pain, and exercise such as swimming breaststroke or hiking with a backpack can make this pain worse.
- Do your exercises correctly. If you are uncertain, ask for advice from a personal trainer, physiotherapist or an exercise coach.
- If you do experience pain in your pelvic joints or pain elsewhere during specific exercises, find a different exercise.
- During all three trimesters, you should try to be physically active for a minimum of 30 minutes every day, and do strength training one to three times a week.
- Remember that you also need to rest.
Read the Norwegian version of this article on forskning.no
Here’s how you should train during the first trimester
- Be physically active for at least 30 minutes every day. Physical activity includes activities such as walking at a moderate pace.
- Do strength training 1-3 times a week. Choose exercises that strengthen the pelvic floor, core muscles, and upper and lower body. For example, a large fitness ball is a good exercise tool because it works a number of different muscle groups at the same time. Use weights that are just heavy enough to allow you to do 6-10 repetitions with each exercise. Do each exercise three times, with a 1-2 minute break between each series. You can also do strength training at home by doing exercises that rely on your own body weight.
Suggestions for exercises
Squats with an elastic band: Attach the band at midsection height. Take a few steps backwards so that the elastic is lightly tightened and your arms point straight to the point of attachment. Stand with your feet a hip’s width apart and your back in a neutral position. Squat as if you are sitting on a chair and return to the starting position. Repeat 6-10 times, rest and do the same thing two more times.
Crab walking: Put the elastic band around your legs and stand with your feet a hip’s width apart. Bend at the hip and knees, so that you are in a half squat. Take four steps sideways, stop and take four steps back to the starting position. Repeat 6-10 times, rest and do the same thing two more times.
Ball push-ups: Lie with your knees on the ball and your hands in a wide stance in front of you on the floor. Keep enough distance so your body is straight. Lower yourself until there is a 90 degree angle in your elbows. Push yourself back up. Repeat 6-10 times, rest and do the same thing two more times.
Recumbent ball press: Lie on your back and hold the training ball between your legs and ankles with your legs pointing straight to the ceiling. Press your legs together, bend your knees and lower them slowly to the floor. Go back to the starting position and do the exercise 6-10 times.
For people who are used to exercising, you can continue to exercise as you did before you became pregnant, but you have to regulate the intensity. People who haven't exercised previously should start now.
- Work on endurance training three times a week. During this phase of pregnancy you should not exercise at a high intensity, as some studies have shown that the foetus may be stressed by too much heat after a session. Warm up thoroughly at low intensity and increase to a maximum of 80-85 percent of maximum heart rate.
Endurance training suggestions:
1. Walk uphill using poles
2. Cycling
3. Swimming
4. Aerobics with a fitness ball
Here’s how you should train during the second trimester
- Be physically active for at least 30 minutes every day. Physical activity includes activities such as walking stairs and taking walks with the dog.
- Do strength training 1-3 times a week. Choose exercises that strengthen the pelvic floor, core muscles, and upper and lower body.
Suggestions for exercises
Narrow squat with ball. Stand with your feet at a little less than a hip’s width apart and your back in a neutral position. Hold the ball in front of you. Move your hips backwards and squat. Shift your weight back towards your heels as you move. Press your hands against the ball and lift it over your head as you rise back to a standing position. Do 10 repetitions three times.
Dynamic plank: Start on all fours with your knees under your hips. Shift your body back toward your heels so that your arms are relaxed in front of you and your rump is resting against your heels. Rest your forehead on the floor. Move your body forward slowly. Support yourself with equal weight on your knees and arms. Put your toes on the ground and stretch out so you are in a straight plank. Your arms should be at shoulder height. Hold the position for five seconds before lowering yourself back to the starting position. Do the exercise six times, rest and do the same thing twice more.
Hamstring curls with ball: Lie on your back with your legs on a ball and arms down at your side. Tighten your rump muscles and lift your hips up to the ceiling. Hold the position for two seconds and then slowly lower to the starting position. Do ten repetitions three times.
Or you can choose from the exercises for the first trimester.
If you are uncertain about how to do the exercises properly, you should get help from a personal trainer or training counsellor.
Use weights that are just heavy enough to allow you to do 6-10 repetitions with each exercise. Do each exercise three times, with a 1-2 minute break between each series.
- Work on endurance training three times a week. During this phase of pregnancy you can work at an intensity that is up to 90 per cent of your max heart rate. Warm up thoroughly at a low intensity, and try interval training, for example, where you increase your intensity up to 90 per cent of your maximum heart rate. Finish by cooling down at low intensity.
Endurance training suggestions:
1. Walk uphill using poles
2. Hike with a backpack
3. Bicycle
4. Row
Here’s how you should train during the third trimester
- Be physically active for at least 30 minutes every day. Physical activity at this stage includes activities such as walking at a leisurely pace.
- Do strength training 1-3 times a week. Choose exercises that strengthen the pelvic floor, core muscles, and upper and lower body. You can also do strength training at home by doing exercises that rely on your own body weight. Adapt the exercises to your growing belly.
Use weights that are just heavy enough to allow you to do 6-10 repetitions with each exercise. Do each exercise three times, with a 1-2 minute break between each series.
Suggestions for excercises:
Pelvic roll on ball for 2-5 minutes: Sit on the ball. Grasp your buttocks and pull your rump slightly out to the side so that you have good contact between the seat and the ball. Your legs should be a good distance apart, with your upper body over the middle of the ball and your back in a neutral position. Keep your head and shoulders still while making circles with your pelvis.
Arm lifts with ball next to wall: Stand with ball next to wall. Support the ball against the wall at chest height, and take a few steps back. Lower yourself in a controlled way with your arms and push yourself back up. Do 10 reps, rest and do the same thing two more times.
Squat with elastic band to shoulder lift: Stand with your feet at hip’s width with a band around your legs. Hold the band with both hands. Sit down as if you are sitting on a chair, and slowly stand up again while lifting your elbows up to shoulder height. Do 10 reps, rest and do the same thing two more times.
- Work on endurance training three times a week. During this phase of your pregnancy, the intensity is limited by itself as you get heavier and bigger.
Endurance training suggestions:
1. Walk uphill using poles
2. Cycle
3. Swim
4. Aerobics on a fitness ball
Here’s how you should train after birth
Start with pelvic floor exercises as soon as possible after giving birth. As you get stronger, you can also do various abdominal exercises and strength training.
Keep in mind that you are in an early phase of training and that you should pay attention to your physical form. Monitor how much you can handle and exercise so that you slowly but surely get back into shape. Customize your endurance training to your physical fitness. Start with leisurely walks, preferably with a stroller, and increase the intensity and length as you get stronger. By being patient with your training, you’ll reduce your risk of injury and other problems.
