Every so often I like to brush up on the research on prenatal fitness, but at times the results are dismal. So I was pleased to discover many new studies that explore the benefits of prenatal exercise during my latest research geek-out. Here are a few of the newest findings. All the studies referenced are free to read, so be sure to check them out in detail.

1. Resistance Training Doesn’t Seem to Hurt

Summary: A randomized controlled study published in AOGS followed eighty women during weeks 14-25 of their pregnancy. The women in the intervention group engaged in moderate to vigorous intensity resistance training exercises for sixty minutes on two days per week. The women in the control group received standard exercise recommendations as well as a visit to a physiotherapist.

Conclusion:

The present study indicates that supervised regular, moderate-to-vigorous resistance exercise performed twice a week does not adversely impact childbirth outcome, pain, or blood pressure.

The Takeaway: There were some limitations to the research, including small sample size and a high drop-out rate. But overall it’s a good study to have in your pocket when you hear claims that resistance training is bad for pregnant women. While this particular study didn’t hit the ball out of the park in terms of proving a benefit, the results strongly suggest that resistance training is not harmful.

And one other interesting finding: the babies whose mothers participated in the weight training program had a lower (but healthy) birth weight than the babies from the non-weight training group. So it seems weight lifting won’t make babies bulky, either.

2. Pregnant Women Tend to Stop Exercising

Summary: This cross-sectional study published in PloS One surveyed over 1,000 women within 72 hours of delivery. A cross-sectional study is an observational study, meaning it analyzes data received from a large group of subjects. As noted in an article in the Journal of Pallative Medicine, an observational study is like a snapshot of a group of people at a given point in time.

Conclusion:

Compared to the pre-pregnancy period, the prevalence of physical activity among participants was lower throughout pregnancy (20.1%) (p = 0.01). Half of the women interrupted practicing physical exercise due to pregnancy. The lowest prevalence of exercise was observed in the first (13.6%) and third trimesters (13.4%). Less than half of women received exercise guidance during prenatal care meetings (47.4%). Walking was the most commonly reported exercise, followed by water aerobics. Factors positively associated with exercise practice were higher educational level primiparity, exercising before pregnancy, and exercise guidance during prenatal care.

The Takeaway: Less than half the women involved in this study received exercise guidance during prenatal visits. In my experience after having three children, exercise is something you have to bring up with your medical provider. If you have questions about what kind of workouts are safe for your pregnancy, don’t wait for your care provider to initiate the conversation, because he or she probably won’t.

Would the women have been more likely to continue exercising during pregnancy if they had received guidance from their doctor? We can’t answer that question based on these results. Maybe they stopped exercising because it was uncomfortable or because they didn’t know if it was safe. But this study is still a helpful snapshot of two trends birth workers and prenatal trainers should be aware of:

1. Women tend to stop exercising during pregnancy.
2. Pregnant women tend not to receive exercise guidance from care providers.

3. You Need More Than Exercise

Summary: This study in the International Journal of Behavioral Nutrition and Physical Activity  analyzed the movement patterns of 46 women in weeks 18 and 35 of their pregnancies (the second and third trimester, respectively). The study’s objective was to quantify physical activity and sedentary behavior during pregnancy. The researchers also wanted to determine whether women who exercised more were less sedentary than women who did not exercise.

Conclusion:

This study demonstrates that pregnant women spend the majority of their day in sedentary behavior (SB). Significant reductions in total activity across pregnancy may be attributed in part to shifts in light physical activity (PA) and increased SB. Based on the lifestyle of our sample, regardless of meeting PA guidelines in mid-pregnancy, no significant difference exists in time spent in SB, however meeting PA recommendations in late pregnancy may reduce SB. Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise.

The Takeaway: Exercising during pregnancy is a worthy and admirable thing. But don’t stop there. Regular movement can be far more effective at reducing aches and pains and improving mental wellbeing than working out for an hour three to five times a week. Don’t underestimate the little things.

4. Mental Exercise Helps, Too

Summary: Taking the time for meditation, prayer, or simply sitting in a quiet space where you can collect yourself is crucial for handling the ups and downs of pregnancy. This randomized controlled trial published in Advances in Preventive Medicine suggests it’s also good for baby.

59 women with high-risk pregnancies were put in two groups. The intervention group received one-hour yoga sessions three times per week. The yoga sessions contained postures, breathing practices, and visualization. The control group received standard care and also participated in a walking program. The intervention began in the twelfth week of gestation and continued until week 28.

Conclusion:

The result of this randomized controlled trial of yoga in high-risk pregnancy has shown that yogic visualization and guided imagery can significantly reduce the impedance in the uteroplacental and fetoplacental circulation. This pilot data can be used to power larger studies to confirm these results and elaborate on the mechanism of action.

The Takeaway: The sample size in this study was small, but the results show promise. And as the researchers noted, this study also makes a strong case for additional studies in the future with larger sample sizes and more comprehensive parameters.

Conclusion

In summary, these four studies support the following:

1. A safe, tailored strength training program doesn’t seem to have negative effects in low-risk pregnancies.
2. Pregnant women who want to keep exercising could receive more support from their providers and the community.
3. Meeting exercise recommendations doesn’t correlate with lower sedentary activity (so keep moving!)
4. A regular meditation practice has benefits for mom and baby.

I love seeing the emerging research on exercise and pregnancy. If you know of any other studies, share your links in the comments below!

More Like This:

• 3 Reasons to Lift Weights During Pregnancy
• 6 Exercises for Rebuilding Your Core After Pregnancy
• Super Mom! How Pregnancy Can Make You MORE Fit
• New on Breaking Muscle Today

References

1. Blehar, M., et al. “Enrolling Pregnant Women: Issues in Clinical Research.” Women’s Health Issues; 23(1), January 2013.

2. K. Fieril, et al. “The efficacy of moderate-to-vigorous resistance during pregnancy.” ACTA Obstetricia et Gynecologica. 29 September 2014.

3. S. Nascimento, et al. “Physical Activity Patterns and Factors Related to Exercise During Pregnancy: A Cross Sectional Study.” PLOS One. June 17, 2015.

4. Carlson, M. and Morrison, S. “Study Design, Precision, and Validity in Observational Studies.” Journal of Pallative Medicine. January 2009.

5. D. Fabio, et al. “Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: An observational study.” International Journal of Behvioral Nutrition and Physical Activity. 2015.

 6. A. Rakhshani, et al. “Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial.” Advances in Preventative Medicine; 2015.

Photos 1 and 2 courtesy of CrossFit Impulse.

Photo 3 courtesy of Shutterstock.

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And then the not-so-nice reality set in. My “baby” is seventeen months old. I didn’t just have a baby. I don’t even technically have a baby in the house anymore. I have a toddler, and still I find myself struggling to do things that used to come easily.

My son and I in 2013, shortly after his delivery. He’s not a baby anymore.

How Long Does It Normally Take?

Recently in the United States, there has been a lot of talk about increasing the length of maternity leave for working mothers. This issue begs a question that is all too often glossed over by Instagram photos of perfect moms who are back to their pre-baby bodies after four weeks: How long does it really take to recover from giving birth?

In America, the standard answer is six weeks, or maybe eight if you had a c-section. Some people will say as little as three or four. For the sake of clarity, let’s consider what “recovered” actually means. Here are some common indicators women and medical professionals use to gauge postpartum recovery:

• Uterus is the same size it used to be
• No more bleeding
• Able to walk for extended periods without pain
• Able to have intercourse
• Back to pre-baby weight

These are all parts of the postpartum recovery puzzle. But what if you have all these pieces in place and you still don’t feel normal? And what if it’s been longer than six or even eight weeks?

Six Weeks Is Not Normal

It might take a long time to feel normal – much longer than six weeks. In a 2012 study, Dr. Julie Wray tracked the recovery of seventeen new mothers for the first seven months after delivery. The majority of mothers were skeptical of the common six-week timeframe for postpartum recovery. Wray reported in an interview, “The women considered the professional view of recovery from childbirth at six weeks to be a fantasy, and that a year was a more realistic timeframe.”

Wray’s research received a lot of attention, but it isn’t new news. A 1993 study published in the Archives of Family Medicine found 25% of new moms did not feel completely recovered from childbirth at the six-month mark. One-fifth of the subjects reported sexual difficulties even at the one-year mark.

“’The women considered the professional view of recovery from childbirth at six weeks to be a fantasy, and that a year was a more realistic timeframe.’”

I’m not trying to be Debbie Downer here, but if you’re expecting to feel completely, 100% back to your pre-baby self after only six weeks, you’re probably in for a rude awakening.

Home from the hospital with my second child in 2011. Her recovery was hardest due to complications from a c-section and adjusting to having two children.

“Normal” Is a Relative Term

So why the disparity between medical recommendations and reality? I think it has a lot to do with how we view the mother-child couple. In the United States, we tend to focus on the newborn’s needs. The new mother often fades into the background as a facilitator and nurturer. But who is nurturing her?

“For the vast majority of the world, it’s probably not normal to be lifting weights less than two months after giving a birth.”

In her article, Postpartum Beliefs and Practices Among Non-Western Cultures, Dr. Yeoun Soo Kim-Godwin described the isolation and frustration she felt after delivering her child in the United States, where birth practices differed greatly from her home country of Korea. She explained how her birth experience in the U.S. differed from her sister’s in Korea:

I remembered my sister’s postpartum recovery period in Korea. After having her baby, she came to our home to receive postpartum care from our mother. For about a month, my sister’s only duties were to eat and sleep to restore her health. In contrast, my American husband and his family treated me as a healthy person who could resume normal activities almost immediately. For example, my husband expected me to drive to the pediatrician’s clinic for the baby’s first physical checkup 7 days after giving birth.

In many non-Western cultures, women are just getting back to activity after the six-week mark. So if you’ve had a baby in the last few months and feel frustrated that things aren’t back to “normal,” consider it might be a matter of perspective. For the vast majority of the world, it’s probably not normal to be lifting weights less than two months after giving birth.

Maybe Normal Doesn’t Even Matter

Many women Dr. Wray interviewed expressed frustration with the pressure to be normal. Wray wrote, “During the provision of formal care giving, constructs of ‘normal’ were attached to women as midwives searched to manage the occupants of the wards.” These definitions of normal and the medical need to enforce them caused anxiety and stress in women, particularly in the first few weeks after childbirth.

“Ultimately it doesn’t matter if going to the gym six weeks after delivery is normal. What matters is whether or not you are ready.”

I encounter so many new moms who feel worried and anxious because they’re not back in the gym after a few months or even weeks. The big question on their mind is often, “Is this normal?” But ultimately it doesn’t matter if going to the gym six weeks after delivery is normal. What matters is whether or not you are ready.

Ask yourself these questions to determine whether your desire to work out for the first time is driven by false notions of normality or your own readiness:

1. Is my desire based on comparison with others? Do I feel the need to get back in shape because Betty Burpee is doing CrossFit three weeks postpartum?
2. Are my ideas based on my own previous birth and postpartum experiences?
3. Do I feel a physical urge to work out? Or am I going to the gym because I feel like I “should” feel ready?

Sit with these questions for a while before your first time back to the gym. Having clarity about why you want to work out will help you be successful and prevent self-criticism. If your desire to work out is based on constructs that don’t apply to your unique postpartum body, I guarantee you will experience burnout and discouragement.

Holding my oldest daughter for the first time after emergency c-section in 2008. I thought I was back to “normal” within a few weeks of delivery but experienced severe breastfeeding complications three months after she was born.

Have the Strength to Not Be Normal

I know from experience that taking it easy is not easy, especially if you’re used to working out regularly. After each of my kids was born, I found myself asking questions like, “What about that mom I saw last week on Facebook who has five kids and just had a baby last month and is running a marathon this weekend? What about her?”

I still ask those questions today. I still have to face the fact that maybe right now I’m not that marathon mom, even seventeen months postpartum. But I’m figuring out how to find contentment in each unrepeatable experience. I’m learning the difference between contentment and complacency. And I’m starting to see when it comes to being a parent, being normal is for the most part irrelevant.

Related Articles:

• My Post Pregnancy CrossFit Comeback
• 5 Simple Tips for Postpartum Mental and Physical Health
• Battling the Baby Blues: How Exercise Can Help
• What’s New on Breaking Muscle Today

The post You Don’t Have to Be Normal: The Reality of Postpartum Fitness appeared first on Breaking Muscle.

The First Pregnancy

For me, the first pregnancy was a cautious time. My husband and I had been trying to conceive for almost two years. We finally decided we would continue trying for three more months and then if it didn’t happen naturally, we’d look into adoption. We knew that if it didn’t happen naturally for us, then we’d love to provide a home for a child in need. Little did we know at the time we made that decision that I was already pregnant. It was miraculous given that fact that I had stage-four endometriosis and my chances of getting pregnant were very slim.

During that first pregnancy, I napped daily, got massages, did a little bit of yoga, and walked as much as I could. I pampered myself and embraced every part of the pregnancy, even the morning sickness that lasted all day. My husband and I took the Bradley Method course, which is a husband-coached childbirth class that focuses on nutrition and natural labor. My labor was thirty hours long, yet meditative, natural, and unmedicated. It changed my life, for I knew I was capable of anything. The first moment of holding my son will be engraved in my memory as magical.

The Second Pregnancy

I am now 35 weeks pregnant with my second baby. For those of you trying to do the math, I’m eight months pregnant. This pregnancy has been a completely different experience. I got pregnant while still breastfeeding and had no idea I was even ovulating yet. Chasing a toddler around has forced me to stay very active during this pregnancy, without the naps or pampering. I did not slow down and even pushed my body a little too much until recently. I was walking five miles a day; doing my daily prenatal yogic squats; skipping the naps; teaching classes, privates, and teacher trainings; and trying to be supermom. Until a couple of weeks ago, when during my routine doctor visit I was put on bed rest due to the risk of preterm labor.

My body was preparing for labor at 32 weeks and having the baby come out would not be ideal. I slowed down, but still was teaching until I got the stomach flu last week and was hospitalized to replenish fluids through an IV. While in the hospital, my contractions were coming strong and every three minutes, so it looked as though I was going into labor. My husband reminded me to breathe. I thought to myself, “I teach students to breathe for a living and it was time to practice what I teach.” I started to breathe slowly and deeply and talk to the little one living in my womb. It was amazing to watch her heart rate go from 190 to 150 (normal for a fetus) beats per minute in a matter of seconds. My contractions lessened in intensity and duration, and I felt an overall sense of peace.

Your Pregnancy

Every pregnancy is different. Some women feel strong and healthy the whole pregnancy. Other women feel sick and tired all forty weeks. Whatever the case may be, there is not a one-size-fits-all prescription for prenatal exercise. Prenatal women are the most intuitive they will ever be because there are two souls in one body. Overall, if there is no medical reason not to, walking is beneficial for the mind and body. Cat and cow exercises are important for getting the baby in the correct position and yogic prenatal squats are great for opening the hips and pelvis for birthing. However, simply meditating and sending love to the unborn baby is essential for creating a lifelong connection between mother and child.

Photo 1 courtesy of Julie Rader.

Photo 2 courtesy of Shutterstock.

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