Training While Pregnant
At 38(!) weeks pregnant, my training has definitely shifted compared to a year and a half ago!
Even after taking multiple prenatal and postpartum coaching courses and coaching many women through the motherhood transition, I have learned so much from being pregnant myself. It has been illuminating to experience firsthand what feels good, what doesn’t, and how that has shifted as I’ve gotten farther along in pregnancy. One of our members and I are just a week apart in pregnancy, and it has been really helpful to talk with her throughout this process. Some movements stopped feeling good for me long before they stopped feeling good for her, and vice versa. It was a great illustration that everyone’s experience is going to be different, and that it’s critical to tune in to your body to make decisions about what is right for you.
Purpose of this article
The main purpose of this article is to provide a framework for making decisions about which movements to include, limit, or avoid during pregnancy. I’ll then give specifics on which movements I consider “red flags” and “yellow flags” — movements to avoid or approach with caution. There are few absolutes, but that doesn’t mean we can’t make informed judgments. I’ll list effective substitutions for movements in both categories. I’ll end by discussing reasons you might want to consider switching to individualized program design instead of modifying group classes for the duration of your pregnancy and postpartum period.
A framework for decision-making
This framework has three points: philosophical, physiological, and personal.
Philosophical — how do you approach pregnancy in general?
Physiological — what is happening with your body in pregnancy?
Personal — what are your preferences in this specific situation? what is your gut telling you?
Philosophical
The key takeaway from the BirthFit coaching education course I took a few months ago is the philosophy of being “in season training for birth.”
This means you are training with a purpose, for a specific event: birth and postpartum recovery. Pregnancy is not an injury or weakness that we modify to work around; it is a specific event that we train for.
A related philosophy is the idea that “just because you can doesn’t mean you should.” When you’re in season training for birth, there are some movements you can do but that won’t help prepare you or might work against you. So while you can do them…what is the purpose? Ask yourself how you will benefit.
Physiological
The physiological component of the framework looks at what happens with your body during pregnancy. The main factors are
growing uterus, placenta, and baby: aka the size and weight of your baby bump
rising levels of relaxin
Note that both these factors will change over time. Your second month will look and feel very different from your ninth!
Growing baby bump
As your baby bump grows, it will affect your body in different ways. Your center of gravity will shift more quickly than your brain can keep up with. This will make balance harder and increase your risk of falling, especially in movements like running, box jumps, and handstands.
Your growing bump will also begin to interfere with bar path in the Olympic lifts, and make other hingeing movements such as rowing and conventional deadlifts less comfortable. It will also limit your range of motion in movements like push ups and burpees.
The increased weight of your growing bump will increase the demands on your pelvic floor, especially with high-impact movements like running and jumping.
And as your bump grows and stretches your abdominal muscles, it will become harder to manage your intra-abdominal pressure. This can affect your entire abdominal support system, including abs and pelvic floor. Doming — when your ab muscles visibly press out into a “dome” shape — is a sign that intra-abdominal pressure is not being managed properly.
Rising relaxin levels
Relaxin is a hormone that makes your ligaments and joints looser in preparation for birth. It starts affecting ligaments as early as six week, peaks at twelve weeks, then stays high throughout pregnancy. This increased joint laxity makes dynamic movements more risky, as your muscles won’t work as well to hold your joints together: think kipping pull ups and kipping muscle ups. It also might allow you to achieve ranges of motion you couldn’t previously access (think squat depth), which can be good but also might lead to injury if you suddenly start training in a range of motion your body isn’t used to. And increased laxity in your pelvic ligaments and joints combined with the increased weight of your baby bump can lead to pelvic discomfort and pain.
Personal
The personal component asks about you. What is your fitness background? What is your body capable of? How about your mental state? Are you a professional athlete, or very new to fitness? How do you feel that day? What worries do you have? What is your assessment of the risk to reward ratio of a given movement or workout?
Given the same information, different women will make different decisions about what they are comfortable with. The “right” decision always has to be right in relation to a specific woman in a specific situation.
Red and yellow flags: movements to avoid and those to limit
Now you have the framework…but you still want some guidance on which movements you should and should not do.
What you’re able to do and what you feel comfortable with will change as your pregnancy progresses. I’ve divided the movements below into two categories: red flags and yellow flags. Red flags are movements I recommend avoiding. Yellow flags are movements that I can make a good case for avoiding, but that aren’t necessarily harmful and might be fine for many women.
Red flags
The main two movements I recommend avoiding through most of your pregnancy are burpees and box jumps. I consider them red flags mainly for philosophical, not physiological, reasons. You don’t need to do either movement to train for birth. Are burpees necessarily harmful? No. Do you really need to be squishing your baby repeatedly during the course of a workout? Also no. What is the purpose of doing that? What are you training for?
With box jumps, the main concern is the risk of falling. This could lead to hitting your stomach on the box or the ground. Is this likely? Maybe, maybe not. But it is more likely than pre-pregnancy, due to your changing center of gravity, and the stakes are high. Significant risk for a marginal reward. Again: what is the purpose? What are you training for?
Yellow flags
More movements fall into the “yellow flag” category. Exercise caution with kipping, pull ups, direct ab work, barbell Olympic lifts, running, and double unders.
Increased joint laxity caused by rising relaxin levels creates greater risk for injury with kipping movements such as pull ups and muscle ups. Pregnancy is a great time to focus on strict strength and build muscle that will help protect your joints even after baby comes.
Even strict pull ups can be surprisingly challenging for your abdominal support system. If you notice your abs doming (pushing out), consider modifying to a different upper body pull variation that allows you to better control your intra-abdominal pressure.
Direct ab work means ab flexion exercises such as sit ups, V-ups, and toes to bar. While we do want to train the core during pregnancy, doing this type of direct ab work quickly and in high volume in workouts can create uneven pressure in your core and pelvic floor. Over time, this uneven pressure can exacerbate weakness and necessitate a much longer postpartum recovery. Also, as your bump grows, it will start getting in the way, making these movements uncomfortable and less feasible.
Once your belly grows big enough to interfere with bar path, I recommend moving away from barbell snatches and barbell cleans. Your technique will suffer, and you run the risk of hitting your bump. Dumbbells and kettlebells can be great substitutes for these lifts.
Running and double unders put an increasing amount of pressure on the pelvic floor as your bump grows. Leaking or a feeling of heaviness in your pelvic area are both signs that your pelvic floor is being worked too hard. If you experience these symptoms after running or double unders, consider limiting volume or avoiding these movements for the remainder of your pregnancy.
Movement substitutions
Movement substitutions will ideally preserve the movement pattern and stimulus of the original movement. Here is a short list of options that have worked well for me and for our members. It is always helpful when you can come in with some idea of what you can do, but check in with your coach, as s/he might have additional suggestions based on the specifics of the workout.
Burpees
No-push up burpee until the plank position becomes too challenging for your core
Box step ups
Russian kettlebell swings
Box jumps
Box step ups
Broad jumps until the jumping becomes too high impact
Russian kettlebell swings
Kipping
Strict variations
Pull ups
Toe spot pull ups
Ring rows
Static hang as long as you can control intra-abdominal pressure and avoid doming
Direct ab work
Single or dual kettlebell front rack march
Suitcase or farmers carries
Deadbug variations
Barbell Olympic lifts
Dumbbell or kettlebell variations
Trap bar deadlift jumps or dual kettlebell deadlift jumps
Running
Bike erg or Assault Bike
Rowing until bump gets too big
Double unders
Lateral plate step overs
Ski erg
Bike erg or Assault Bike
How about individualized program design?
There are many ways to modify group classes, and you don’t need individualized program design to keep working out through pregnancy. However, here are two reasons to consider making the switch:
In season training for birth
Optimize postpartum recovery
Once you become pregnant, you are in season training for birth. CrossFit will build you a base of general fitness, but that is different from sport-specific training. To use running as an example: exclusively doing CrossFit WODs can make you fit enough to finish a marathon, but you won’t be as fast as you would be if you trained specifically for that marathon. Specific goals benefit from specific training. Birth is no different.
Programming for women in the motherhood transition needs to support balanced core strength, pelvic floor health, and a well-regulated nervous system. Individualized program design always starts with an assessment, which will give insight into your starting point with respect to all of these, and will ensure your program design sets you up for your most successful birth and postpartum recovery. Unlike the general programming of our group CrossFit WODs, which ends after your hour in the gym, with individual design we incorporate breathing practices and lifestyle protocols to intentionally support a healthy pregnancy.
For similar reasons, individualized programming will optimize your postpartum recovery. Pregnancy is a major physical event. Your recovery process will vary depending on what kind of birth you had. Uncomplicated physiological birth? physiological birth with significant tearing? planned C-section? labor followed by an emergency C-section? These all affect your body differently.
Many women take 1-2 months off around birth, then resume classes as normal, figuring they will scale workouts until they are back to 100%. As with scaling CrossFit WODs in general during pregnancy, that can work fine and isn’t inherently a bad thing. But there is a difference between “working fine” and optimizing your recovery. Working individually with a coach is the best way to make sure you’re not skipping any foundational steps as you resume working out, and that you set yourself up for long-term success.
Conclusion
I was struck by how much unsolicited advice I started getting as soon as people knew I was pregnant. It didn’t bother me too much, as it usually came from people with far less knowledge in this area than me (and without nearly as much stake in my pelvic floor health!). But it was annoying. Then there are all the internet articles telling you how dangerous it is to do X, Y, and Z while pregnant…not to mention some doctors who still give outdated blanket recommendations to not lift more than 15 pounds!
My main goal with this article was to provide a framework for you to make decisions about your workouts during pregnancy, and also to give some specifics so you can see the framework in action. Every recommendation needs to take into account the woman receiving it. The decision-making framework includes philosophical, physiological, and personal factors, some of which are necessarily subjective. Ultimately, you are the final authority on your body, and get to be responsible for your own decisions.
If you take seriously that you are in season training for birth, I highly recommend individualized program design. If you decide individualized is not for you, at the very least consider signing up for one of BirthFit’s general prenatal/postpartum-specific training programs. They are specifically for women in the motherhood transition, and their programming is excellent. I followed their third trimester program 2-3x/week, and it was a fantastic resource.
Wherever you are in the motherhood process — preconception, prenatal, or postpartum — I would love to be a resource for you! I’m always happy to talk about training and help you explore your options.