How Should Training Change During Pregnancy?

Though there is a solid chance you don’t fall into one of the contraindicated buckets, training still must evolve drastically throughout the perinatal period. But evolve doesn’t necessarily imply debilitating restrictions either…There will be some things that will definitely be advised against (which we will get into shortly), but that list is much shorter than intuition would lead you to believe.

The key to effectively training through pregnancy is understanding why and how deviations from the norm should be applied.

Accounting for Anthropometric Variability

Wtf is anthropometric variability?

That’s just a fancy way of saying your proportions will be changing rapidly, and these changes must be accounted for when designing a program.

It’s not hard to visualize a woman going through the physical progressions of pregnancy—and from this, intuit how these changes might impact exercise.

To start, the continuous and rapid growth of the infamous pregnancy belly is going to require some serious workarounds. Most women will begin to see visible distention by the second trimester, if not sooner. Obviously, the onset, speed, and severity of this process will vary from mother to mother, but the outcome inevitably leads to some degree of exercise modification.

Though overly simplistic, the “backwards backpack with a bowling bowl in it” analogy isn’t too far off from the perspective of program design—the mechanics and impact on the body are pretty similar to that of the third trimester. And we probably don’t have to follow through with this thought experiment in practice to understand that shifting the center-of-mass anterior and dramatically expanding the waist circumference will create many downstream effects that have to be managed. Due to the former, the pelvis will get pulled into anterior tilt; the posterior postural muscles will be asked to work overtime; and the hamstrings will lengthen, quads/hip flexors will shorten, and glutes will , in turn, be mechanically disadvantaged from producing force. Because of the latter (enlarged waist circumference), gait will be altered, movement patterns affected, range-of-motion limited, and certain exercises rendered impractical.

Though I’ve chosen to highlight these specific variables, that’s not to say that there won’t also be sweeping anthropometric and biomechanical changes happening elsewhere. But the anterior shift in center-of-mass and expanding baby bump are, by far, the most impactful when it comes to affecting how expecting mothers need to think about training.

There’s a Human Growing In There

Because there’s a little person inside your belly, we should probably take care to not compress it too much or increase intra-abdominal pressure too violently. I would really hope that this one is pretty intuitive and doesn’t really require a whole section to hammer home the point, but let’s just cover our bases…

Babies are precious and delicate and vulnerable; and they should be treated as such. At every point throughout this process, the health of the mother and child should be the absolute priority. But one thing that’s easy to overlook is that the mom is much more resilient and robust than the baby. Whereas the mother can voice her aches and discomforts, the baby can’t. Whereas the mother can easily shake off a bruise or mild trauma, the baby can’t. Whereas the mother can respond and adapt to external demands, the baby can’t.

So it’s on us (i.e. the designers and/or implementers of the program) to make a priori assumptions about the baby’s fragility/condition/state and account for them ruthlessly. We have to operate within the supposition that any exercise that unnecessarily compressed the belly, or any technique of that excessively raises the intra-abdominal pressure, should be preemptively avoided.

Training through pregnancy isn’t about eliminating all risk—that’s just not possible under the circumstances. Instead, it’s about not doing the dumb shit that creates unnecessary risk.

And with that, it should go without saying that lying flat on your belly and/or wearing a lifting belt should be vehemently contraindicated once you begin to show.

What About Intensity?

Ah yes, my favorite topic! But this time, it’s intensity with a twist.

When I talk about intensity, it’s usually in the context of a proximity to failure. RPE and RIR tend to dominate the conversations as ways to modulate that proximity. And the quality of our volume is typically measured as a function of that proximity.

But with pregnancy (especially the last two trimesters), we shouldn’t care AT ALL about failure. It’s doesn’t even need to be in the discussion. As such, RPE and RIR can still be useful tools, but we need to think of them slightly differently. Rather than measuring the quantity of effective reps, the focus should be shifted to the quality and magnitude of effort and strain.

In theory, this is actually what RPE should be gauging (RPE=Rate of Perceived Exertion). In practice, the default use case has almost always been correlated with failure. However, with pregnant women, effort and strain must be our North Star, because the line between “not enough” and “too much” is the difference between “regression of fitness” and “unnecessary risk”—and that line is contracting by the day.

So what are we to do? We don’t want to just be going through the motions creating absolutely zero stimulus and wasting time. But we also have to be extremely cautious about drifting too close to the Sun.

Even someone who knows nothing about pregnancy or exercise can probably come to the logical conclusion that training intensity should taper down as the due date approaches. And they would obviously be correct in that assessment if we were still measuring intensity as we normally would; but in my opinion, that is still viewing a very complex topic through an overly-simplistic lens.

The definition of intensity, as we’re now using it, is something new—Shifting from reliance on the rigid and binary failure as the primary target to the intangible and fluid hardness allows us to cheat the system somewhat. We can make things challenging without making them traditionally intense, by absolute or relative standards.

The simplest way to do this is by shifting exercise selection to movements that reduce ancillary dependence and isolate only ONE quality or muscle group at a time. While Smith Squats are a phenomenal way to build the quads under normal circumstances, they can easily be replaced by Leg Extensions, thereby, reducing the ability of the glutes and erectors to contribute, as well as lowering the need for abdominal bracing. Similarly, a Standing Barbell OHP might be a great way to build upper body pressing strength but the stability prerequisites impose unnecessary demands for the pregnant athlete; whereas, moving to a Seated variation allows the same qualities to be trained without the potential risks.

Additionally, we can deliberately shift to more unilateral work, adjust tempos, implement more machine/cable movements in lieu of their barbell/dumbbell counterparts, and even get creative with techniques that can increase the intensity without increasing the intensity like isoholds, loaded stretching, 2 Up/1 Down, etc.

Granted, everything that is proposed here is meant to be a template rather than prescription. There are still more ways to fuck this up drastically than there are ways of actually doing it right. Much of how intensity during pregnancy should evolve will come down to subjective feedback and modification in the direction of best fit for the individual.

As a general rule, remember that intensity must be thought of differently during the last two trimesters and postpartum—from there, select the appropriate building blocks, plug-and-play, iterate, and refine the programming until the end result is practical, effective, and most of all, safe.

Y/N Exercises:

We’ve gone over a good amount of information up to this point, and I’m sure you’re sitting there screaming “JUST TELL ME WHAT TO DO FFS!”

First, take a breath.

Second, something about teach a man to fish yada yada nonsense.

Third, ok fine here we go…

Let’s walk through a very non-comprehensive list of movements that should generally be avoided during pregnancy, and how to modify them to their simplest and most similar corollary (i.e. still keeping within the same general patterns):

• Conventional Deadlifts -> Trap Bar Deadlifts
• Barbell Squats -> Wide Stance Landmine Goblet Squats
• Leg Press -> Wide Stance Deadstop Leg Press
• Standing Barbell OHP -> Seated Machine OHP
• Seated DB OHP -> Tall Kneeling Single Arm Landmine Press
• Chest Supported Rows -> Seated Low Cable Rows
• Bent Over Barbell Rows -> Single Arm DB Rows
• Barbell Bench Press -> Machine Chest Press (preferably sitting upright)
• Weighted Crunches -> Deadbugs (though, supine positions need to be modulated by individual)
• Barbell Hip Thrusts -> Feet Elevated Hip Thrusts (remove load across lap; hip thrusts/bridge movements can also be done unilaterally)
• Barbell Hip Thrusts -> Single Leg Cable Glute Kickbacks (further regressed from above)
• Lying Hamstring Curls -> Seated Hamstring Curls
• Ab Wheel Rollouts -> Swiss Ball Planks
• Ab Wheel Rollouts -> Push-Up Position Planks (further regressed from above)
• Ab Wheel Rollouts -> Push-Up Position Planks Against Bar (further regressed from above x2)
• Russian Twists -> Band Pallof Holds

Again, I want to emphasize that this is a very short list of the movements that will inevitably be affected by pregnancy, and the modifications are just meant to be examples of how specific exercises can be adjusted to account for the pregnancy-induced contraindications. Always get your programs created and tailored to your individual needs by a professional who knows what they’re doing.