“I’m pregnant.” Hearing those words from a client might make you jump for joy alongside her or leave you wondering if you’ll lose her as a client. Her good news can be good news for you too, because exercise during pregnancy is not put on pause; it’s a shift. Most healthy individuals can continue to train during pregnancy. In fact, it is recommended by health organizations worldwide.
This shift will require care and attention on your part. It requires conscious program structuring and a physiological understanding of how the body changes during pregnancy. In this article, we’ll walk you through how to build programs for pregnant clients in each trimester and how to incorporate strength training and pelvic floor exercises for optimal health. We’ll also dive into the do’s and don’ts of training pregnant women and how to help them stay moving through the healing postpartum period.
Planning Exercise During Pregnancy
Exercising during pregnancy has many benefits for both mom and baby. It promotes physical and mental health and may make the postpartum recovery period easier. Exercise has also been shown to decrease back pain, promote healthy weight gain during pregnancy, and decrease the risk of gestational diabetes and the need for a C-section.
Exercise programs can include a variety of activities as your client’s health allows, including cardio, strength training, and flexibility work. Most clients benefit from moderate-intensity physical activity during pregnancy. For those who have been highly active leading up to their pregnancy, they may be able to sustain higher-intensity activities, and for those with complicated pregnancies or other conditions, it may be more beneficial to choose low-intensity activities.
The American College of Obstetricians and Gynecologists (ACOG) recommends that pregnant women engage in 150 minutes of moderate-intensity aerobic activity each week. Encourage clients to choose exercises that engage large muscle groups, such as walking, swimming, or aerobics. Your client’s needs and abilities will likely change as they progress through their pregnancy, and it is important that their program changes with them.
Building Trimester-Based Training Plans
Each trimester of pregnancy comes with its own unique set of challenges and characteristics. If you train athletes, you could think of pregnancy as a macrocycle, with each trimester being broken down into mesocycles. Just as you would change a client’s program regularly to encourage progress, a program for a pregnant client needs regular updates to ensure that it is safe for both mother and baby.
Before starting or continuing any exercise plan, the client’s OB-GYN should be consulted. They can provide valuable insight into activities beneficial for the client and those that should be avoided.
Now, let’s dive into some specifics for each trimester:
First Trimester
During the first trimester, women typically experience a range of symptoms, including morning sickness, fatigue, and hormonal fluctuations. If your client experiences morning sickness, try changing your sessions to afternoons or evenings, a time when she might feel better and have more energy. Morning sickness also makes it difficult to keep food down, which can result in lower energy levels and poor nutrition if not monitored.
Workouts should be altered accordingly to ensure that energy expenditure is not contributing to a calorie deficit. Pregnancy is not the time to focus on weight loss. If your client has been on a weight loss program, it should be stopped during pregnancy, unless otherwise indicated by the client’s OB-GYN.
Fatigue can make exercise programs more difficult to adhere to. Rather than pushing clients to be at the top of their game, encourage self-compassion and grace. Focus on any movement that feels accessible and good. This may mean trading your strength session for a yin yoga class or a tempo run for a bike or swim.
In all trimesters, especially the first one, care should be taken to ensure that the client does not overheat. Workouts should be done as much as possible in temperature-controlled spaces or with appropriate clothing for the weather if done outdoors.
Building healthy exercise habits during pregnancy starts in the first trimester. If you, as a trainer, can help it feel safe and enjoyable, your clients are far more likely to stay active throughout their pregnancy and beyond.
Second Trimester
During the second trimester, morning sickness may ease up, resulting in higher energy levels and greater tolerance for loads and intensity. Your client may feel better and up for more exercise if this is the case.
It is during this trimester that many women begin to show as the baby grows, which may make some exercises uncomfortable.
Starting at the beginning of the second trimester, women should not do exercises that require them to lie on their backs. This can compromise blood flow to the mother and baby. Instead, choose exercises where clients can remain upright or seated.
Third Trimester
During the third trimester, the most outwardly noticeable changes occur. As the baby grows, it can affect a woman’s balance, stability, and center of gravity. Posture may also be compromised by weight gain and the moving baby.
Comfort and safety are key in this stage. Continue to avoid exercises that require lying down on the back or belly, and change the intensity and speed of exercises as needed so that they can be done without loss of balance. Exercise volume may need to decrease during this time as well, so plan each workout with intention – cutting out extra exercises or replacing single joint ones with a single compound movement to lower volume while still making progress.
Program exercises to support posture and relieve back pain, including gentle stretching and strengthening exercises. Use supports or props as needed to facilitate activity. Belly bands are a great option to offer support and pain relief during activity.
Throughout a client’s pregnancy, match your programming to the trimester they’re in, not just the symptoms they’re experiencing.
Programming Core and Pelvic Floor Exercises
It may seem counterintuitive to work the core muscles during pregnancy, as they’re constantly being pushed and expanded, but it can actually be just the opposite. Core strength can help reduce back pain, improve posture, and support a healthy pregnancy, delivery, and recovery.
A gentle reminder that the core includes so much more than just the ab muscles. Especially when working with clients during pregnancy, incorporate exercises for all core muscles – the abdominals, lower back, glutes, hips, and pelvic floor.
Let’s address the pelvic floor. Few trainers know how to train it, and even fewer want to. My invitation to you, trainer to trainer, is to get comfortable talking and teaching about it. Your clients will thank you (once they get over that initial awkwardness you both may feel). Having a strong pelvic floor can make all the difference in the end uncomfortable stages of pregnancy, improve the delivery experience, and help encourage healing in the months and years following giving birth.
Pro Tip: Before you talk about pelvic floor exercises with your clients, practice conversations with yourself. Learn to speak comfortably and respectfully. If you appear more at ease, your clients will be too. In a recent class, I brought up the pelvic floor and saw a few eyes bug out before we talked through it, and by the end, everyone was comfortable and laughing. If the pelvic floor isn’t something you’re comfortable addressing with your clients, consider referring them to a resource (handout, book, video, other trainer, etc.) that can provide guidance.
When training the core and pelvic floor during pregnancy, your typical sit-ups and leg raises aren’t ideal. Instead, we want to focus on functional movements that build strength and stamina without increasing intra-abdominal pressure. Avoid exercises that increase this pressure and ones when your client tends to hold their breath. Planks are a common example. They can be done safely in some cases, but many people hold their breath during planks, making it unsafe during pregnancy.
Throughout all exercises, coach your clients on their breathing and make sure they maintain a steady inhale and exhale to ensure a constant flow of oxygen to the baby.
Beneficial prenatal core exercises include:
- Diaphragmatic breathing, which encourages oxygen flow and can be beneficial during labor.
- Kegel exercises to strengthen the pelvic floor and aid in delivery.
- Pelvic tilts to strengthen the abdominals and ease lower back pain.
- Bird dogs (if balancing is difficult, lift only one limb at a time) to improve core strength and balance.
- Cat-cow yoga pose to stretch and strengthen the core.
You can incorporate these exercises into your regular workouts or give them their own day or segment. Another great way to add activity and core work is to offer or refer clients to classes like prenatal pilates or prenatal yoga. They’re a great way for other expectant moms to connect and exercise together.
Strength Training for Personal Trainers Working with Pregnant Clients
When it comes to creating an exercise program for pregnant clients, specific recommendations are made for cardiorespiratory activity (150 minutes/week of moderate-intensity activity, in case you missed it earlier in the article), but strength training is left more open to interpretation.
Strength training is beneficial at all stages of pregnancy and can help regulate weight gain, increase energy levels, boost confidence, and so much more. When other forms of exercise become difficult later in pregnancy, strength training is often an activity that can be done in every trimester if done safely.
Incorporate each major muscle group in your programming, and don’t be afraid to get creative or use different equipment. Free weights and resistance bands are often more forgiving of changing body sizes, while machines can offer support and stability for loosening joints. Focus on functional movements that will support your client’s current and future daily activities and that improve stability.
Where possible, choose a variety of exercises in both standing and seated positions. If your client is short on energy, try low-impact compound movements to make the most of their time and ability. If they are experiencing morning sickness or have difficulty balancing, try seated exercises or ones with extra support.
Exercises that involve the Valsalva maneuver, breath retention, or otherwise increase intra-abdominal pressure should be avoided during pregnancy. Read on for additional safety precautions when training pregnant clients.
Exercise Safety Precautions for Prenatal Training
As with any special population, there are several precautions that should be considered when training pregnant clients.
Activities where a client or their baby could become injured should be avoided. These include contact sports, activities with high fall risks, exercise in extreme weather, and activities outside of a client’s typical altitude level (e.g., high altitude training or scuba diving).
In all activities, promote good posture and steady breathing. Pregnant clients should not lie on their backs starting in the second trimester to maintain blood flow and oxygen delivery to mom and baby. Avoid activities that lock out joints or that overstretch them. Hormones that increase during pregnancy can cause joint laxity, making joints more prone to injury.
The recommendations made in this article are based on the assumption that your client is apparently healthy and has been cleared to exercise by their OB-GYN. Pregnant women should be in frequent communication with you and their healthcare provider regarding their exercise to ensure that their program changes as their needs do.
If a client has complications or high-risk conditions, they should be referred to a medical professional before training. In some circumstances, they may need a medically-supervised program or may be unable to exercise until after delivery. Remember to stay in your scope of practice and know when to refer out to keep you and your clients safe.
Postpartum Programming to Support Overall Health and Recovery
Once the baby arrives, the body still needs time, structure, and support. Your client’s priorities will likely change, and a great amount of time and energy will be devoted to the care of their new baby. Rather than pushing them to get back to their “pre-baby body,” emphasize a gradual return to strength work, starting with gentle stretching, mobility, and breath-led movement.
Movement often begins with upper body stretching to combat tight muscles from holding their baby. Once cleared by their OB-GYN to do so, help your clients rebuild abdominal muscles and restore pelvic floor function. This should be done before progressing to heavier loads and complex exercises.
The internet is rife with moms who seemingly bounce back within days of delivering. Remember, though, and remind your clients that everybody recovers on their own timeline, not arbitrary milestones.
Protect Yourself with Fitness Liability Insurance
Training pregnant clients carries elevated legal risk, and liability insurance is non-negotiable for protection against accidents or injury. Choose insurance that covers prenatal training and over 500+ fitness modalities to match your evolving scope.
Insure Fitness Group provides up to $1 million per occurrence and understands the needs of certified personal trainers and their pre- and postnatal clients. Liability coverage reinforces your professionalism and safeguards your business as much as structured programming protects your clients. It ensures that your business is as protected as the programs you write.
Training clients through pregnancy can be rewarding all around. When you help your pregnant clients create healthy lifestyles, you are impacting them and their future family. With a policy and support from Insure Fitness Group, you can be sure that your business is as safe as the programs you write. Get insured today to get started.
