Trimester by Trimester: Your Instruction Manual For Exercise and Movement

When most women find out they are pregnant, they think twice about what they feed their body and baby, striving for high nutritional value.  Sometimes they crave nutrient-dense food; other times it’s mashed potatoes and ice cream.  Like everything in life, there’s room for both, and finding a good balance is best.  The same is true for movement. 

What is your appetite for movement? 

If you crave intense, heart-pumping cardio, you may need to build in some thoughtful rest.  And if you crave rest and stillness, you may need to build in some more movement and exercise.  It’s all about balance.  And this lesson will serve you well in motherhood.  Society and social media appear to reward perfection when we should strive for balance instead.

Speaking of balance, your center of gravity constantly shifts throughout your pregnancy, so avoiding activities with a high likelihood of falling is best.  This also isn’t the best time for contact sports or exercising in the extremes of temperature.  But most importantly, you should choose forms of exercise and movement that bring you joy. If your internal conversation during your exercise sounds like this:

• “I hate this.”
• “I’ll never be good at this.”
• “I can’t wait until this is over.”

….your body may be registering your movement session as stressful.  We have plenty of other things to be stressed about these days.  Exercise shouldn’t be one of them, and there are far too many choices when it comes to getting nutritious movement to pick something you don’t enjoy.  Plus, don’t make me pull up the research about how your own stress and anxiety affect your baby!

Let’s take a look at what is happening throughout your pregnancy to help you choose a movement strategy that’s a good balance of everything you need to build a body capable of supporting your pregnancy, birthing your baby, and is primed for a smooth recovery.

(Disclaimer:  Here’s everything the American College of Obstetricians and Gynecologists thinks you should know about exercising safely during your pregnancy.)

First Trimester

Congratulations, you’re pregnant! Now what?! As long as you’re not considered a high-risk pregnancy, you can continue with your regular exercise routine in the first trimester with a few simple modifications.

1. As mentioned above, avoid high-contact sports, extremes of temperature, and fall-risk activities.
2. Keep your cardio activity at a moderate intensity level or less.  It can feel somewhat hard but you should be able to maintain a conversation without gasping for air.
3. The pregnancy hormones progesterone and relaxin can make joints and ligaments throughout your body (but especially in your pelvis) feel more unstable.  Your pregnant pelvis prefers symmetrical activities like squatting instead of one-legged activities like kickboxing or aggressive step classes.

But what if you don’t have a regular exercise routine? 

Well, there’s no better time to build one.  Aim to get 30 minutes of cardiovascular activity on most days.  What does that look like?  If your area and temperature allow it, that can be a brisk walk in nature.  You can also swap that for some treadmill time or pedaling on a stationary bike.  Water exercise is a favorite among many pregnant women.  That could also look like intentional movement around your house: turn up the music and do your house chores with a little more heart-pumping zest.  Or discover more creative commuting time to work: trading an Uber or cab for a walk, parking at the far end of the parking lot, skipping the elevator and taking the stairs, returning phone calls as you do laps around the building, or doing a few squats after every email you send! 

You also want to build in 2-3 days of strengthening with extra focus on developing core strength.  Now is the time to trade making the big muscles bigger for focusing on the deeper muscles responsible for stabilizing the hips, pelvis, and spine.  Looking for ideas?  See the blog I wrote on my eight favorite Prenatal Pilates exercises.

And what if you feel too lousy even to contemplate a movement routine in these first three months when you’re using every available energy reserve to stay hydrated and nourished?  There’s room for you too, and your second trimester is just around the corner, so hang in there!

Second Trimester:

Most women claim to have the most energy in this trimester, so it’s an excellent time to fine-tune your fitness routine.  You can keep up the cardiovascular activity from the first trimester. Still, as your uterus and baby grow, that is more weight for the pelvic floor muscles to deal with, so I recommend avoiding high-impact activities involving wide-leg separation.  For example, replace regular jumping jacks with half jacks.  

In addition to keeping the core muscles strong, don’t forget about building in some upper body strength as well.  After all, that baby you’re carrying in your belly will eventually need to be carried in your arms (along with a diaper bag, car seat, etc).  But I’d caution you against lifting heavy weights, especially overhead.  This might be a little too much intra-abdominal pressure for your pelvic floor muscles to manage, plus it’s not like you’ll be asked to press your nurse during delivery overhead so there’s no real NEED to train this way right now.  

Speaking of intra-abdominal pressure, the pregnancy hormones relaxin and progesterone affect all the connective tissue in your body, not just in the pelvis. Hence, the area between your “6-pack” muscles, called the linea alba, might be slowly separating to accommodate your growing baby and growing uterus (you were perfectly designed to birth a baby so this is not a flaw in the plan).  However, this is not the time to add the extra intra-abdominal pressure of aggressive abdominal exercises like crunches, weighted twists, double leg lowering, or even excessive time in all 4’s positions.  Otherwise, this tissue may stretch beyond its anatomical capabilities.  Learn more about diastasis rectus abdominus in pregnancy here and here.

Get creative with your pelvic floor exercises as well.  While Kegels are great for getting the pelvic floor regularly contracting AND relaxing, you cannot simply Kegel your way into the 4th trimester unscathed.  It’s time to start incorporating your pelvic floor into the exercises you are already doing (like squats and side leg raises, and bridges) and the daily activities you are regularly participating in (sit to stand, lifting a pot from the bottom cabinet, sneezing/coughing). Read more about why Kegels aren’t enough here (link to Kegels Aren’t Enough) and here (link to What Your Pregnant Pelvic Floor Needs). 

Third Trimester

There’s a light at the end of the tunnel.  You can see the finish line!!!  But you might be starting to slow down.  After all, it takes energy to grow another human while you are growing so much yourself!  You may need to trade some moderate-intensity cardio for some lower-impact/lower-intensity movement.  If you have access to a pool, water exercise can be a welcome relief while still keeping your heart rate up.  

The core strengthening you did early on in your pregnancy will pay off for you now.  You’ll be grateful to have woken up those deeper stabilizing muscles to help support your pelvis, but it’s also never too late to nudge them into action.  Continue to be mindful of activities that may create a level of intra-abdominal pressure that might be hard for the connective tissue between your abdominal muscles and pelvic floor muscles to manage.

If you haven’t added in some hip stretching, now is the magic hour!!!  Regardless of the position you deliver your baby in (supine, side-lying, squatting, all 4’s, etc) your hips need to be flexible enough to work with you, and your pelvic floor needs to know how to lengthen and relax to slide your baby out.  

Here are a few of my favorite pregnancy stretches:

1. Flat Back: Position yourself near a countertop or the back of a couch.  Keep your back straight, hinge from your hips to set your forearms on your surface to support your upper body.  Keeping your knees straight, lunge your bottom back like you are trying to touch the wall behind you.  Think about bringing the back of your thighs to the floor while you enjoy a glorious hamstring stretch that keeps the weight on your pelvis symmetrical. Hold 30 seconds.
2. Inner groin:  Keeping the same alignment as above, separate your legs wider than hip-width (as long as you are not experiencing any pain in the pubic symphysis region).  Allowing your upper body to be well supported on your forearms, bend your right knee and lunge towards the right.  Think about bringing your left inner thigh towards the floor to enjoy a magical stretch in the left inner groin.  Hold 30 seconds. Repeat on the other side.
3. Modified Happy Baby: Instead of laying flat on your back, which isn’t the best position for this stage of pregnancy, sit on an exercise ball or ottoman near a wall (make sure you have support to get in and out of this position safely).  Slide the ball or ottoman to the small of your back and place your feet up on the wall turned out.  Allow your bottom to sink towards the floor to experience a deep stretch in the adductor muscles, perfectly preparing you for most birth positions.  Stay here for 30 seconds (or longer if you’re up for it).  Note: This should NOT cause tension in the neck and shoulders, so adjust your ball or ottoman to find a comfortable position.  If you are experiencing discomfort in the pubic symphysis, this and other movements involving wide separation of the legs should be avoided.
4. Mermaid:  I love this exercise so much that I wrote a whole blog about it!

While that’s all the time I have for today, there are better ways to exercise and move in the 4th trimester (the 40 days after you give birth). Read more on that here and here.

Before I sign off, just a reminder about the importance of balance, getting a good balance of cardio and deep core strengthening and stretching is essential.  Balancing your movement and exercise strategy with your current mental state and trimester is genius.  And remembering, as Jill Churchill tells us, “There’s no way to be a perfect mother, and a million ways to be a good one.”