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Cardio through the Trimesters

When women find out they are pregnant, they often experience a whirlwind of thoughts and emotions. They might be happy, surprised, or relieved. But after the happy dance around the pee stick, the call to the significant other or the quiet contemplation of what is to come, most of us think a singular thing:

What do I do now?

As we mentally shift from “me” to “we” our confidence in our bodies can fade. Suddenly we wonder whether we are doing the right things in the gym. We wonder if we are doing the right things for the baby. We want to know the best things that we can do for our health and our baby’s health.

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I recently wrote an article for the NDDC about the safest exercises you can do during pregnancy. But today we aren’t going to talk about weights–today we are going to talk about the “c” word.

Don’t get any funny ideas, I’m talking about cardio! In my experience, women tend to have a conflicted relationship with cardio. Cardio is often used as a weight loss strategy for women. Many women assume because most distance athletes are thin, the key to getting thin themselves is to become a distance athlete (or a gym equivalent) too. So they start clocking hours on the elliptical, they take 2-3 classes a day and they start to run themselves into the ground.  (Teta, J., & Teta, K. (2015). Lose weight here: The metabolic secret to target stubborn fat and fix your problem areas. New York, NY: Rodale.) This approach, however is flawed. Hours of cardio will not make you thin. Many distance athletes are naturally thin, and they’ve chosen a pursuit that suits their bodies.

Very seldom does cardio the way we traditionally think about it help women achieve the physique they seek. Cardio becomes a punishment–something women do to change their bodies, not something they do because they enjoy it or because it will make them more fit and capable. Our bodies are not best served by clocking endless hours on the treadmill or the elliptical. And neither is our pregnancy.

Cardio is one of those things that, done right, can really open up our world. More energy, better sleep, and improved likelihood that we’ll reach our weight loss goals. But done wrong, we open ourselves up to metabolic damage, pelvic floor dysfunction, weight gain and more.

Cardio…a full body endeavor

20160211_080541Our heart depends on movement to help it function correctly, which is a fact lost on many of us. We think the heart is the only muscle responsible for pumping blood through our bodies, but our circulatory system is immense! Think about all the veins, arteries and capillaries reaching out to the far corners of our body. Each follicle of hair has it’s own blood supply!  Supplying oxygen to that entire network with just the heart would deprive the heart and lungs of oxygen…yikes! We don’t have enough blood to fill our entire body all the time. If we did, we would be too heavy to move around well. So, our body made a compromise. We are lighter and have less blood. The heart needs movement to get the blood all the way out to the capillaries. Our bodies need movement for proper circulation.

Katy Bowman puts it best, “If you don’t move, your cells don’t get fed. If your cells don’t get fed, they die. So now we have yet another reason movement is not optional…movement is an essential step in the process of oxygen delivery.” (Bowman, K., & Lewis, J. (2014). Move your DNA: Restore your health through natural movement.)

When we are pregnant our blood volume doubles. Between this and building a placenta, we often feel so tired during that first trimester! Your pregnant heart needs to now work twice as hard to deliver oxygen to all your cells. This makes cardiovascular exercise and movement even more important. We want to grow our babies under the best conditions possible. We want to rid waste efficiently. We want to fuel our bodies. Oxygen delivery is essential for you and your cells to survive and thrive.

I want to encourage women to move and move often during pregnancy. Whether we were exercising before pregnancy or not, we want to move because it is so important to our health and the health of our baby. But there is a delicate balance here–I want women to move in ways that supports us mentally, emotionally and physically without causing harm. Exercise should enhance your life, not take away from it! Let’s see movement as an essential part of our lives without feeling like it is a punishment. Exercise is a privilege. It is a gift we give ourselves, our babies and our children. I’m going to break down the best ways to use cardio as a tool for optimal fitness and recovery throughout all four (you heard right…I include postpartum as the fourth trimester) trimesters.

First Trimester

Cardio can be a great way to get some energy back and get some endorphins flowing to combat that three month hangover known as the first trimester. We might not be showing on the outside yet, but we are most likely feeling pregnant on the inside. The first trimester is when most women feel tired and nauseous. Although you may be tempted to do pretty much what you were doing before conception, I like to have my mama clients begin utilizing the “talk test.” The talk test means we exercise at an intensity that still allows us to hold a conversation. Many women in their first trimester might be surprised that they reach their limit faster than they think. It is normal to be a little out of breath because of how hard your body is working to grow your blood volume and the placenta.

Keeping the intensity a little lower in these first three months is also a good idea because relaxin levels are at their highest in the first trimester. Relaxin is believed to promote implantation and the growth of the placenta but it’s famous for loosening or “relaxing” the joints and ligaments of the body in preparation for birth. Lower intensity cardio can lessen chances that there will be a loss of balance or a trip or fall. (Perry, L. J., & Vodstrcil, L. A. (2007, January). Relaxin physiology in the female reproductive tract during pregnancy. Retrieved September 21, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/18161480)

My favorite cardio recommendations for the first trimester are low intensity, steady-state sessions or Fartleks, either walking outside or on the elliptical. Steady-state cardio refers to exercising at a consistent (in this case, low) intensity. Fartleks are an interval-style approach where the work and rest times are dictated by how the exerciser feels and are variable. For example, if you are outside you can try and speed walk from one tree to another then walk slowly until you feel rested. Plus, the fresh air can combat nausea! Or, on the elliptical, you can “sprint” during the chorus of your favorite song, then go slowly until you feel recovered. I like the elliptical better than the treadmill for indoor options because the treadmill pulls your feet backwards, which can keep the pelvic floor from functioning properly. Minding the function of your pelvic floor is important, even this early in the game.

Second Trimester

The second trimester feels kind of like a second wind. Most women start to feel much more like themselves again. Your energy levels are most often up. Your sex drive improves (capitalize on that!). You might find that even using the “talk test,” you are able to do a lot more.

The second trimester is when I highly recommend that you give up running. During the second trimester your baby is starting to grow rapidly. The weight of the baby resting on your pelvic floor, coupled by the repeated impact of your morning jog can spell disaster for core function during and after pregnancy. In addition, that growing baby is starting to pull you out of proper alignment which can also contribute to poor core function, back and knee pain.

I suggest that my clients try hill “sprints” instead. A fast walk, in the balls of your feet, up a hill and a leisure walk down is a great way to get the benefits of cardio exercise without the pitfalls and impact of running. Hills put your body into an ideal alignment that sets you up for proper core function.

Another type of cardio that I recommend during the second trimester is circuit training. This is a weights based training where the repetitions are high and the weights are low. I usually set my clients up with 3-4 exercises that they move through for a set period of time. This helps build endurance that they will need for the rigors of childbirth. It will get their heart rate up. And the variability of movement helps pump blood into the capillaries, feeding the cells.

Third Trimester

Low intensity is your best friend as you round the home stretch in pregnancy, especially if you are able to get outside. A leisure walk outside might be about all you feel you are able to do. Scientists have found that exercise not only improves brain function (good for those bouts of “mommy brain”) but also increases dopamine in our system. This means that we feel fresher and happier! (Stroth, S., Reinhardt, R. K., Thone, J., Hille, K., Schneider, M., Härtel, S., . . . Spitzer, M. (2010). Impact of aerobic exercise training on cognitive functions and affect associated to the COMT polymorphism in young adults. Neurobiology of Learning and Memory, 94(3), 364-372. doi:10.1016/s1074-7427(10)00152-8) For these long, leisure walks I encourage my clients to try not to waddle. The side to side motion of waddling can tighten muscles in your pelvis and core that can put pressure on your abdomen, widening the gap between your abdominal muscles (diastasis recti). Swimming or water walking is great during this time as well because the pressure of the water can calm your nervous system, the buoyancy can help your joints and back feel better. Steer clear of activities where you might stumble as your balance will be changing during this time.

Fourth Trimester

Slow and steady wins the race after baby is born. With this transition many women can feel some very strong urges to do too much too  soon. Some women feel pressure to get their pre-baby body back. Our society seems to glorify the quick postpartum “bounce back.” This can be really detrimental to a new mom. It sets unrealistic expectations of her body. It can pressure her to do exercises that are too hard for her healing postpartum body. And it sets the standard that there is something wrong with a woman’s body changing despite the fact that she just did something amazing! Actress Kerry Washington said it best: “I’ve been really focused on not being ‘back’ to anything but being the best version of myself right now. My body is the site of a miracle now. I don’t want to be pre-miracle.”

Another thing to consider is the “high” that some women feel postpartum. This has been called the “baby-pinks.” After having my last baby I was on a high for over two months. I felt impossible, overwhelming love for everyone. I had an unreasonable amount of energy for someone who was sleeping half the recommended amount while also producing enough food to sustain and nourish another person. I had to constantly remind myself to slow down. To do a little less. To honor my body’s healing process. Women who experience the baby-pinks will want to tread carefully with exercise because they might be tempted to push themselves too hard, too fast because they are so full of endorphins.

However, with my first baby my experience was completely opposite. I suffered from a deep depression that made me feel like doing nothing. I felt vacant and lethargic. Postpartum depression is often a terrible surprise for many women who have been happily anticipating their baby’s entrance into the world. Postpartum depression affects over 3 million women in the United States. (Postpartum depression facts. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/postpartum-depression-facts/index.shtml. Accessed July 16, 2015)

Exercise has been shown to greatly improve mood and lessen the effects of PPD. (Daley, A., Macarthur, C., & Winter, H. (2007, February). The Role of Exercise in Treating Postpartum Depression: A Review of the Literature. Journal of Midwifery & Women’s Health, 52(1), 56-62. doi:10.1016/j.jmwh.2006.08.017) Women who suffer from PPD, or women who want to make efforts to prevent PPD can and should use exercise as a way to boost endorphins naturally. In the early days of postpartum a short walk outside might be enough. As you get stronger and feel that your core is functioning properly, adding a set of squats into your daily activities can help get your heart rate up and aid in the release of those happy hormones.

Some of the best ways to graduate back into cardio after baby are hills (again, I know, but they are so good), leisure walks and eventually circuits.

I don’t recommend running until at least 6 months postpartum, and even that seems a little early. Pregnancy and childbirth is the biggest, most extreme transformation a body can go through. Before introducing any impact on your healing pelvic floor, you’ll want to take some time to strengthen it and make sure that it is functioning properly with the rest of your core and body.

Cardio is a great way to explore movement in your body. Find the things that you like to do. Get outside. Use cardio as a way to celebrate, love and explore your body…not punish it. Reclaim the “c” word!  Reclaim cardio!

P.S. If you’re looking for more guidance with working out during pregnancy and after, make sure you don’t miss our upcoming 6 week workshop Core Essentials! Get event info and register here.

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