More than heavy weights: Resistance training may hold big benefits for pregnant women
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Key takeaways:
- Resistance training is safe and effective for most pregnant women, but expert guidance is lacking.
- More support and education are needed about resistance training during pregnancy.
Pregnant women seeking an exercise routine that can potentially alleviate some pregnancy symptoms and improve delivery outcomes might be surprised to learn that resistance training, performed with guidance, could be an easy option.
Despite evidence that demonstrates resistance training is safe and even beneficial for pregnant women, exercise recommendations for pregnant women still minimize the importance of resistance exercise and provide little or no guidance, according to Rachel Tinius, PhD, ACSM-CEP, associate professor of exercise science at Western Kentucky University and the CEO of BumptUp Labs Inc. The health benefits of aerobic exercise during pregnancy are well known; however, emerging evidence suggests resistance exercise is equally important for improving a range of conditions, from gestational diabetes and obesity to labor and delivery outcomes. And despite what some may think about resistance training, it is not all heavy weights and dumbbells, Tinius said.
Healio spoke with Tinius about the lack of guidance available for resistance training during pregnancy, the potential health benefits for both the pregnant person and fetus and simple exercises for anyone who wants to get started.
Tinius and colleagues’ review on the benefits of resistance training for maternal and fetal health was recently published in the International Journal of Women’s Health.
Healio: Why is there so little information on resistance training during pregnancy?
Tinius: In general, pregnancy research continues to lag behind. Before you can perform any intervention with a pregnant person, it usually needs to be performed with a nonpregnant person. Many studies involve aerobic training or exercises that are easier to do, like walking or swimming. Resistance training requires more training and oversight. A trialist is not going to simply hand a pregnant women some dumbbells for a study.
It is a unique subset of the pregnant population that wants to do resistance training. But there are people out there doing it and there is no clear guidance out there that says, “This is safe.” It is safe, it is effective and it is something pregnant people should feel free to do. But we need evidence that talks about the combined benefits and potential risks and puts that all in one space.
Resistance training is not for everyone. But resistance training is not just about lifting 50-lb dumbbells and going to the gym. Resistance training with body weight is still resistance training. A person can perform push-ups and air squats in the backyard with their toddler. We need to flip the narrative and let people know that these exercises count as resistance training and they are really good for you.
Healio: What might be some of the health benefits for the pregnant person who performs resistance training exercises?
Tinius: The benefits you would expect to see in a nonpregnant person pretty much all transfer over to a pregnant person.
The mother has better overall fitness, strength, stamina and reduced low back pain. Some people fear that these exercises could exacerbate pain and it is actually the opposite — we see reduced pain from pregnancy symptoms with resistance training. Women also see reductions in high blood pressure, body weight and reduced risk for preeclampsia and cesarean delivery. Resistance training, alone or in combination with aerobic exercise, has also been shown to limit excessive weight gain and mediate the negative effects of weight gain on maternal health. It all comes down to calories burned and movement. Resistance training helps your body become more metabolically efficient.
When mom is healthier, the baby is also healthier. We see better outcomes for the fetus, including an increase in placental vascularity and growth and reduced oxidative stress from an increase in blood flow, which promote fetal growth and well-being. If I tell you, you are more likely to deliver vaginally, have a more efficient labor and have a baby at a healthy weight, those are motivating factors.
Healio: Who might be optimal candidates for resistance training during pregnancy?
Tinius: Anybody who wants to do it. That said, I would not recommend someone in their second trimester who has never done resistance training to suddenly start CrossFit in the weight room. But even a novice exerciser can perform air squats or modified push-ups. There are plenty of resistance training exercises that anyone could do.
I would reframe the question to say that there is no ideal candidate; however, the specific exercises you should do are based on your fitness level and your past experiences. Resistance training is not like running or walking where a person can just jump in. You must be trained on how to perform any exercises appropriately, especially when lifting heavy weights. Some of the mnemonic machines in the gym can help keep you from having bad form, because they are not free weights. They are another option for someone early on the resistance training spectrum. There are also people who love running or cycling or some other form of aerobic training, and then become pregnant, and for whatever reason those activities are no longer an option. Those women may benefit from trying something in the gym that is maybe more practical.
A big message is that just because you have never done resistance training before does not mean that you cannot start during pregnancy. If you already perform workouts with heavier weight exercises, there is little evidence to suggest you should stop doing that.
Healio: Are there risks that come with initiating or continuing with resistance training exercises during pregnancy?
Tinius: The risks are the same for pregnant and nonpregnant people. These include things like hurting yourself with weights or an injury from performing exercises using improper form. But unless someone, say, hits themselves in the belly with a weight very hard, there is very little risk for the fetus with resistance training.
Experts caution against doing a Valsalva maneuver during pregnancy because you do not want to isolate forces on the pelvic floor when pregnant. But most women are not purposefully doing that when training anyway. Appropriate breathing during pregnancy would certainly be helpful, and there are certainly some modifications in the exercises, but most of those come naturally.
But as we state in the paper, rather than increasing the risk for injury, resistance training decreases the risk of musculoskeletal injury during pregnancy when performed safely.
Healio: Clinicians may not have specific expertise in this area. How should providers counsel pregnant people about topics like resistance training during prenatal visits?
Tinius: I say that this is not the physician’s job. Clinicians are well trained in every aspect of managing a pregnancy. They are not supposed to be — nor should they be — exercise experts. They do not have the time to provide thorough counseling in this area and it should not fall on their shoulders. It is unfair. That said, patients may want this information and clinicians do not have it or do not feel comfortable providing it. So, whose job is that? Where did the ball drop? There needs to be a better system in place. How do we navigate this problem?
One potential solution is our mobile app, BumptUp. It has 300 resistance training exercise and outlines how to perform them appropriately. The app includes videos of pregnant women performing all of the exercises. I would love for physicians to be aware of that resource. It is expertly derived and evidence-based. The app is just one option, but it is a way to take this out of the physician’s hands.
Healio: What are your top takeaways from this review?
Tinius: Resistance training is safe and effective during pregnancy and it can be for anybody. However, to be successful, education and support are needed. Pregnant women who want to begin or continue with resistance training should not feel like they cannot. It is important to empower women who want to take this on.
References:
- BumptUp. https://bumptupapp.com/. Accessed July 8, 2024.
- Duchette C, et al. Int J Womens Health. 2024;doi:10.2147/IJWH.S462591.
For more information:
Rachel Tinius, PhD, ACSM-CEP, can be reached at rachel.tinius@wku.edu.