Many years ago, while I was pregnant with my second child, something happened that I hope no other group fitness instructor goes through. As I was driving to teach class, I experienced some cramping, but dismissed it. After all, I needed to get to the studio and I didn’t have anyone to cover for me. “I will go to the doctor later,” I thought. However, the cramping became so severe that I was rushed to the hospital. The diagnosis: an ectopic pregnancy. I was hemorrhaging internally, and I lost the baby. Within a few hours, the blood started compressing my lungs and I had trouble breathing. Emergency surgery saved my life. If I had taught class that day, I would not be alive to tell this story.
James F. Clapp III, MD, a pre- and post-natal fitness researcher, advocates exercise during pregnancy. However, he cautions pregnant athletes to be extra aware, because they do not have the same internal mechanisms that nonathletes do to tell them when to stop. Group fitness instructors can be put in that same “athletic” category. It’s important that fitness professionals know how to teach and train their pregnant clients, but also how and when to modify moves and lifestyle choices for themselves. This article addresses some of the top questions pregnant instructors ask.
Do I need to keep my heart rate at 140 beats per minute?
In 1985, the American College of Obstetricians and Gynecologists published its guidelines for prenatal exercise, cautioning women not to exceed a maximum heart rate of 140 bpm (Clapp 2002). Pregnant athletes found themselves in a quandary over these guidelines, since for many fitness enthusiasts 140 bpm hardly qualifies as a workout. In 1994, ACOG made its guidelines less restrictive, but the organization still failed to address the upper limits of exercise.
Current ACOG guidelines suggest moderate intensity, which means being able to talk during exercise (ACOG 2002). The American College of Sports Medicine recommends that moms-to-be stay within pre-pregnancy intensity levels and use rating of perceived exertion to measure intensity (Artal, Clapp
Vigil n.d.). Although an upper level of safe exercise intensity has not been established, women who exercised regularly before becoming pregnant and who have uncomplicated, healthy pregnancies should be able to engage in moderate-intensity activities such as jogging and aerobics with no adverse effects.
Can I do sit-ups?
ACOG continues to recommend that pregnant women not lie in the supine position after the first trimester (ACOG 2011). The concern is supine hypotensive syndrome, where the combined weight of the baby and the uterus obstructs the venous return and decreases cardiac output. This doesn’t mean that you can’t work the core; however, it’s important to remember that since the rectus abdominis is stretched over the uterus, it doesn’t have the same strength it did pre-pregnancy. You can still do a variety of vertical or incline core exercises, and even plank variations, as long as doing so does not cause stress to the back.
The Final Trimester
Do I need to stop working out/teaching during my last trimester?
The answer: Absolutely not. You may continue to exercise and teach; consistency is very important. If you work out three times per week at the beginning of your pregnancy, then you should strive to keep that frequency through each trimester. Your workout intensity may decrease, but you don’t have to compromise frequency as long as the number of workouts is consistent.
What about yoga? If you normally teach more-active classes, do you now need to teach prenatal instead? That depends on the class. There isn’t much research on yoga and pregnancy. Modifications are necessary, and it’s advisable not to participate in a hot yoga class. In Exercising Through Your Pregnancy, Clapp (2002) states that the upper limits of thermal response during exercise are not known. A rise of up to 3 degrees Fahrenheit does not seem to pose a risk. However, while you may be able to keep your core temperature in a safe range, is it worth the risk? Inversions are also not recommended. Pregnancy hormones cause ligaments to relax and put joints at a higher risk for injury (Nordahl et al. 2005). Because your center of gravity has changed, balance exercises may also pose a risk. Yoga has many benefits; it just needs to be modified for the pregnant body. Chances are you can teach many of the exercises without having to do the questionable ones yourself.
What About HIIT?
Can I teach a high-intensity workout like CrossFit®?
The answer to this question depends on whether you are coaching the exercise or actually doing it. If you’re actively participating, proceed with caution. At the time this article is being published, no research has examined the effects of high-intensity workouts on pregnancy. Science can study only women who absolutely refuse to give up their high-intensity workouts. Anecdotally, we are seeing many women participate in these workouts throughout their pregnancies. The truth is, we don’t know how much is “too much.” Increased joint laxity may result in an increased number of sprains or injuries. At FIT4MOM, we choose to proceed with caution. We abide by ACOG guidelines, and we believe we can keep women fit throughout pregnancy without putting them at risk. If nothing else, please know the contraindications (see the Contraindications sidebars).
How many days per week can I teach?
In the absence of contraindications, pregnant women are encouraged to engage in 30 minutes or more of moderate exercise on most days of the week—if not every day. Always check with your caregiver before beginning an exercise program. Listen to your body. This may not be a good time to teach multiple classes in a day, unless you are simply coaching them.
Can I keep teaching if I’m breastfeeding?
Yes! Exercise will not affect milk supply. Stay well hydrated, and adjust your caloric intake depending on the exercise type and intensity. Some babies don’t like to nurse after you’ve exercised. Chances are that that’s because of sweat on the breast and not due to a change in milk quality. Nurse right before working out, so that the baby is content and your breasts don’t feel too full.
It’s likely that exercise will alleviate or at least lessen almost every pregnancy discomfort. Teaching fitness can be a great way to take care of yourself and your baby; however, take safety precautions. Line up subs so you don’t feel obligated to teach on days when you don’t feel well. Talk with your club manager about team-teaching, so that the responsibility isn’t solely on you. Let your students know that while you may abstain from some exercises, they don’t need to. Create a maternity leave plan. The best instructors are coaches, and they don’t have to do all of the exercises. Ask yourself if your class is best for your baby. If you have any doubt, follow your mother’s instinct—it will protect you and your baby.
ACOG (American College of Obstetricians and Gynecologists). 1994. Technical Bulletin 189: Exercise during pregnancy and the postpartum period. Accessed Mar. 11, 2015. www.ncbi.nlm.nih.gov/pubmed/7913067?dopt=Abstract.
ACOG. 2002. Committee Opinion 267: Exercise during pregnancy and the postpartum period. Accessed Mar. 11, 2015. www.acog.org/Resources-And-Publications/Committee-Opinions/committee-on-Obstetric-Practice/Exercise-During-Pregnancy-and-the-Postpartum-Period.
ACOG. 2011. FAQ119: Exercise During Pregnancy. Accessed Feb. 2015. www.acog.org/Patients/FAQs/Exercise-During-Pregnancy.
Artal, R., Clapp, J., & Vigil, D. (n.d.). Exercise During Pregnancy. ACSM Current Comment. Accessed Mar. 11, 2015. www.acsm.org/docs/current-comments-exerciseduringpregnancy.pdf.
Artal, R., & O’Toole, M. 2003. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British Journal of Sports Medicine, 37, 6-12.
Clapp, J. 2002. Exercising Through Your Pregnancy. Omaha, NE: Addicus.
Nordahl, K., Petersen, C., & Jeffreys, R. 2005. Fit To Deliver. Vancouver, BC: Hartley & Marks.