Background: many pregnant women are unsure how long they can keep exercising, or when they should or may start again. Is strength training or jumping dangerous during pregnancy? What happens to the pelvic floor during…
Background: Many pregnant women are unsure how long they can keep exercising, or when they should or may start again. Is strength training or jumping dangerous during pregnancy? What happens to the pelvic floor during training, and how can – and may – I train it and my abdominal muscles again after pregnancy?
Overview: This post gives an overview of various international guidelines (including the USA, UK, Denmark and Norway) plus individual RCTs, to answer the questions above as well as possible. The aim is to paint a picture of the whole course of pregnancy and the period after birth in terms of women's general capacity for load and training.
What do the guidelines say?
In the past, several studies showed that training during pregnancy has many positive effects for the mother-to-be (less weight gain, lower likelihood of gestational diabetes and incontinence, lower likelihood of depression and more). A review by Szumilewicz et al. (2015) therefore examined 11 guidelines from 7 countries for their training recommendations for pregnant women. The aim was to derive recommendations, since it also shows that many pregnant women exercise too little.
- 11/11 guidelines recommend endurance training
- 9 guidelines recommend strength training during pregnancy
- The WHO recommends 150 minutes of endurance training and strength training twice a week
To put this in context, the relevant parameters (type of training, frequency, intensity etc.) also need to be defined. Unfortunately, the guidelines provided little information on this. Typical recommendations were endurance sports such as swimming, walking and jogging (2–3 times a week for 30–60 min.), and for strength training good technique, a load appropriate to training experience and supervision by an expert. A more recent review of the updated guidelines by Yang et al. (2022) reaches similar conclusions.
Strength training and jogging after birth
In this situation, the question is often when normal (abdominal) training can resume and when not. Which exercises are OK? Can you go jogging, and when can you start again? To answer these questions, various individual studies were consulted. A survey by Prevett et al. (2022) asked whether heavy strength training during pregnancy (80% 1RM) led to more problems. Rates of depression or gestational diabetes, for example, were lower than in the average population.
A consensus paper by Christopher et al. (2024) with 118 experts found that a return to running after birth should be linked to the following criteria:
- At least 3–4 weeks' break after birth
- Individual planning
- Consideration of bone health, mental state, and pelvic floor and abdominal muscles in terms of coordination and strength
- No incontinence of any kind, and completed wound healing if an injury occurred during birth
- Lower-body strength and balance/proprioception back to pre-pregnancy level
Possible test exercises in this area could be: walking for 30 min., standing on one leg for 10 sec., jogging on the spot for 1 min., 10 (horizontal) jumps, 20 calf raises or 20 single-leg hip bridges. The necessary general education should also have taken place and, if needed, various aids/equipment can be used (compression, a special sports bra, suitable shoes etc.).
Training the abdominal muscles
Reviews by Gluppe et al. (2021) and Skoura et al. (2024) could not derive precise recommendations for abdominal training. However, various exercises/methods (curl-ups, eccentric training, pelvic floor training, breathing exercises) can help reduce diastasis recti; they are therefore recommended as preparation for everyday tasks and are also classed as safe. Both deep and superficial muscles may – and should – be engaged. Coordination training of these muscles is therefore also important.
Conclusion
In summary, strength and endurance training should always be recommended for women without contraindications, as it has various positive effects for mother and child. Training should always be based on the current situation and can be monitored with the Borg scale or a rate-of-perceived-exertion tool, for example. If you have questions, talk to a specialist doctor or a pelvic floor specialist.
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