Pregnancy (1/4)
Imagine the scenario... your female client tells you she's pregnant, or even more terrifying... you take on a client who's already pregnant.
And while this is not your average 'transformation', it's actually incredibly safe, healthy and rewarding to train a pregnant client, if you follow a few key ground rules.
In this module, you will learn everything you need to guide your client through a successful pregnancy and give her child the best chance in life. We will explore:
- Special considerations when working with clients who are pregnant.
- How to adapt the training plan through the different trimesters of pregnancy.
- How to support pregnant clients with their nutrition.
- Important lifestyle choices and considerations for female clients.
Why is it important to tailor your delivery for pregnant clients?
Growing and giving birth to a child is one of the biggest milestones in a woman’s life. It’s even been estimated it is as physically challenging as running a marathon! [1]. Now more than ever, maintaining a good level of health and fitness with regular exercise has become a priority for many pregnant women.
But not only that, it's a question of providing an outstanding customer service. At Ultimate Performance, is it essential that all clients receive maximal value and a training experience that is unique to her individual requirements, including pregnancy. But before we can dive into the specifics, we need to learn a bit more about what actually happens during pregnancy.
Pregnancy: a quick biology lesson
Pregnancy occurs when a woman’s body releases an egg during ovulation, and a sperm fertilises it.
Ovulation tends to occur around 14 days after the start of a woman's menstrual cycle, which is marked by day one of her period. Following fertilisation, the ovum moves down through the fallopian tubes and implants into the womb’s lining. If this delicate process is successful, pregnancy occurs.
The average full-term pregnancy lasts 40 weeks or 280 days, with anything under 37 weeks being considered pre-term. Babies born before 39 weeks have a greater chance of breathing problems, low blood sugar and other problems that may result in them being admitted to a neonatal intensive care unit.
As a result, your contribution to supporting and maintaining your client's health will play a critical role in helping her deliver a healthy baby at full term.
Stages of pregnancy
The process of pregnancy is generally broken down into three stages, referred to as trimesters. Each of these stages is marked by specific foetal developments. These include:
First trimester (weeks 1-12)
The baby’s body structure and organ systems develop. The first trimester is when miscarriage and birth defects are most likely to occur. Around 10% of pregnancies, unfortunately, end in miscarriage.
Second trimester (weeks 13 to 27)
Often referred to as the ‘golden period’, many of the unpleasant symptoms of early pregnancy disappear. Women often report feeling less nauseous, experiencing improved sleep and energy levels. However, back and abdominal pain, as well as cramps and constipation, may become more frequent.
Weeks 16-20 are when your client is most likely to feel her baby’s first movements.
Third trimester (weeks 28-40)
The final stage of pregnancy is often accompanied by shortness of breath, haemorrhoids, urinary incontinence, varicose veins and sleeping problems. These symptoms occur because of the growth of the uterus, which expands to prepare for birth.
The role of body composition in pregnancy
Pregnancy is a time that can pose several risks to womens' health. And with the obesity crisis, these risks are only increasing.
Data show that 49.6% of pregnant women in England are categorised as overweight or obese
While obesity causes numerous negative health outcomes for mother and baby, pregnancy also seems to be a big contributor to obesity due to weight gain [3,4].
Simply put, women often gain weight through pregnancy, fail to return to her pre-partum weight and continue to gain weight either post-partum or during subsequent pregnancies. But that's not all.
BMI pre-pregnancy is a strong predictor of key health risk factors in both mothers and children. However, the research on the efficacy of diet and lifestyle changes during pregnancy is mixed.
Some evidence indicates that weight loss programs during pregnancy only have a limited impact on maternal and infant perinatal outcomes, leading some clinicians to recommend that women should achieve a healthy weight before pregnancy.
So does that mean that there's no way back once women are pregnant? Far from it.
It is estimated that around 20% of women retain over five kilos of additional weight one-year post-partum, with weight gain during pregnancy being a significant predictor of obesity.
Randomised controlled trials have found that interventions during pregnancy can help reduce excessive gestational weight gain and improve weight retention post partum. And those aren't the only benefits.
Diet and exercise interventions that reduce gestational weight gain by around 20% also do not appear to increase the risk of c-section births, premature births or adverse neonatal outcomes.
So, while it may be more optimal to reach a healthy weight before falling pregnant, it’s still as good a time as any for women to start making changes to their lifestyle.
Is it safe to train clients through pregnancy?
Many people's natural instinct is to wrap up women in cotton wool once they are expecting. But there is a wealth of evidence that training is one of the best things women can do for themselves and their babies' health during pregnancy.
One of the biggest contributors to gestational weight gain is that many women tend to lower their physical activity levels during pregnancy. While this is understandable given the vast changes that occur during this time, there is plenty of evidence to suggest that physical exercise during pregnancy helps maintain and increase fitness, which can also improve pregnancy outcomes. And there's good reason for this.
The World Health Organisation (WHO) recommends that adults between 18-64 years perform at least 150 minutes of physical activity per week, 75 minutes of vigorous-intensity aerobic physical activity per week, or a combination of both. For obese women, physical activity reduces the risk of pre-eclampsia, reduces pelvic and back pain, decreases gestational weight gain, and helps to improve overall well-being. And exercise doesn't just make pregnancy easier - it increases the chances of a better birth too.
Activity levels have been shown to positively affect birth duration and difficulty. A 2010 observational study found that women who performed ≥30 minutes of moderate physical activity per day saw their average duration of labour drop by an average of 58 minutes. Likewise, the likelihood of c-section decreased, alongside birth weight and maternal weight gain
And that's before we even mention the other pros of training while pregnant, which include:
• decreased risk of gestational diabetes
• reduced post-natal recovery time
• decreased risk and severity of back pain
• decreased risk of incontinence
• reduced risk of caesarean births
• reduced risk of low mood and depression
• improved physical fitness
And these benefits extend far beyond the nine months of carrying a child. A 2006 study showed that 44.6% of women still struggled with urinary incontinence 5-7 years after giving birth. 35% of women find sex painful in the 12 months following childbirth, and up to 19% require surgery for pelvic organ prolapse or incontinence. But the great news is that resistance training improves outcomes for all these conditions, and can benefit clients regardless of their experience levels, so long as:
• She has the all-clear from her doctor or midwife to exercise;
• She does not have any contraindications;
• You follow safety guidelines when training your client.
So let's take a closer look at some practical tips for training pregnant clients through each trimester.