Pregnancy (4/4)
Lifestyle Choices During Pregnancy
Last but not least, it's also important to look at your client's lifestyle.
Lifestyle factors like stress, sleep, alcohol, and smoking, have an important impact your client’s ability to carry a healthy baby to term.
Keep a lid on stress
Research shows that the mother’s psychological state influences the intrauterine environment by altering blood flow to the baby. Stress during pregnancy appears to increase the risk of congenital defects due to changes in foetal cortisol levels. So it's worthwhile working with your client to minimise her stress as much as possible to support her baby’s health.
Try to keep a consistent sleep routine
It’s common for women to experience sleep loss and poorer quality sleep through pregnancy, such as insomnia and sleep-disordered breathing SDB.
SDB includes problems such as sleep apnoea, with obese women being far more likely to experience the condition than lean women. Sleep loss appears to act as a form of physiological stress that may lead to ‘stress overload’, which can cause inflammatory reactions and, therefore, adverse pregnancy outcomes.
Sleep loss also increases the risk of gestational diabetes mellitus (GDM), which is associated with numerous adverse maternal, foetal and neonatal outcomes, including pre-eclampsia, caesarean section, pre-term labour, macrosomia, and death.
However, it appears that this phenomenon is not caused primarily caused by gestational weight gain in the third trimester but often relates to increased fat deposition around the neck. As a result, GDM appears to be more common in women who are obese before becoming pregnant. However, reaching a healthy weight and quitting smoking are two key changes that can improve loud snoring and alleviate breathing problems during sleep.
Quit smoking
There are obvious multiple health benefits from quitting smoking, but this lifestyle change becomes particularly crucial during pregnancy. Smoking is strongly correlated with foetal growth restriction, with increasing evidence linking smoking with stillbirth, pre-term birth, placental abruption, and possibly also sudden infant death syndrome. Smoking also increases the risk of spontaneous abortions, ectopic pregnancies, and placenta previa and may increase the risk of childhood behavioural disorders.
One drink is one too many
Many clients will have heard the old wives’ tales suggesting ‘a glass or two’ is ok during pregnancy. Unfortunately, the evidence shows that even moderate levels of alcohol intake during early pregnancy can result in alterations of growth and abnormal cell development in the foetus.
When a woman drinks during pregnancy, the baby also ingests the alcohol via her bloodstream. Drinking alcohol during pregnancy can cause foetal alcohol syndrome (FAS), a serious condition that causes long-term problems with development, learning, behaviour and social skills. There is currently no known ‘safe’ alcohol level during pregnancy.
However, we do know that the more alcohol a woman drinks, the more severe the outcomes. The safest bet is therefore to not to drink at all.
Keep moving
Physical activity often declines throughout pregnancy. Low physical activity levels are associated with excessive weight gain and increased risk of pre-eclampsia, gestational diabetes mellitus, hypertension disorders, delivery by caesarean section and stillbirth.
Evidence suggests that several successful interventions can help to reduce the decline in physical activity during pregnancy. These include goal setting with regular feedback, creating an enjoyable exercise routine and raising awareness of being highly sedentary.
If you train a pregnant client, don't forget to set daily activity goals. A daily step target is a simple and effective way to maintain daily activity. Where possible, it is also recommended to keep a regular exercise and training schedule with your client. However, be aware of your client’s well-being as she progresses through pregnancy. You may need to adjust and tweak your plans based on how she feels day by day.
The take-home
Pregnancy is a time of immense change that brings a unique set of challenges for women. But that doesn't mean your powerless to give her a great client experience.
The changes that your client may experience might not necessarily be something she can influence. But there are many positive steps you can take as her trainer to improve her training experience through pregnancy and support her in making positive changes for her own health as well as that of her baby.
If concerned about training, diet or lifestyle through pregnancy, speak to your doctor or midwife, who will be able to best advise for unique circumstances.
Key takeaways
- Reaching and maintaining a healthy body composition before and during pregnancy plays a crucial role in perinatal health outcomes for mother and baby.
- It is safe for women to train during pregnancy, as long as she has been given the all-clear from her doctor or midwife.
- Training during the first trimester should focus on developing strength, muscle mass and improving cardiovascular fitness. Focus on posterior chain and anterior core areas to prepare for the increase in body weight.
- Training during the second trimester may require changes to program design and exercise selection. Opt for lighter loads and use exercises that the client is competent at and enjoys. Avoid prone based exercises.
- Training during the third trimester is often dependent on how the client feels on the day. Be prepared to change exercises, reps, sets and load if your client is feeling discomfort. Adjust supine exercises and ensure no extra downward pressure is placed on the pelvic floor.
- Nutritional choices made by your client during pregnancy and beyond help shape her baby’s long-term health. Encourage your client to maintain a high-quality diet throughout pregnancy.
- Clients don’t need to eat for two. While the number of calories required increases throughout pregnancy, this is often offset by a reduction in physical activity during the third trimester. Evidence suggests calories do not need to exceed ~10% increase above pre-pregnancy levels.
- Ensure your client supplements with folate, omega-3 and vitamin D to provide her baby with the best start in life.
- Encourage your client to prioritise good sleep hygiene and use strategies to reduce stress to minimise cortisol levels in the foetus.
- There is no recommended upper limit for alcohol consumption during pregnancy. Therefore, the safest option for your client is to avoid drinking alcohol entirely.