BWW Weighs In: What Every Pregnant Ninja Needs to Know About Their Fitness by Amanda Ting

Historically, women have been advised to stop exercising when they became pregnant, with many physicians and healthcare professionals treating pregnancy as an illness or disability. Women were also told to increase their caloric intake, creating a system set up for elevated maternal weight and subsequent obesity. DA FUQ?

In recent committee opinions published by The American College of Obstetricians and Gynecologists (ACOG) as well as the Journal of the American Medical Association (in 2015 and 2017), guidelines for physical activity in pregnancy and the postpartum period were detailed with corresponding research to encourage women with uncomplicated pregnancies to continue exercising before, during, and after pregnancy with proper supervision of their physician. It has also been shown that it's healthy to begin an exercise program during pregnancy.

As with any exercise program, it's important to consult with your obstetrician or healthcare provider before beginning any physical activity. In most uncomplicated pregnancies, it is heavily encouraged to maintain or begin an exercise regime as well as a healthy and balanced diet.

Why Do I Need to Stay Fit While Preggers?

Sadly, no ACOG studies have linked exercising during pregnancy to slaying like Queen Bey. Yet.

The benefits to exercising during pregnancy far outweigh the risks to mom and baby and, more often than not, yields better overall health in both.

Prior to 1985 and the first committee opinion on exercise during pregnancy by ACOG, advisement against exercise was based on the thought that exercise may cause pre-term births or excess stress to the baby.

A study in 2016 published by ACOG revealed that there is no association between exercising throughout pregnancy and preterm birth or low birth weight. Multiple studies have uncovered minimal changes in fetal heartrate during exercise, only 10-30 beats per minute. Moral of the story: KEEP EXERCISING!

Benefits of exercising while pregnant for Ninjamom and Ninjakid include:

• Improved or maintained physical fitness
• Prevention of excessive weight gain
• Decreased risk of gestational diabetes, surgical deliveries (cesarean or operative vaginal), pre-eclampsia, low back pain, incontinence
• Improved recovery time following delivery
• Decreased glucose levels in women with gestational diabetes mellitus
• Improved psychological well-being (less stress, fatigue, anxiety, depression)

Should I Exercise Less?

The Department of Health and Human Services's recommended amount of physical activity for any healthy woman is 150 minutes of moderate intensity aerobic activity per week or 20-30 minutes of moderate intensity aerobic activity on most days of the week.

Guess what? This recommendation remains unchanged for women who are pregnant a.k.a. Ninjamoms who are with Ninjachild. HUZZAH! Exercising should be completed in a climate-controlled area to prevent overheating, and Ninjamoms should eat a snack before working out to prevent any drops in blood sugar.

How Hard Should I Get After It?

So you're going to keep working out, but what the hell is moderate intensity? In these sorts of guidelines, intensity typically refers to a heart rate range. However, during pregnancy heart rate is not always the best indicator due to the cardiovascular changes that come with growing a Ninjakid.

An easy way to gauge the intensity and the amount of work being done is by using the Talk Test, being able to hold a conversation while completing the workout. If you can talk and complete the exercise, chances are you're not overexerting.

What Kind of Moves Are Best?

As far as the types of exercise, low impact activities such as walking, jogging, yoga, pilates, and strength training (FUCK YES) are all recommended with modifications as needed.

Activities with increased risk of falling, contact sports, scuba diving, and activities performed in a hot environment like hot yoga or hot pilates should be avoided.

Most healthcare providers also advise against beginning an intense training program while pregnant, such as training for a marathon or a powerlifting meet.

Do I Need to Modify My Workouts?

So now comes the creative arts and crafts portion of our show! How does a Ninjamom need to modify exercises to make them the most effective and safe?

As your pregnancy progresses and the Ninjakid grows, it will be a constant collaboration between your doctor's recommendations, your trainer's program for you, and most importantly, YOU! Your wellbeing is the biggest factor in this equation as you are truly the expert of your own body.

Through the duration of your pregnancy, there are a few recommendations that remain consistent:

1. 1. Breathing should be continuous, avoiding a Valsalva maneuver, a.k.a. holding your breath and straining, during any exercise. Holding your breath increases blood pressure as well as the pressure on your pelvic floor.
   2. Flexibility and your range of motion, especially of the hips and wrists, will also increase due to relaxin, a hormone that allows the ligaments to stretch during pregnancy. It's best to move in a range that is pain-free as well as one that keeps your spine in a relatively neutral position. As far as the wrists, we want encourage a neutral or straight wrist and exercises that involve excess pressure or supporting your full body weight may need to be adjusted if it becomes difficult to maintain that position.
   3. It is also advised that you continue moving (an active rest, if you will) during rest breaks in classes as this helps continue blood moving through the veins of the legs.

The most limiting factor in the first trimester will be fatigue and morning sickness. During this time, it's appropriate to adjust or increase rest periods or exercise order as well as the numbers of sets and repetitions.

Throughout the second and third trimesters, some positions will need to be adjusted due to the growing Ninjakid and changes in posture of Ninjamom. Your squat position may need to be adjusted to a wider, more turned out stance and exercises that involve laying on your back can be modified to seated, standing or side-lying.

An incline bench or foam wedge can also be used for exercises on your back with slight modifications. Modifications may need to be made for balance purposes such as using a dowel or adjusting to a wider or "kickstand" stance.

Here's a helpful chart to summarize!

When Should I Stop Exercising?

You should stop exercising and check in with your doc if you experience:

• Vaginal bleeding
• Regular painful contractions
• Amniotic fluid leakage
• Shortness of breath
• Dizziness
• Chest Pain
• Weakness that affects your balance
• Calf pain or swelling

And What About After Ninjakid Arrives?

HOLY SHIT, you birthed a new Ninja! First off, congrats and STRONG WORK! Childbirth is the most extreme workout.

After Ninjakid has arrived, it's OK to resume exercise gradually once cleared by your obstetrician or healthcare provider. Typical recovery time is 4-6 weeks for vaginal deliveries and 6-8 weeks for Cesarean deliveries, with most physicians judging return to activity based on the uterus returning to normal size.

Research findings suggest that rapid return to activity after delivery presents no issues to mom. Pelvic floor exercises (yaaaaas kegels) can be started immediately after delivery and should be continued as a part of your normal exercise routine. When first returning to your workouts, it's important to keep your movements in a normal and pain-free range as your body is getting rid of relaxin and your flexibility is adjusting.

If you are breastfeeding your Ninjakid, make sure to feed him or her prior to exercising and wear a supportive bra to decrease discomfort while at the Clubhouse getting your workout on. It's also totally appropriate to make use of an abdominal splint or binder for comfort and support, at least in the beginning, and to assist if you have been diagnosed with diastasis recti.

Parting Shots

Run your own race and take each trimester as it comes. It's best to listen to your body carefully and modify your exercise program as needed. Each trimester will bring new highs and lows, some lasting longer than others. And, most importantly, take time to thank your body for growing a Ninjakid - that's amazing! We can't wait to love on you and your new addition!

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Amanda Ting is a Doctor of Physical Therapy and a Certified Strength and Conditioning Specialist. When not teaching the Ninjas of MFF Bowery to twerk, you will find her healing the Broadway gypsies, SLAZZing it up in dance class, or hanging with Clubhouse Pooch, Weezie.

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Sexy Sources

• ACOG Committee Opinion no. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015;126(6): e135-e142.
• JAMA Opinion: Exercise During Pregnancy. J Am Med Association. 2017;317(11): 1113-1114.'
• DiMascio D, Magro-Malosso ER, Saccone G, et al. Exercising during pregnancy in normal-weight women and risk of preterm birth. Am J Obstet Gynecol. 2016;215(5): 561-571.
• Szymanski LM, Satin AJ. Exercise during pregnancy: fetal responses to current public health guidelines. Obstet Gynecol 2012;119:603-610.
• Lang, Annette. "Training the Pregnant and Postpartum Client." NYC. April 2017. Lecture Notes.