Back Bay Health

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Unpopular opinion: While you absolutely should train in pregnancy… you don’t NEED to train FOR birth.

You can strength train in pregnancy. You can strength train postpartum. Birth is a physical event, yes. But you do NOT NEED to train FOR birth.

Physical activity is safe and beneficial in pregnancy. But you don’t need to train FOR birth.


It grinds my gears when people compare birth to a marathon saying that “you wouldn’t run a marathon without training, so why would you want to birth without training?”

Don’t get me wrong… I am a HUGE advocate for training in pregnancy and postpartum. The research shows us the benefits are significant and there aren’t any extra downsides to training when you’re pregnant vs not pregnant unless you have pregnancy related contraindications. It’s recommended pregnant people get 150 minutes of physical activity per week spread over at least 3 days (FYI this is NOT less than the recommendations for physical activity in adults by the WHO https://apps.who.int/iris/bitstream/handle/10665/336656/9789240015128-eng.pdf?sequence=1&isAllowed=y).

Here’s a few of the benefits of physical activity in the pregnant population that are well documented in the research… (https://bjsm.bmj.com/content/52/21/1339)

Exercise in pregnancy is associated with DECREASED likelihood of

  • prenatal anxiety and depression

  • gestational hypertension

  • pre-eclampsia

  • gestational diabetes

  • excessive gestational weight gain

  • fetal complications such as large for gestational age

Exercise in pregnancy is NOT associated with…

  • Miscarriage

  • Low birth weight

  • Perinatal mortality

  • Preterm birth

  • Premature rupture of membranes

  • Still birth

Physical activity is also safe whether you were or weren’t previously active before pregnancy. So the old myth that you can’t try new types of exercise when you are pregnant is just that - a myth. Also, prenatal exercise is correlated with benefits related to birth such as a decreased likelihood of c-section, instrument assisted delivery, and urinary incontinence as well as shorter labors and faster recovery time.

Physical activity in pregnancy is so important. Yet only 15% of the pregnant population meets the guidelines listed above. Pregnancy is not a fragile state. You can train, you can do hard things. Evidence supports resistance training including body weight exercises, or using bands and weights. It supports cardiovascular exercise from walking to running to swimming. Intensity wise, the evidence supports moderate to vigorous intensity exercise (next blog is on intensity as it relates to prenatal exercise and what that means - stay tuned) all while still reducing risk factors listed above and promoting positive outcomes listed above.

When it comes to what you do for prenatal exercise, do it for you, because it feels good, it’s enjoyable, and it’s good for you, your pregnancy and your growing baby. But training in pregnancy is not the same as training in real life. It’s not a time for PRs and maxing out. It’s not really a time for progressing lifts either…

In pregnancy your blood volume increases by as much as 50%, there’s an increase in plasma volume but a decrease in oxygenation making it a bit harder to judge exertion. Your heart rate increases, cardiac output increases, VO2 max increases, but respiratory capacity decreases due to reduced functional residual capacity in the lungs (baby takes up space and diaphragm can’t descend as much). There’s a forward shift in your center of gravity and increased ligament laxity, and did you know most people gain weight in pregnancy (this is a joke most people know this). And there’s a related increase in metabolic demand with nutritional requirements increasing by about 300Kcal. These are all normal good things, but things that impact training capacity, endurance, output and exertion capacity not to mention nutritional needs related to fueling for exercise and hydration as well has tolerance to heat. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9456821/


Whether it’s running, weight lifting, barbells, KBs, dumbbells… it can be done in pregnancy safely. But pregnancy is not a health neutral state either. All objective health markers go down in pregnancy. YOU ARE GROWING A HUMAN. After you become pregnant, often priorities change in life and priorities should change in the gym also. For these reasons, training is different when you are pregnant, plain and simple.

So back to the marathon thing. You simply cannot compare physically training for a marathon to physically training in pregnancy for birth.

For starters… (I’ll give a little) Birth is in some ways like a marathon… A long hard physically, mentally and emotionally challenging task. But birth is more like a marathon that you don’t know exactly when or where the starting line is. Exactly when or where the finish line is. Is it 26 miles? Or 86 miles? And will you be running in 35 degrees in rain or in 50 degrees with the wind at your back. IYKYK.

We also have lots of data about pregnant people who are in coma’s that have successful vaginal births. IN A COMA. I’m guessing it’s safe to say that their physical activity was limited in pregnancy. Probably not a lot of physical prep for birth going on when you’re in a coma.

So no… you don’t NEED to train FOR birth as though your body can not do what it needs to do if you aren’t trained enough.

The thing that gets me about the marathon analogy is that it implies that if you do not strengthen your body during pregnancy, then you can’t birth a baby or you cannot push a baby out. The thing is, the smooth muscle of your uterus are what pushes the baby out. Smooth muscles are muscles you can not train with exercise. The rest of your skeletal muscles - the ones you can train with exercise or resistance training in pregnancy: pelvic floor, glutes, pelvis stabilizers etc - need to GTFO during birth. So physically, your training plan in pregnancy should be geared towards creating awareness, finding your ability to connect and engage, but by the end you should be working on LETTING GO not building up capacity in terms of strength, muscular endurance, etc.

Birth is about letting go. It’s a mental (and physical) grind. It’s about keeping calm (as you can) during discomfort, maybe lack of sleep or lack of food, fast progressions and long lulls. It’s hard. And it’s also an amazing, empowering, and wild experience - but that’s a blog for a different day.  If there are benefits of physical exercise that are directly related to birth it’s knowing you can do hard things, feeling empowered, developing subjective qualities of grit and resilience. It’s still NOT necessary to physically train for birth the way you certainly need to physically train for a marathon.

You cannot meditate your way to the finish line of a marathon without physically training, but you sure could meditate your way to birth your baby earthside with minimal physical training.

So… when you are pregnant or if you become pregnant. Exercise. Train. Walk. Lift weights. Do yoga or pilates, or go for a swim. Do kettlebell snatches or barbell deadlifts. But do it because you enjoy it not because you won’t be able to birth if you don’t.