Exercises for strength building for childbirth

December 26, 2012 5:58 PM

I'm currently 22 weeks pregnant and am wanting to start some kind of muscle building exercise to help prepare me for (a hopefully unmedicated) childbirth. I have some health problems which place limitations on the types of exercise I can do.

This is my first pregnancy, I'll be 37 when the child's born and am physically very weak. So far all indications (1st and 2nd trimester ultrasounds, basic genetic testing, all appointments with the midwife) have been that the little one is doing well, yay! And so far I've had no pregnancy related red flags.

I would very much like to have as natural a birth as is safely possible. I am hoping that this will lead to a shorter recovery time and hopefully a reduced chance of a relapse of my illness. I also have had unreliable reactions to some pain meds in the past and would like to avoid a negative reaction (with all the resulting stress and illness) to a new med during labor.

I'll be giving birth at a fairly progressive hospital with a midwife and possibly a doula (also, my husband will be there and hopefully my mother) and am under the impression that they allow movement, have birthing balls and showers. I would like to utilize as many non-medication pain management techniques as possible. The problem is that I am so muscularly weak that I have difficulty standing up from a squat now, even though I have a healthy bmi and my belly is very small.

For context, I have had a chronic health problem (ME/CFS) for the last 3 years. One aspect of my illness is POTS, which basically means my body doesn't regulate blood flow well when I am upright/standing so my heart rate jumps in an (often futile) attempt to get blood to my brain. When the POTS is bad my heartrate can jump from 60bpm (resting) to 120+bpm (standing) within 3 minutes and I get lightheaded and sick from lack of oxygen. Btw, I have seen a cardiologist and perinatologist about the POTS, and they are in agreement that I should have a little more monitoring (L&D vs. the birth center), but they are not overly concerned about its effect on the pregnancy and delivery, and I am still in the primary care of my midwife. The POTS makes it difficult for me to do exercise which include prolonged standing (tai chi, chi kung, standing postures in yoga, that kind of thing). The ME/CFS also places constraints on what type of exercise I am able to do - it makes aerobic exercise and any prolonged exercise routine difficult to impossible.

So, in summary, what kinds of (non-aerobic, non-prolonged standing) targeted exercises would be good for developing muscle strength to better support a natural child birth? I would assume leg muscles will be very important as squatting seems to be a big part of childbirth, but any more specific (or different) recommendations? The more 'efficient' the exercises the better - i.e. the most useful muscle development for the amount of energy invested.

posted by pennypiper to health & fitness (16 answers total)

You should really really really be asking your midwife this question, not the Internet.

(I did squats daily per my midwife, I started at 5 and by the end of my pregnancy I was a squatting machine. But please, ask your midwife!)
posted by julie_of_the_jungle at 6:18 PM on December 26, 2012 [1 favorite]

I was gifted some sessions with a prenatal-certified certified trainer when I was pregnant, which was very useful. We mostly concentrated on weight training with compound exercises, and was much more appealing to me that the prenatal yoga stuff.
posted by snickerdoodle at 6:36 PM on December 26, 2012

I did prenatal vinyasa yoga which focuses a lot on breathing, stretching and strenthening the core. It has some standing poses but alternates between standing, squatting, sitting etc. I used this DVD which I found excellent. It has modified poses for the later trimesters or when you're feeling weak.
Also, I tried to walk 30mins minimum every day which I felt helped with opening up my hips, too. I tried swimming but baby didn't like it and would kick me. Don't push yourself and listen to your body! I had a complication- and medication-free birth with very little recovery time afterwards.
Take a doula and arm yourself with knowledge if you're aiming for a natural birth (I recommend The Thinking Woman's Guide to a Better Birth). Oh, and congrats!
posted by The Toad at 6:50 PM on December 26, 2012

It's great you're making these steps; the stronger, fitter women I knew have had a considerably easier time of giving birth than those who weren't. You will probably want a mix of both strength and some aerobic exercise, as giving birth requires both.

For strength training find a trainer who has significant experience in pre-natal strength training. Strength training is fantastic and incredibly important but there is not a lot of good scientific information out there on what is beneficial or harmful for pregnant women. I know pregnant women who were doing squats with 135lbs on the day of birth, but 135lbs was far from their non-pregnant maximum squat and they were experienced strength athletes. You'll have to find the happy medium where you're not unduly limiting yourself because of the pregnancy but not working out like the baby isn't there.

But aerobic conditioning can actually improve the POTS, so it is worth looking into that. Are you able to swim or do recumbent cycling (some gyms have stationary recumbent cycles)?
posted by schroedinger at 6:59 PM on December 26, 2012

I think that the simplest answer with the greatest benefit would be simple walking. Could you manage a 30 minute walk a day?
posted by wilful at 7:09 PM on December 26, 2012 [1 favorite]

Essential Exercises for the Childbearing Year was written in 1976, but is still current (revised as necessary) and excellent. Many of the exercises are done lying down. You might also look into Chair Yoga, which has gentle seated postures that can be very useful in building strength while still supporting your body more than standing. Congratulations and best of luck - you'll find childbirth uses muscles you never knew you had, and also that your existing muscles are stronger than you thought possible.
posted by judith at 7:18 PM on December 26, 2012

FWIW, I never did any particular muscle training, yoga, Lamaze, birthing classes, or anything else of the like, am not and was not particuarly physically fit, and still had a natural, unmedicated delivery. If you are not able to maintain a squat (I have no medical problems, but I am absolutely certain I could not have maintained a squat for more than a few secs), then your husband and/or doula can assist you by supporting you around the waist/shoulders, or holding your legs, or whatever seems helpful at the time. Please do not be intimidated by thoughts that only very athletic, fit, "prepared" women can have natural births. I totally assure you that is not the case. Determination, mental preparation (understanding the delivery process, believing you can do it, and developing visualizations to focus on that are meaningful to you), and supportive birthing partners are the truly necessary ingredients.

Another thing to keep in mind is that if there are unexpected complications which do not allow for a completely natural delivery, all is not lost. Delivery is but a short time in the life of a mother and child. Best of luck to you!
posted by RRgal at 7:27 PM on December 26, 2012 [3 favorites]

Thanks for all the responses! I'm new here, so forgive me if I'm responding too much:

I plan to ask my midwife AND the internet : ) I like to do my research before going into medical appointments, it helps me ask better questions, synthesize what the doc says and better utilize the sometimes very limited time allotted.

I'm trying to focus on non-aerobic because aerobic exercise can exacerbate my illness (ME/CFS, not the POTS) and also I've never seemed to benefit much from aerobic exercise. Even when I was healthy my aerobic fitness would barely increase from regular aerobic exercise - it generally just made me feel crap - even after months of regular activity (though I am able to build muscle). So I don't have high hopes of being able to actually impact my aerobic capacity. But I do walk as a part of my daily routine, usually 15min twice a day (including some hills).

I did attend one prenatal yoga class, and found it both difficult (dratted muscles) and unimpressive, though I think this was due to the teaching quality. Before becoming ill I did do yoga (vinyasa and astanga) regularly, so I'm probably more of a critic than I should be. But the dvd is appealing because I could hopefully go at a slower pace, and the Essential Exercises book sounds like it would be very informative.

And learning as much as possible about the process and how variable it is - Ask MetaFilter has been WONDERFUL for this . Thanks for the encouragement RRgal!
posted by pennypiper at 7:49 PM on December 26, 2012

I use the Shiva Rea prenatal yoga DVD, and I like it for the most part, and you can skip straight to the non-standing sequences and just do those segments. Also, there are 3 women in the DVD, one of them represents the 3rd trimester and you can follow her modified moves, she uses a chair for many of the poses and makes them easier. I also like the fact that the DVD reminds me to do kegels.

I also second swimming. The nice thing about swimming is that it takes the weight off you (more and more important as you get further into pregnancy and feel huge) and you can take a break anytime while you're doing it as well.
posted by treehorn+bunny at 7:54 PM on December 26, 2012

Many women, including myself, experience increased libido during pregnancy. During an orgasm, the uterine muscles contract in much the same way as they do during labor/childbirth. I suspect that there is a connection between these two things, that the one serves as practice for the other. So my suggestion is to have as many orgasms as is feasible and prudent.

Obviously check with your midwife though, especially if you have any preterm labor issues, because the chemical hormone oxytocin is released after orgasm, which stimulates contractions (pitocin is the synthetic version that they give to induce labor) which is kind of the point, but you would want to check to see if there are any contraindications in your particular case.
posted by fancyoats at 7:57 PM on December 26, 2012 [2 favorites]

Ask your midwife for a referral to physical therapy, and seek out a physical therapist who has experience treating pregnant women. (At this point I feel like I should inform the Metafilter community that I do not stand to gain financially from all my recommendations! Just really appreciated how physical therapy helped me during my pregnancy.) Since you have a (chronic?) health condition, it'd probably be helpful for you to go over the possibilities with an expert. And, depending on your insurance plan, it might work out to be much less expensive than a personal trainer.

Watch out about the squats - if you develop SPD, as do many pregnant women, excessive squatting before birth will make things worse. And frankly, squatting during active labor is a way different beast than the squats one does in an exercise class!!

That said, I was definitely one of those "stronger, fitter" women pre-pregnancy and throughout most of the pregnancy, but ... well, RRGal put it better above. I love fitness and exercise, but it seems like pregnancy is just one more opportunity for people to harangue women about their bodies. And physical fitness is no guarantee of a particular labor/delivery experience -- I needed the assistance of a physical therapist to manage pain late in pregnancy, and despite my commitment to and preparation for a natural(ish) childbirth, my baby stayed in 42+ weeks and we had to induce. And then I had a really oddball birth injury that one would not expect from a "fit" person, but that's just the way childbirth goes. Women all over the world give birth without the benefit of Pilates trainers and yoga dvds, you know?

But Kegels are for real, and I wish I had gone swimming more because just bobbing in the water felt pretty darn good.
posted by stowaway at 7:58 PM on December 26, 2012

I just want to quickly add that one of the big keys to a quick unmediated birth is not strength but is relaxation, basically finding a way not to fight what your body is doing but instead be as relaxed as possible, which will speed labor along. For me, that meant being in a very warm birthing tub until very late in the process, which basically used no muscles at all (or at least none I could exercise). I had actually planned to give birth either in the tub or squatting, but it turned out that lying down on my side with one leg held was what worked for me. So, while core strength is absolutely important I would rank focusing on relaxation techniques as the most important thing. Remember, even some parapalygic and otherwise chair bound women have successful vaginal births.
posted by anastasiav at 9:03 PM on December 26, 2012 [1 favorite]

Based only on my own experience, I'd suggest Pilates with an instructor used to working with pregnant women. I'm quite fat but I have a very strong core thanks to being a professional classical singer; that is not the only thing that contributed to my ridiculously fast labors, but I think it helped. (First labor, 4.5 hours and 20 minutes pushing, medicated. Second labor, 78 minutes and 8 minutes pushing, unmedicated.)
posted by KathrynT at 9:13 PM on December 26, 2012

There is some great advice above, specifically that physical strength is not what you need for childbirth (but maybe afterwards). Your husband should be prepared to support you if needed - it may be comfortable for you to hang in his arms.

Like anastasiav, a hot tub was a good thing for me during labor, but the actual birth happened while standing up straight, supporting myself against a bed. The midwife and nurse were the ones who had to crawl. It only really hurt for like, ten minutes.

This was no. 2; no. 1 was in many ways complicated, but I am 100% sure that it would have been as easy as no. 2 if I had been allowed to decide, I really knew what I wanted. Doctors and their crazy ideas are a pain.

Walking around and generally standing up is a good thing. Fight anyone who wants you to lie on your back.

Also: during pregnancy, walking is a good thing, otherwise you may experience crazy pain. Walk as much as you can.
posted by mumimor at 3:17 PM on December 27, 2012

Thanks everyone! I'm still going to try to do some strength building but it sounds like it will be more important for me to understand the stages/process of labor, educate myself on options for pain management (positions, movement, meds, etc), and practice relaxation techniques. I really appreciate all the advice and ideas!
posted by pennypiper at 11:05 AM on December 28, 2012

I just joined so I could answer this; sorry for being late to the party. I had a (mostly) unmedicated birth this summer. I was in the worst shape of my entire life and it didn't matter one bit. Handling the pain was nothing like I expected--all I did was lie on my side and go deep inside to relax and breathe through it. No walking, no exercise ball, no massage, nothing. It just wasn't what I wanted to do, once I was actually there in labor.

And, in spite of all of my own expectations--I've been doing yoga for ages, although not much prenatally, and can squat with the best of them--I gave birth on my back. Seriously. It was the only way I was comfortable, go figure. My doula, my husband, and the L&D nurse held my legs up for me, so no strength required on my part.

Reading Ina May Gaskin's work helped immensely, as did having an OBGYN who supported my desire for an umedicated birth. Good luck!
posted by orange (sherbet) rabbit at 5:54 PM on December 31, 2012