The 3 Goals of Effective Prenatal Training

Get a deeper understanding of what your pregnant clients are training for
so you can coach them more effectively.

© 2020 PROnatal Fitness 1

OVERVIEW

Typically, when we think of prenatal exercise, we think in terms of “pregnancy modifications.” Fit pros often want to
learn the things they need to avoid or regress to keep their clients safe at a time when their bodies are placed under a
significant degree of stress. But let’s look at it another way: If a client came to you wanting to train for her first
marathon, would you immediately begin thinking about all the things you should to stop doing to keep her safe prior to
that marathon? No. More likely, you would first consider the demands of that event – she must be able to run 26.2
miles. Then, you would probably assess her starting point. Perhaps she can only run 5 miles currently. From there, you
would devise a training plan to get her from her starting point to where she needs to be on marathon day. In other
words, your focus would be on preparing her body to be strong enough to successfully manage the high-stress demands
ahead of her so that she is not only able to complete that marathon, but to do so with minimal risk of pain or injury – all
while enjoying her performance of such a herculean event.

The journey through pregnancy, childbirth, and the postpartum experience also places very specific and high stress
demands on an individual’s body. Yet, we don’t often approach training for this journey the way we do other major
performance events -- an oversight that can leave those who are expecting woefully unprepared to manage the stresses
placed on their bodies.

We view the pregnancy journey in an entirely different light. We view it like the major athletic event that it is. That’s why
we developed an evidence-based Performance Training Approach that prepares pregnant and postpartum individuals
to successfully manage the stresses placed on their bodies and, not only recover from them, but emerge even stronger.
By helping our clients train better for the ultimate athletic event ahead of them, we in turn give them the freedom to
focus more on enjoying the thrill of this special time (which so many parents know goes by far too fast).

So, what exactly does this type of training look like? Well, to prepare the body most effectively for any specific event –
whether that’s a marathon, tennis match, golf tournament, or pregnancy -- the training should be specific to the
demands of that event. That is why training specificity is at the heart of our Performance Training Approach. While any
movement is better than NO movement, we want to prepare our clients for the specific stresses and demands they will
face so that their bodies are prepared to handle them.

Therefore, the very FIRST step in prenatal training is to define the prenatal training goals. Without an understanding of
your client’s goals, the plan you create – and the resulting preparation – could be less effective. So, in this e-guide, we
will first define the three goals that every pregnant person is training for. Next, we will dive into each goal to examine
some of the factors that influence success in achieving that goal. This will help you to think through some of the various
components to include when developing prenatal training programs, which will make you a more effective coach for
your clients.

THE THREE GOALS OF PRENATAL TRAINING

If you asked your pregnant clients what their training goals are, some may tell you they want to avoid gaining too much
weight. Others may tell you they want to prepare for childbirth, or that they simply want to “have a healthy pregnancy.”
While everyone has their own specific goals, in general all pregnant people are training for the following three goals:

© 2020 PROnatal Fitness 2

 (1) Pregnancy

As their bodies change and grow, we want to help our clients minimize injury and maximize daily function. In
other words, we want individuals to thrive during their pregnancies – continuing to move with energy and ease –
and not feel like it is something they must endure while in discomfort.

(2) Childbirth

For most people, childbirth will be the greatest physical and mental feat of their lives, and we want them to be
as prepared as possible for their BIG day. Therefore, we are training to help facilitate an easier labor (for parent
and child), and to reduce the risk for requiring medical intervention.

(3) Motherhood

This goal is often overlooked in prenatal training, but it’s an important one. There are three components of it.
First, we want our clients to be able to recover quickly and fully from pregnancy and labor. Second, we want to
ensure they can successfully carry out the very physical demands of parenthood. Third, we of course want to get
our clients back to doing all the things they loved doing before pregnancy (and perhaps even more).

During prenatal training, clients are training for these 3 goals simultaneously. Now that we have defined these goals,
let’s dig into each of these a bit to understand some of the factors that influence success in achieving them.

GOAL 1: PREGNANCY

To be successful at being pregnant, the individual must be able to withstand the myriad of physiological changes that
accrue over a long 9 months. Now, the full list of changes is far too lengthy to cover here. Every system in the body
must adapt to grow a human in 40 weeks. In our full-length Pre/Postnatal Performance Training Specialist Course, we
cover the 8 most important changes to understand. We will discuss 3 of those changes here:

Hormonal Changes

There are a host of hormonal changes that the body undergoes (estrogen, progesterone,
prolactin, etc.), but the main one for movement pros to consider is the increase in the
hormone relaxin. Just as the name sounds, relaxin works to soften the joints, ligaments,
and other connective tissue, to allow the body to adapt to carry a growing baby, and to
provide the laxity and mobility needed to push a baby out. A consequence of this soft
tissue laxity is that it often increases mobility and decreases stability.

This is an important point to consider when thinking about taking your clients to end
ranges of motion, either via stretching or doing strengthening moves. Your client may
develop a greater range of motion (ROM), but she may not yet have control over that new range of motion.

Relaxin impacts the entire body, but is most often felt in the pelvic/hip area, especially when combined with the shifts in
alignment and center of gravity (discussed next). So, be aware that clients may have more trouble controlling single-leg
activities like lunges, step-ups, or other change-of-direction activities. Finally, it is important to note that relaxin impacts
every person differently. Some people will not feel its effects much at all, while others will experience greater changes.

KEY TAKEAWAYS
The effects of relaxin often lead to increased mobility, and decreased stability (especially in pelvic/hip region).
Avoid overstretching
Watch for stability deficits in single-leg activities and offer regressions if needed
Help your client build pelvic stability by focusing on strengthening the deep core/pelvic floor and glutes
© 2020 PROnatal Fitness 3
Alignment Changes

The amount of weight gained directly impacts the changes to one’s alignment. The common shifts we see are:

1. Lumbar lordosis: As the belly grows, it often tips the pelvis anteriorly resulting
in lumbar lordosis (or the excessive lower back arch). This is one of the
reasons that low back pain is the #1 most common pain during pregnancy.

2. Thoracic spine kyphosis: A consequence of the lumbar lordosis is that the

other curves in the spine will accommodate, often leading to a more
pronounced kyphosis of the thoracic spine. This can be exaggerated by the
weight of the growing breasts.

3. Shift in Center of Gravity (COG): The COG for a non-pregnant individual is a

few inches below the navel. During pregnancy, the growing belly shifts this
COG out and up. This can often lead to leaning backwards to counterbalance
the weight in front (as you can see in the picture here a bit). This places even
greater pressure on the lower back, and could lead to a posterior pelvic tilt.

4. Wider Pelvis: Relaxin also increases the width of the pelvis. This results in an
increase in foot width, which means that gait and movement patterns will
likely be altered, resulting in movement compensations (and more aches and
pains).

It’s important to note that the movement compensations – and resulting pains and injuries – discussed above do NOT
have to be an inevitable part of pregnancy. Therefore, coaching your client into neutral alignment will be a critical
component of your prenatal training. In fact, this is the very FIRST thing you should address with a client. We cover
neutral alignment in detail in our education and will also share more about this in upcoming emails, so be on the lookout
for these.

KEY TAKEAWAYS

Pregnancy tends to shift an individual’s alignment and COG, which can lead to various pains and injuries
Coaching your client into neutral alignment should be a major focus during prenatal training

© 2020 PROnatal Fitness 4

Intra-Abdominal Pressure (IAP) Changes

When a body gains weight during pregnancy, it is primarily centered in the abdominal
cavity. This added mass increases the pressure in that cavity, or intra-abdominal
pressure (IAP). Specifically, it increases pressure outward onto the abdominal wall and
downward onto the pelvic floor muscles. While a certain amount of IAP is needed for
the core to assist in accelerating, decelerating, or stabilizing movement, too much
pressure over time can lead to core injuries like Diastasis Recti (abdominal separation)
and Pelvic Floor Dysfunction – two conditions discussed at length in our education.

Proper core training and IAP management will be a key component of your prenatal
coaching – whether you are an individual coach or group instructor. This means not just
knowing what to avoid, but also what to focus on to help your clients better regulate
their IAP and develop a strong and functional core.

KEY TAKEAWAYS
Growing belly creates excess intra-abdominal pressure (IAP).
This leads to greater risk of developing Diastasis Recti and Pelvic Floor Dysfunction.
Proper “IAP Management” will be a critical piece of your coaching.

While we dive much more deeply into these and other pregnancy changes in our education, you can already begin to get
a sense of how these pregnancy changes impact your clients’ body and movement. They must be taken into account to
know what to focus on, and avoid, as pregnancy progresses.

GOAL 2: Childbirth

Often, those who exercise during pregnancy do so because they want to get in shape
for, what they imagine to be, the grueling physical experience of labor. While there is a
general sense that childbirth is difficult, fitness professionals need a more specific
understanding of the physiological demands so that they can prepare their clients
most effectively. After all, how do you prepare a client for an event you know little or
nothing about? This is why we discuss childbirth in detail in our Pre/Postnatal
Performance Training Specialist Course – helping you understand the stages of labor,
exactly what happens during each stage, and what strategies you can use to help your
clients successfully prepare for the various demands of each stage.

Here we will focus on two key stressors to consider when preparing your client for Stage 1 Labor (the longest stage):
energetics and biomechanics.

© 2020 PROnatal Fitness 5

Energetic Demands

The progression of contractions from early to late labor follow a pretty predictable pattern. They start out very brief
(maybe 30 seconds) and mild in intensity. The rest interval in between is long, perhaps 15-20 minutes or more. As they
gather steam – signaling that the baby is getting closer to making its appearance – the contractions get longer (perhaps
60 seconds) and much more intense, while the rest interval in between gets shorter and shorter (perhaps 2-3 minutes).

The entire process can take hours or days, depending on several factors. And if we scratch the surface of those
numbers, we can glean an important relationship: stress (contractions) to recovery (rest interval). In other words, the
waves of contractions are nature’s interval training (actually the “ultimate” High Intensity Interval Training) and these
high intensity intervals can last for several hours. This means that energy system training will be a key piece of your
prenatal programming as well. You will learn how to do this in our Specialist Course by how you structure your client’s
work-to-rest ratios as pregnancy progresses. You will also learn how to utilize a technique called LIIT™: Labor Intensity
Interval Training to help your clients prepare physically and mentally the challenging cycles of stress-to-recovery.

Biomechanical Considerations

When left to their own devices, laboring people often choose one of the following positions to help ease the discomfort
of contractions:

• Deep squats

• Hinges (with arms supported)

• Quadruped

• Side-lying

In addition, these positions (which almost always put the

pelvis in a posterior tilt) can help the baby descend and
advance labor. By observing the body’s instinctual
movements, you can use them to guide how you train
your clients. Your role as a fit pro is to ensure your client
can access these when the time comes. This means
practicing these labor and birthing positions during the
prenatal program, especially a deep squat, which may be
a more challenging position for some.

There are many more ways you can help clients prepare for their BIG day, including pain management strategies and
pushing preparation. These are taught in the Birth Prep Stage of our Prenatal Performance Training Framework.

KEY TAKEAWAYS
The more you understand the demands of childbirth, the better you can prepare your clients for it.
Focus on energy-system training to prepare your client for the energetic demands of labor.
Focus on position practice to ensure your client can access a wide range of positions as labor progresses.

© 2020 PROnatal Fitness 6

GOAL 3: Motherhood

Many pregnant women do not consider what happens after the big day comes and goes (after all, they deserve a
vacation!). But, in many respects, that is when the work begins. The initial postpartum period can be intensely physical
and, by analyzing precisely how the body is taxed, you can devise strategies to help prepare your clients to better
manage (and prepare for) these tasks. For example, new moms spend an inordinate amount of time performing the
following Activities of Daily Living (ADLs):

• Carrying (with 1 or 2 arms)

• Bending
• Squatting
• Lifting
• Hinging
• Level changes (getting up from and going down to
the ground, often while carrying baby)

The way they move during these ADLs directly impacts the
speed and effectiveness of their recovery, and
unfortunately many women perform these activities with
poor alignment (spinal flexion when hinging, lateral flexion
while carrying, belly bulging when lifting heavy objects,
etc.). Therefore, it is essential to teach your prenatal
clients correct ADL patterns early on to ingrain good
mechanics, especially because they will be performing these activities while exhausted and recovering from labor…then
a few years later with a 25-30 lb toddler. When your clients can learn to move with proper mechanics, they will be able
to perform their daily tasks with greater ease (and less energy) while minimizing stress to their bodies, which will help
significantly improve their recovery speed. In our Pre/Postnatal Performance Training Specialist Course, we teach you
several ADL-based movement patterns to incorporate into your client’s programming that utilize the actual name of the
activity (i.e. ground pickup, crib reach, bath time kneel, etc.).

KEY TAKEAWAYS
Proper movement mechanics during ADLs will have a significant impact on recovery.
Teach your prenatal clients functional ADL-based patterns early on to ingrain proper movement mechanics.
It’s important they translate how they perform these moves in their workouts to how they perform them in real life.

Where to Grow from Here

Now that you have a clearer sense of the specific goals that your prenatal clients are training for – and some of the
factors that influence success in achieving them – hopefully you are able to think more critically about the structure and
progression of your prenatal programs. If this has piqued your interest, consider exploring our education to become a
Pre/Postnatal Performance Training Specialist. Alternatively, if you are a Group Fitness Instructor and looking for
guidance on how to safely and effectively coach the pre/postnatal clients who attend your classes (instead of learning
how to design customized 1-on-1 programs for this population), check out our Mini Course: Pre/Postnatal Education for
Group Fitness Instructors. Finally, stay tuned for more information and education in future emails. We thank you for
your interest in working with this incredibly deserving – yet underserved – population, and we are excited about the
impact you can make!

© 2020 PROnatal Fitness 7