DAY ONE

What You Need to Know

About Strength Training
During Pregnancy
STRENGTH TRAINING DURING PREGNANCY: HOW TO STAY SAFE,
HEALTHY, AND STRONG

Day 1: What You Need to Know About

Strength Training During Pregnancy

What if I told you that you’re about to learn information that will change
your life (or the life of anyone you know who’s pregnant)? Whether it’s a
friend, family member, client, patient, or any woman who comes to you
for help?

What if you were about to learn:

o How to strength train during pregnancy while keeping yourself and

your baby safe?
o How to reduce your risk of common pregnancy issues like low back
pain, pelvic pain, and incontinence?
o How to set yourself (or the women you help) up for the best
postpartum recovery possible?

Would you be interested? I thought so!

Before we dive in, here’s something you might not know:

Strength training during pregnancy has a ton of benefits. It’ll not only help
you maintain your strength and aerobic fitness, but also reduce your risk of
prenatal issues like gestational diabetes, preeclampsia, and incontinence.
Plus, you’ll reduce your risk of preterm birth, and potentially, your risk for
a C-section, which typically has a longer recovery than vaginal birth.

And that’s not all! When paired with pelvic health physiotherapy, training
during pregnancy can help reduce the risk and severity of a number of post
pregnancy health conditions.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

This is critical, especially if you consider these shocking stats:

o While numbers vary, a 2006 study showed that five to seven

years post childbirth, 44.6% of women have some form of urinary
incontinence.1
o 35% of women have painful sex in the 12 month period following
childbirth.2
o Up to 19% of women will have surgery for pelvic organ prolapse or
incontinence at some point in their life.3

Translation: Chances are, a woman you know is struggling with issues

related to pregnancy or postpartum at this very moment… and you might
not even know it.

Now that you understand how much this can impact women’s lives —
you’d think it’s something everyone knows, right!? But they don’t! In
fact, many health and fitness professionals who work with pregnant and
postpartum women have big gaps in their knowledge. And it makes sense!
OB/GYNs aren’t supposed to be exercise experts, and coaches and trainers
aren’t expected to have the same knowledge about the pelvic floor as a
physiotherapist.

This course is designed to close those knowledge gaps. Our team of pre-
and postnatal experts come from 12 fields of study and have a combined
300+ years of practical and clinical experience working with pre- and post-
natal women.

Whether you’re a coach, trainer, physio, nurse, midwife, doctor, or mom-to-

be, you’re going to come away with a better understanding of how to help
women gain ALL the benefits of strength training during pregnancy while
also staying safe and healthy.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

In other words, this free course will be life-changing for anyone who’s
pregnant (or who works with someone who’s pregnant). What you’ll learn
here can impact the quality of your life (or your clients’) for the next 5, 10,
20, or 30+ years.

And that’s why I’m SO happy you’re here! I’m Molly Galbraith, co-founder
and woman-in-charge at Girls Gone Strong. Over the next five days, you’ll
learn exactly what you need to know to keep yourself, your friends, your
family, your clients, your patients — or anyone who comes to you for help
— safe, healthy, and strong during pregnancy.

Once you finish this course, you’re going to:

o Fully understand the benefits of strength training during pregnancy

— including how it can improve your pregnancy and set you up for
a good postpartum recovery (which, as I’ve mentioned, can impact
quality of life for decades after childbirth).
o Know how to modify strength training workouts for each trimester.

o Feel more confident and prepared to help yourself (or the women
you work with) strength train during pregnancy in a way that will
keep both mom and baby safe.

Today, we’re going to start things off with the must-know information you
need to accomplish that.

Ready? Let’s start with the basics.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

So, Is Strength Training Safe During Pregnancy?

Yes! As long as you...

• Have the go-ahead from your doctor to exercise

• Don’t have any contraindications (we’ll get into those shortly)
• Follow some simple safety guidelines

… strength training during pregnancy is both safe and incredibly beneficial,

regardless of your experience level with it. (That means even absolute
beginners can get started with strength training during pregnancy!)

In fact, all the major governing bodies, including the American College
of Obstetricians and Gynecologists,4 the Society of Obstetricians and
Gynaecologists of Canada (SOGC), and the Canadian Society for Exercise
Physiology,5 recommend women who are pregnant get:

o At least 150 minutes of moderate-intensity physical activity each

week, spread over three or more days (though daily activity is
encouraged).
o Resistance training plus aerobic training (or in other words, strength
training plus cardio).

Why? Well, strength training during pregnancy has a ton of benefits,

including:

• Decreased risk of gestational diabetes

• Decreased risk of preeclampsia (i.e., a combination of high blood
pressure and increased protein in urine)
• Decreased postpartum recovery time
• Decreased risk and severity of low back pain
• Decreased risk of urinary incontinence

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 Day 1: What You Need to Know About Strength Training During Pregnancy

• Decreased risk of Cesarean birth

• Prevention or improvement of depression
• Maintenance of physical fitness

Those are some pretty awesome reasons to keep training (or start!).

But how do you actually do it safely?

That’s the million-dollar question, and I’m going to answer it — starting

with four guidelines for training safely during pregnancy.

4 Guidelines for Training During Pregnancy

Whether you’re completely new to strength training or you want to
continue training during pregnancy, keep these guidelines in mind.

GUIDELINE #1: THE BASIC PRINCIPLES OF STRENGTH AND CONDITIONING

STILL APPLY
There are hundreds of exercises that are appropriate during pregnancy.
So you don’t need to feel like your options are limited.

In fact, there are just a handful of activities and exercises pregnant women
should avoid completely, and some specific symptoms to watch out for
while you train — to learn what these are, head to the link at the bottom of
today’s lesson page to download your bonus resource packet.

The bottom line, though, is that as long as your doctor says you can
exercise, you can go ahead and squat, deadlift, push, pull, lunge, and carry
throughout pregnancy!

Of course, you may need to modify some exercises, especially later on in

pregnancy. In the coming days, I’ll explain exactly how to do that in each
trimester.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

GUIDELINE #2: IF YOU’RE A BEGINNER, START SLOW

You may have heard that when it comes to exercise, pregnant women
should:

• Keep doing what they were doing before they got pregnant.
• Avoid doing anything new.

As it turns out, this advice isn’t always accurate or helpful.

If you’ve never trained with weights before, you (or your clients) can still
start a strength training program while pregnant as long as you have
clearance from your doctor. Pregnancy is actually a fantastic time to get
started because of all those benefits we talked about earlier!

If you’re a beginner, there are two important things to remember:

1
1. Start at lower intensities and for shorter periods of time.
2
2. Gradually work up to a moderate level of intensity.

Let me clarify that a little. By “intensity” I mean both intensity of load

(how much weight is being lifted) and intensity of effort (how hard you’re
working).

If you’re a beginner, you’ll want to start on the low-end of what you feel
you’re capable of, both in terms of how heavy you’re lifting and how hard
you’re working.

How do you know how hard you’re working?

We like to use the perceived effort scale. The perceived effort scale is
exactly as it sounds: It’s a way to measure how intensely you’re working
based on how you feel.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

As you can see in the image, according to the perceived effort scale, low
intensity would be about a 2–3 out of 10. Moderate intensity would be
about 4–6 out of 10.

So if you’re just starting out, ease into training and stick with lighter
weights while not pushing yourself above a 3 or so effort-wise. Once you
get a little more practice, you can increase the weights and push that effort
up to a 6.

Little or No Activity:
1 Anything other than sleeping, such as watching TV, reading, or riding in
a car.

2 Light Activity:
Easy and could be sustained for hours. It’s easy to carry on a
3 conversation.

4
Moderate Activity:
5 Feels like you could sustain it for hours, but your breathing is heavy, and
it’s more difficult to hold a conversation.
6

7 Vigorous Activity:
On the verge of becoming uncomfortable. You can only speak a sentence
or a few words at a time and can’t sustain the activity for long periods.
8

Very Hard Activity:

9 Very difficult to sustain. It feels like you can hardly breathe, and you can
barely speak a word.

Maximal Activity:
10 Almost impossible to keep going. You can hardly breathe, and you can’t
speak at all.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

As long as you keep those two recommendations in mind during your

workouts, you can absolutely begin strength training during pregnancy,
even if you’ve never tried it before or it’s been a while since you last picked
up weights.

Guideline #3: Ditch the Heart Rate Monitor

Speaking of the perceived effort scale, there’s a reason we recommend
using that rather than a heart rate monitor for most women.

During pregnancy, your heart rate tends to go up as a natural response to

pregnancy. If you’re a beginner or intermediate athlete, like most women,
and you cap your efforts based on heart rate, you’re probably going to stop
far sooner than you would if you were going by perceived effort. And if all
your workouts are too easy, you’re not going to reap as many health benefits!

Translation: Heart rate and effort do not align well during pregnancy, and
you can probably work harder than your heart rate monitor is telling you.
That’s why we recommend using the perceived effort scale rather than the
heart rate monitor.

There is an exception to this rule, however: If you’re an elite athlete, you’re

already capable of pushing yourself SO HARD that your heart rate can get
exceptionally high, even while your perceived effort feels moderate or
low. So, if you’re an elite athlete, make sure you monitor your heart rate
and keep it below 85–90% of your max so you don’t accidentally overexert
yourself.

Guideline #4: Celebrate Showing Up

Finding the motivation to be active isn’t always easy when you’re pregnant.
Aches, pains, nausea, and fatigue may become parts of your (or your

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 Day 1: What You Need to Know About Strength Training During Pregnancy

client’s) everyday life. Remember to celebrate when you make it through a

workout, even if it’s just a high-five or a quiet acknowledgment to yourself
that you made it work.

During this course, I’ll provide you with specific exercises, programming
ideas, and coaching tips for the first, second, and third trimester.

But for now, let’s talk about when strength training isn’t such a good idea.

When Is Strength Training NOT Safe?

If you have contraindications to exercise during pregnancy, then strength
training may not be safe.

There are two kinds of contraindications to know about.

Absolute contraindications mean strength training is definitely not safe.

Relative contraindications mean strength training may be safe with

approval from your medical team.

We don’t have time to go over all the contraindications in today’s les-

son, so please check out the bonus resources — available at the bottom
of the lesson page — for a comprehensive list of contraindications.
You’ll find them in the section called Stop, Caution, Go.

Please note: If you’re a coach, it’s not your job to diagnose contraindica-
tions. That’s typically done by a primary care provider or physiotherapist,
but it’s still helpful to be aware of them.

So how can you keep yourself (or your clients) safe?

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 Day 1: What You Need to Know About Strength Training During Pregnancy

If you’re pregnant:

o Check with your doctor before starting or continuing an exercise

program. Ask them to fill out the PARmed-X for pregnancy, which
is a screening form that covers all the absolute and relative
contraindications for exercise during pregnancy. You’ll find a link in
that Stop, Caution, Go section of your bonus packet.
o Stay aware of how you feel while exercising. If something feels “off,”
get it checked out by a pelvic health physiotherapist or your primary
care provider.

If you’re a coach working with clients who are pregnant:

o Ask your client to bring in a signed copy of the PARmed-X form her
doctor has filled out. This form will confirm she’s cleared to exercise
and will share what limitations the doctor suggests, if any.
o Put a screening process in place (if you don’t already have one) to
check for additional contraindications or risk factors so you can
refer your client out if necessary. For example, if you find out your
client is experiencing incontinence during exercise, you could refer
her to a pelvic health physiotherapist. You’ll find GGS’s pregnancy-
specific intake form in today’s bonus resource packet; this is a great
tool to use with your prenatal clients to make sure you can design a
safe and effective program tailored to their needs.

While we’re talking about this, I want to emphasize that for most pregnant
women, strength training is totally safe. But there are a few specific types
of exercise and exercise techniques that we recommend all pregnant
women avoid. Again, these are covered in today’s bonus resource packet.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

Friendly Reminder: Scope of Practice

Before we wrap up today, I want to quickly mention scope of practice.

If you’re a trainer, coach, nurse, midwife, physiotherapist, or any other type

of health professional, scope of practice is what you can and can’t do under
your credentials by law. (For example, if you’re a personal trainer, you can’t
diagnose the cause of low back pain or prescribe a treatment for it.)

Your client may come to you with symptoms or concerns that are beyond
your qualifications. If this happens, then it’s crucial to refer her to a qualified
practitioner. Then, hopefully, you can work in tandem with that practitioner
to provide your client with the best possible interdisciplinary care.

We talk about referrals a lot at GGS (in fact, we include a whole bunch of
resources on how to build a referral network within our Pre- and Postnatal
Coaching Certification). Aim to build a network of qualified professionals
with varied specialities who will take good care of your clients. We’ve
included some tools to help you get started with that in today’s bonus
resource packet.

Summary
Great work getting through a ton of information today! You’re well on your
way to confidently helping yourself (or the women you work with) strength
train safely during pregnancy — and reap the decades-long benefits.

Of course, there’s so much we didn’t get to today.

Things like... the special considerations for each trimester of pregnancy.

Whether or not it’s safe to keep running while pregnant. What birth prep
exercises look like. And so much more.

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 Day 1: What You Need to Know About Strength Training During Pregnancy

So if you’re thinking there’s still lots left to learn, you’re absolutely right.

Tomorrow, we’ll answer some of your most pressing questions, including:

o Does exercise increase the chances of miscarriage?

o What modifications do you need to make as soon as you find out

you’re pregnant to keep yourself and your baby safe?
o How many strength training sessions per week should you really
be doing?

The answers to these questions might surprise you. You won’t want to
miss out!

Before you leave, don’t forget to download and study today’s bonus resource
packet so you can make the most of this free course. And remember to fill
our today’s study guide to cement your knowledge and deepen your under-
standing of the material.

See you tomorrow!

REFERENCES

1. Glazener CM, Herbison GP, MacArthur C, Lancashire R, McGee MA, Grant AM et al. New postnatal
urinary incontinence: obstetric and other risk factors in primiparae. BJOG, 2006.

2. Banaei M, Kariman N, Ozgoli G, Nasiri M, Ghasemi V, Khiabani A, Dashti S et al. Prevalence of

postpartum dyspareunia: A systematic review and meta-analysis. Int. J. Gynaecol. Obstet., 2021.

3. Jelovsek, JE. Pelvic organ prolapse in women: Choosing a primary surgical procedure. UpToDate.
<https://www.uptodate.com/contents/pelvic-organ-prolapse-in-women-choosing-a-primary-surgical-
procedure> 2001.

4. Physical activity and exercise during pregnancy and the postpartum period. ACOG Committee Opinion
No. 804. American College of Obstetricians and Gynecologists. Obstet Gynecol 2020;135:e178–88.

5. Mottola MF, Davenport MH, Ruchat SM, Davies GA, Poitras V, Gray C et al. No. 367-2019 Canadian
Guideline for Physical Activity throughout Pregnancy. J. Obstet. Gynaecol. Can., 2018

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