PROGRAMMING CONSIDERATIONS FOR CLIENTS IN THEIR FIRST TRIMESTER

Training clients during pregnancy can be daunting but it doesn’t need to be. With over 85% of women having children at some point in their life, if you train female clients, it’s not a matter of if but when you will train your first pregnant client, instead of needing to refer onto other trainers educate yourself about how to train this target market. Today’s article will delve into the first trimester, the physiological and psychological changes that occur and how we can train our clients to give them more energy in what can be a very exhausting time.

Firstly, let’s recap what the benefits of exercise during pregnancy are. It is important to remind our clients of their “why” when first trimester symptoms such as; morning sickness, mood swings, and fatigue can make exercise seem like a daunting task on the best of days.

●      Reduces back pain

●      Eases constipation

●      May decrease your risk of gestational diabetes, preeclampsia, and cesarean delivery

●      Promotes healthy weight gain during pregnancy

●      Improves your overall general fitness and strengthens your heart and blood vessels

●      Prepares the client for labor and birth

●      Decreases postpartum recovery time

●      Prevents/ improves depression, anxiety, and other mental health illnesses

●      Decreases the risk of postnatal depression

●      Decreases risk of urinary incontinence 

●      Prevents postpartum weight retention

●      Increases energy levels

●      Increase in lean muscle mass

●      Less pregnancy-related bone density loss

Even if your client has been very active before falling pregnant the first trimester can bring some or all of the following physiological changes and symptoms

●      Increased blood volume and heart rate

●      Increase in hCG, hCS and hPL, estrogen and progesterone hormone levels

●      Fatigue

●      Morning sickness - this can affect some women in the afternoon or even all-day

●      Breast tenderness, feeling fuller or heavier

●      Headaches

●      Increased urination

●      Insomnia

●      Vivid dreams

●      Dizzy spells

Not all pregnant women will experience these symptoms but many will experience multiple, if your client is one of these women their goal for the first trimester should be to take care of herself and rest where possible.

During the first trimester, women experience changes in their memory, moods, mental health, energy levels, and appetite. It’s important to understand how a pregnant woman may be feeling, if her pregnancy is planned she may be excited, anxious or overwhelmed. Unplanned pregnancies can also bring joy and happiness but for some women, this may be stressful or sad news. With these feelings, along with extra hormonal changes that can cause unpredictable moods and thoughts it is important for the trainer to give positive reinforcement to each client. Each and every woman will have an individual pregnancy experience so it is paramount that we always ask open-ended questions to check in with our clients and see how they are feeling each time they train with you, some days they may feel great and want to train hard and others they may be exhausted, feeling nauseous and overwhelmed so a gentler session may be more appropriate.

Before beginning any exercise program with your pregnant clients or when your client advises you they are pregnant it is best practice to have your client answer a pre-exercise questionnaire specific to pregnancy before they start training with you, the Canadian Society for Exercise Physiology has an excellent one on their website, there is a link to this in the references below. The American College of Sports Medicine recommends women should accumulate 150 minutes of moderate Physical Activity each week. Exercise is encouraged daily but should be completed at least 3 times per week.

Goals for the first trimester should include

●      Focus on posture and alignment

●      Increase strength and muscle mass

●      Pelvic floor

●      Developing a solid aerobic foundation

●      Promote healthy weight gain

We need to know when to stop exercise with a pregnant client, if your client exhibits any of the following signs you should stop exercise immediately and get in touch with their lead maternity carer

●      Bleeding from the vagina

●      Feeling dizzy or faint

●      Shortness of breath before beginning exercise

●      Chest pain

●      Headache

●      Muscle weakness

●      Calf pain or swelling

●      Regular, painful contractions of the uterus

●      Fluid gushing or leaking from the vagina

The volume and intensity of your program will vary depending on your client’s previous experience, fitness level, any complications they may have, her current pregnancy symptoms, her goals, and the amount of time she has to dedicate to training. Through her pregnancy, these may change so it is best to keep open communication with each other frequently.

Things to avoid during the first trimester include;

●      Getting too hot, avoid activity done in high temperatures

●      High impact activities such as contact sports or anything with a high risk of falling

When it comes to strength training very few modifications need to be made during the first trimester as your client’s belly will not yet be in the way but there are a few things to consider

●      Building a strong upper back will help support a women’s growing breasts and belly

●      A strong core will help her carry the weight of the growing baby

●      A strong posterior chain can help keep the spine aligned and reduce back pain

●      It is not recommended to lift in the 1-5 rep range as this increases abdominal and pelvic floor pressure

●      Your clients may feel breathless so you may need to lower the intensity as necessary

Building or maintaining a good cardiovascular base can help clients sleep better, reduce stress and recover from strength sessions. Women who are overweight can also reduce the risk of developing gestational diabetes. For most clients and those who are new to exercise working at a level of 4-6 out of 10 is ideal and HIIT training may not be appropriate. For those who are more conditioned, you can work at a 6-8 out of 10 and include HIIT training if the client is feeling up to it. If they are suffering from extreme fatigue or nausea it would be best to leave the HIIT and higher intensity sessions to another time. 

Just like any client, when creating a program for the first trimester you need to factor in your client’s goals, the duration and frequency of sessions, what your client enjoys, any complications or symptoms they may have, training load/ volume/ range of motion/ exercise choice and a balance of pushing v.s pulling movements. Each program should be tailored to the individual but the most important thing to remember is exercise during pregnancy should increase energy levels not leave your clients fatigued and nauseous, learn to adapt a program for your clients fluctuating mood, energy level, and level of nausea and you will play a big part in keeping them active through their entire pregnancy so they can reap the benefits.