Part 1 of 5: Pregnancy and the current recommendations for exercise & strength training

I think every mom can remember the exact moment that she got those 2 pink lines on a pregnancy test. Before you actually got the nerve to purchase the test (oh God please don’t let anyone I know see me) and then think of some Instagram-worthy way to tell your husband the news, there are usually some weird symptoms that you can’t quite attribute to anything else. In the back of your mind you know what’s probably gone down but you just ignore it until you decide you can’t keep pretending to drink out of your wine glass at girls’ night.

No? Just me? Anyway… I can remember going out into my garage gym one June afternoon to train, and when I tried to arch my back during the bench press I felt a sharp, nagging pain that ran right down the midline of my abdomen. Never having experienced this before I decided to chalk it up to maybe some weird stomach cramp or tenderness from my belt. I proceeded to finish the session with a flat back, thinking it was an isolated incident, but it happened again the next time I benched, and again the time after that.

A few weeks later I would find out I was pregnant, date of conception being early in June. I can’t say for certain that this was the cause of pain in my abdominal ligaments, but perhaps the hormonal changes had something to do with it (and honestly I kind of just knew). I would later have to make additional modifications to my bench press and other lifts in order to accommodate my growing belly.

These modifications were not anything specific that I read in a book, heard from a doctor, or even worked closely with a coach on. Sometimes I was able to get advice from other moms who lifted through pregnancy, but other times I had to figure it out on my own. I wasn't able to find a local healthcare professional who supported barbell training, nor could I find other women who trained while pregnant and experienced some of the same things that I was. The point of that riveting introduction about my bench press was to illustrate that information on lifting throughout pregnancy is lacking and that everyone experiences pregnancy differently.

The purpose of this 5-part series is not to make promises or even speculations about what your specific experience will or won’t be if you choose to train while pregnant. I really wish I could tell you that if you train, you will have a shorter labor, an easier delivery, no medical intervention, and you won’t even lose control of your bowels (TMI?). But I can’t. Still interested? Excellent. Because what we are going to discuss is:

  • the current recommendations for exercise and strength training during pregnancy

  • the benefits, potential risks, and myths surrounding training while pregnant

  • modifications you can make to your barbell lifts

  • programming during pregnancy

  • getting back under the bar postpartum

Grab your bellies ladies, here we go!

Lifting during pregnancy has become more and more commonplace and strong women everywhere are challenging the notion that heavy lifting during pregnancy is deleterious. Despite there being no evidence that this is true, women who choose to train while pregnant will receive criticism from people who are otherwise uninformed. I’m not a medical doctor, so obviously don’t take my word as gospel, but I am a physical therapist and barbell coach who lifted heavy barbells while pregnant and delivered a perfectly healthy baby girl. And I’m here to shed some light on the issue of training while pregnant so that next time you get lowkey judged about your pregnancy decisions, you can just go strongly and silently about your business.

The Center for Disease Control and Prevention (CDC) and the American Congress of Obstetricians and Gynecologists (ACOG) agree that exercise has many benefits during pregnancy. I mean really, who would’ve guessed that exercise is beneficial? *eyeroll* Exercising while pregnant can reduce back pain, ease constipation, and promote healthy weight gain (woohoo!). It reduces the risk of gestational diabetes, lowers the incidence of cesarean sections, improves cardiovascular health for the mother, and may even have a positive impact on the baby’s cardiovascular health as well. Regular exercises also has the added benefit of just generally making you not feel like a beached whale all the time (take it from me). A woman who exercises throughout her pregnancy is also more likely to lose her pregnancy weight sooner after delivering. Yay! Exercising while pregnant sounds magical. So what should I do?

The CDC recommends “150 minutes/week of moderate intensity aerobic exercise” and suggests things like walking, riding a stationary bike, water aerobics, yoga, and the like. The ACOG also suggests that pregnant women avoid exercise involving contact, risk of falling, high altitudes, and hot temperatures. That’s about as specific as it gets and quite frankly, it sounds boring as hell. Where are the strength training recommendations? Does the ACOG even lift? Chances are if you’ve read this far then you are someone who trains. Training is following a pre-designed program of workouts in order to accumulate the effects of said series of workouts over a period of time, with a long term goal in mind (e.g. increased strength). Training manipulates certain programming variables in order to take advantage of the stress-recovery-adaptation cycle. If that didn’t make any sense to you, then don’t worry, it’s a topic for another time. On the other hand, exercise is an activity performed for the short term effects, or performing any sort of physical activity hoping for a flat stomach and a nice butt...I mean uh, improved health and fitness.

Most doctors who don’t lift will agree, across the board, that a woman with a normal pregnancy can safely lift up to 30lbs. That seems kind of ridiculous to those of us who are adapted to lifting weights in the hundreds of pounds. In fact I think I detrained a little just by typing it. Even my own doctor told me this when I inquired about my training, probably because he didn’t want to touch that with a 10 foot pole.

But the truth is that there are just no good studies on pregnancy and strength training (or really any type of training), mostly because studies on pregnant women and controversial topics are a little hard to do from an ethical standpoint. You can’t exactly take 500 pregnant chicks and tell half of them to squat barbells at double bodyweight and the other half to do 15lb kettlebell squats and see which group has more miscarriages or preterm labors then if something goes wrong be like “oops sorry well now we know” (by the way, about one third of all pregnancies result in miscarriage, so the chances of it happening during any given activity are already relatively high).

Like I just mentioned, there is very little information about pregnancy and strength training and most of it we don’t even really care about, but I’ll go ahead and summarize:

  1. Drawing conclusions based on survey responses from women who have been pregnant. This isn’t all that helpful if the responses aren’t relevant to you because most of those women (more than 90%) don’t even lift.

  2. Studies on supervised resistance training during pregnancy that usually involve something silly like 3 sets of 10 bicep curls.

  3. Studies on heavy lifting in the occupational setting, which is obviously not the same as lifting barbells 3-4x/week for 1-2 hours in a very controlled environment, so again, not helpful.

I literally could not find a single study on lifting heavy barbells during pregnancy, so if you find one, let me know! In the meantime, there are no studies that support that heavy lifting (more than 25 lbs., lol) increases the risk of miscarriage, low birth weight, or premature delivery. There is, however, evidence to suggest that women with high-risk pregnancies should limit physical activity. This article does not apply to those people so if that’s you, best to consult your doctor.

So let’s say you’ve been training and you become pregnant, what do you do? Go ahead and keep training as long as you can. At some point, you may have to stop or modify, at which point you will be training mostly for maintenance and to reap the benefits of exercise stated above, which is completely fine. You’re growing a human being, after all. If you are pregnant and haven’t been training but would like to start, best to wait until after you deliver and just exercise in the meantime, because exercising is certainly better than sitting on your butt eating donuts. The reason is that you are not yet adapted to the stress of training, and it is advisable to stick with something that your body is already adapted to while pregnant.

The bottom line is that heavy lifting done by women with an otherwise normal pregnancy poses no significant risk to the fetus or the pregnancy if this is something she’s already adapted to doing.

Hence, most practitioners will say “if you’ve been doing it since before you were pregnant, you can keep doing it” (wish that applied to drinking wine too, am I right?).

The biggest concern is that due to the shifted center of gravity and the softening of connective tissue, mom may be more likely to injure herself while lifting, as if somewhere between conception and the third trimester she missed the memo that she has to move a little differently now. This all gives rise to the touchy-feely “do what works best for you” approach that we will discuss in a later part of this series. Stick around for the rest of our 5-Part PRS Pregnancy Series when we go over each barbell lift in more detail, as well as our approach to programming. But before we do that, I’ll go over some common myths in Part 2 as well as some things that you should legitimately be concerned about if you’re growing a human being inside of you. So stay tuned, mama!

Dr. Elizabeth Zeutschel is a PRS Strength Coach, licensed physical therapist and certified Starting Strength Coach who resides with her husband and daughter in Meridian, Mississippi. You can contact her at and on Instagram at @liz_nicole25