Part 3 of 5: Training During Pregnancy - Meet Us At The Bar

In Part 1 and Part 2 of this series Dr. Liz Zeutschel discussed the research and recommendations on exercise and training during pregnancy, and hopefully put your mind at ease about some of the common myths. If you’ve decided to continue to train during your pregnancy, you probably have questions about how your belly and physiology are going to affect your lifts and training schedule.

In this article we are going to discuss the squat, bench press, overhead press, deadlift, and power clean, barriers you might encounter with them during pregnancy, and alternatives to continue training around them. Although many of our clients are competitive lifters with specialized programs, we program these 5 lifts with many of our general strength training clients so we feel it’s important to discuss all of them.

You’ll soon see that the recurring theme here is to try out different positions, see how it goes, and find out what feels good to you (wait, are we talking about lifting or…?). Dr. Liz having been through this herself, and working with women before, during, and after their pregnancies, we can make some suggestions for things you might try if the main barbell lifts give you trouble during pregnancy. Take note: not everything that we suggest here is going to feel right for you because each pregnancy, and each body, is different. We recommend only implementing things that feel right to you, so if it hurts, or makes you uncomfortable, don’t do it!


Personal Equipment

One of the first concerns a woman typically has, after making the decision to continue training, is how to implement use of personal equipment such as a belt. Will tightening my belt hurt my little lima bean? (Side note: why do all pregnancy apps compare the baby to various types of produce? It’s weird). Anyway, if the belt is comfortable to you, it’s most likely not doing any harm. Dr. Liz, and many of our clients, continued to use their belts during the first trimester. At a certain point it no longer felt comfortable, so they stopped. If your belt no longer feels comfortable, is causing pain, or no longer feels natural on your little apricot to wear it tight enough to be effective, we recommend discontinuing use of the belt. If it feels fine, keep wearing it!

Some women also find the shoes they used to train in no longer groove well or fit them (a moment of silence for all pre-pregnancy shoe collections, please). A common issue that arises for women who squat in weightlifting shoes is that the combination of the ½-¾ inch heel and their expanding bellies tips them forward. Of course, the other issue is that mean old Mister Gravity causes some spreading of the bones with the ligamentous laxity that comes along with pregnancy, and may produce some swelling as well. So, when your shoes no longer fit and no longer produce help with effective balance, then switch to something more comfortable and a little flatter. While the use of proper footwear is something we are pretty adamant about for non-pregnant lifters, a pregnant lifter should wear whatever feels comfortable and stable for them. We still don’t recommend lifting without shoes so if being barefoot feels good to you, at least wear something like a pair of Converse, Metcons, those weird finger-like shoes, wrestling shoes, or even Vans, Sperry’s or Tom’s. There are plenty of options to keep your feet safe, clean, and healthy waddling around in the gym as your belly and feet expand.

Lastly, as eggplant continues to grow there is usually associated swelling in the lower extremities from the compression the expanding uterus and heavy placenta have on the main vascular structures to and from the legs. Because of this, many women find that, at some point, their knee sleeves are too hard to get on and off, or cause severe distress to their calves when they wear them (cut these things off of me!). There are many alternatives to the standard competition sleeves (that are thick and tight) that produce warmth, comfort, and mild support to the knee joints without producing the suffocating effect of standard competition sleeves. Rehband, Hook Grip, Rock Tape, and many other companies make thinner, less compressive sleeves that maybe alleviate some of the stresses of thicker sleeves while still providing some benefit during pregnancy. Look for a 3-5mm sleeve and size up if you need to.


Squat

Many women can continue squatting the same way they always have for the first, and maybe second, trimester. The two biggest issues that could potentially arise are your belly getting in the way of proper depth, and back or pelvic pain. As your pregnancy progresses you can adjust your stance width and toe angle to accommodate your belly, but the principle of keeping your knees in line with your toes will still apply. If you’re a low bar squatter and the more horizontal back angle is causing pain, consider switching to high bar.

Late in the second and third trimester Dr. Liz began using a wider, more turned out stance with the bar a bit higher, almost like a goblet-style squat with a barbell (it also probably looked ridiculous, but she trains in her garage so who cares anyway?). For women with pubic symphysis pain, this stance may actually feel worse, and if you can’t find a way to alleviate it you might have to switch to leg presses or box squats at a height that does not cause pain. Play around with your bar position and stance and do what feels good. If someone gives you a hard time about your technique, just be like, “I’m making a human being inside of me, what did you do today?”


Bench

Many women become concerned about lying supine as the fetus grows. The research and recommendations on this were discussed in Part 2 of this series, so we will let the reader make the decision on how long they are going to continue to bench lying flat. If you are at all worried about lying supine, switch to incline bench for your own peace of mind.

If you’re cool with, and understand the rules for laying on your back, arching during the bench press may become bothersome or difficult. No big deal, there are options!  Switch to a flat back bench, but don’t let your body turn into a soft, unstable mess. When benching with a flat back, continue to keep your shoulder blades retracted, puff your chest up as much as you can without arching to the point of discomfort, and use some leg drive to keep yourself stable on the bench.

You can also prop your feet up on blocks or plates to reduce strain on the lower back. This is a safer alternative to benching with your feet up on the bench. Hey, even though it seems like you shouldn’t be able to fall while lying down, benches can be narrow (and let’s be real, you’re not getting any narrower), and you don’t want to get hurt, or worse, end up in a gym fails compilation. Lastly, switching to incline or standing press might be the best alternative for you in the later stages of pregnancy.

The final thing worth noting on the bench press is that breast tenderness is common, so we’ll go ahead and save you a rather uncomfortable experience and suggest lowering your touch point by a couple inches or working with a tempo of a 2-3 count lowering phase to reduce the velocity of impact, if you know what we’re saying.


Press

Abdominal tightness is an important factor in performing a well-executed overhead press. Additionally, as loads get heavy, there will be moderate amounts of layback (arching) in order for the lift to be completed. Women who use the standard standing press, and find that they are requiring a lot of layback to perform each rep, should work with lower intensities such that they do not need to lean back quite as much and are within their comfort zones. For those that use the Press 2.0 (see Starting Strength: Basic Barbell Training, 3rd edition) and find they are unable to contract their now non-existent abdominal muscles in order to keep their lumbar spine locked, switch to the standard press (press 1.0 in earlier editions of Starting Strength), and continue pressing this way for the duration of the pregnancy or until you no longer feel comfortable.

We also want to emphasize exhaling and taking a new breath between every rep. One of the last things we want in the gym is for a pregnant woman to become lightheaded and fall with a barbell over her head. If you are at all concerned about loss of balance or falling, best to switch to seated dumbbell presses, seated press, or incline barbell or dumbbell presses.


Deadlift

Similar to the squat, back pain and belly size are probably going to be the limiting factors in the deadlift. As your belly grows, you may need to widen and/or turn out your stance in order to maintain a proper setup with the bar over the middle of your foot, your back set in extension, and shoulder blades over the bar.

You may find that your stance widens to a point where it feels more intuitive to take your grip inside your legs, or in other words, pull sumo. With sumo, your back angle will be more vertical than with a conventional setup which may feel better for women with back pain and/or a protruding belly, but the principles of the setup and initial pull off the floor are the same. Additionally, the trap bar deadlift could also be a good alternative for you if the more horizontal back angle of conventional is cumbersome with your belly and the wider stance of the sumo deadlift causes discomfort in your pelvis. For women who aren’t able to continue deadlifting off the floor, a switch to RDLs may be best for you. Some people find these to be quite uncomfortable, so again, you’ll just have to experiment. So many options! You do you, mama!


Power Cleans

 If you are someone who was doing power cleans or snatches as part of your programming, the obvious issue here is that eventually the cantaloupe in your belly is going to be in the way of the bar path. You can try to continue cleaning and snatching if you wish, but at some point your technique is going to be so affected by your belly being in the way that they’re not really worth continuing.

Normally we prescribe barbell rows for those that aren’t appropriate for power cleans, but again... belly and possible back pain. If you need to substitute a different back exercise for your cleans or barbell rows, we suggest lat pulldowns, cable rows, bent over dumbbell rows (supporting yourself with your hand on the bench), TRX rows, or bodyweight inverted rows at an incline that feels comfortable.


Your Overall Approach to Training

The last modifications we’ll discuss in this article are just some general mindset considerations when approaching your overall training regimen. There are plenty of accounts of pregnant women setting PRs, even in their third trimester, but that doesn’t mean that has to be you. Remember, if you have been training for a while, your body is adapted to the stress of training, but during pregnancy there may be a general shift in the training vs. exercise mentality, as discussed in Part 1. A little bit of grind isn’t necessarily a bad thing as long as you have it in you, but in general I would exercise caution when setting hard-headed goals.

Dr. Liz often approached each session not with a specific goal for weight on the bar, but just proceeded with her warm-ups and then worked with a weight that was moderately challenging but still comfortable and pain free. If that meant the intensity wasn’t super high, she might have increased the volume, or maybe not, it just depended on how she was feeling and how badly she wanted to go inside and eat Blue Bell while watching trashy television. She personally decided that setting PRs was not the most important thing to her during pregnancy and so this “go by feel” approach worked well. She also did not time her rest periods when training, but rather just sat down and rested until her breathing returned to normal and she felt ready to do her next set. And it’s best if you come to terms now with the fact that even if you want to be that round-bellied, badass, preggo chick in the gym setting PRs at 36 weeks, if your body is saying no, you may have little choice but to listen to it.

You should also keep in mind that you may not be able to lift as much weight if you’ve had to change your technique or make modifications. After all, they are new lifts! But if the pregnancy is going well, your weights are still increasing, and you don’t have any discomfort or health concerns, then you should be able to continue to make progress. If you can PR your deadlift and feel great about it, then that’s awesome! If you can’t, that’s also awesome! You. Are. Awesome. Some PRS lifters have continued to train following individualized programs written for them by their coach, and in the next article Dr. Rori Alter will discuss how we program for these clients.

Notice that the recurring theme here is “do what works for you”. It’s true, for a client with no injuries or medical issues, the way it feels may not always be as important as efficient technique, bar speed, or learning to grind. But if someone had told Dr. Liz to  “screw your feelings” when she was pregnant, or even postpartum, she probably would have gone home and cried, or potentially hurt the bun in the oven. The most important thing really is that you listen to your body. The human body is extremely self-regulating, especially during pregnancy, and the bottom line is that a pregnant woman should never do something in the gym that she is not comfortable with or that causes pain or distress.

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 liz@progressiverehabandstrength.com and on Instagram at @liz_nicole25