It can be confusing to know what to do about diet and exercise when you are trying to conceive or have experienced recurrent miscarriage.
When you are trying to conceive (TTC), it is an ideal time to prepare your body to be strong and healthy for the demands of pregnancy and motherhood. Pregnancy places extra stresses on your body as you become heavier and your body is learning to adapt to all of the physical and physiological changes. Then at the end of the pregnancy you may be in for some endurance training throughout the labour and birth process too!
TTC is the time do away with any notions of exercising to burn calories. It’s time to consider exercise as part of your overall self-care programme. A self-care programme in itself is an excellent habit to get into and one you can learn to commit to through out pregnancy and perhaps more importantly once you become a mother because you may find yourself needing that space at times! The earlier it becomes part of your routine, the better placed you will be be to come back to it after birth with all the new demands that being a new mother brings and later to role model the importance of self-love to your child.
We are told that we should exercise because it is healthy for both the mother-to-be and the baby but we are not given any real guidance on what kind of exercise is safe or how hard we can – or should not – push ourselves. We do know that increasing levels of lean, metabolically active muscle mass encourages healthy body fat levels and insulin responses and may reduce the risk of both infertility and gestational diabetes. Research has shown that overweight women are less likely to ovulate or spontaneously conceive, and upon conception, have an increased risk of miscarriage. However, excessive exercise and calorie restriction can also lead to a reduction in frequency of ovulation, poor endometrial development, amenorrhea and sub fertility (https://journals.physiology.org/doi/full/10.1152/physrev.00023.2015)
Exercise burns calories which is beneficial if you are looking to maintain good body composition (healthy levels of body fat and lean muscle mass), but on the other hand you want your body to be a safe and healthy, welcoming environment to grow a tiny human being. Therefore you will want to avoid being in any kind of calorie deficit, as this can negatively impact your hormones when it comes to fertility. While TTC is not the time to be pushing yourself in HIIT (High Intensity Interval Training), there is still a huge benefit in increasing your cardiovascular fitness and strength to be able to meet the added psychological and physiological stress that comes with TTC and pregnancy as well as the demands that pregnancy and labour place on your body!
Aerobic activity also helps get a better night’s sleep (http://www.sciencedirect.com/science/article/pii/S1755296611000317 ). Regularly scheduling rest and recovery sessions for eliciting the parasympathetic nervous system is a great way to relive everyday stresses. High bio markers of stress have been linked with a longer time to pregnancy and increased risk of infertility (https://academic.oup.com/humrep/article/29/5/1067/2913997)
So what can you do?
Depending on your training history, you can do some high intensity cardio (HIT) if you are used to doing it and you can also integrate some medium intensity cardio (MIC). Previously the recommendations for pregnancy cardio were not to allow your heart rate to go above 140BPM but this is outdated advice and now the general rule during pregnancy is breathy but not breathless (to ensure adequate flow of oxygenated blood to the uterus).
Much of the focus can be on building lean muscle and maintaining healthy levels of body fat. Specifically through movement patterns such as the hip hinge, lunge, squat for the lower body (protect the lower back when picking up/putting down the baby, get up from and down to the floor), press and pull for the upper body (push the buggy, strengthen the back to mange the weight of the breasts and abdomen) walking and rotation (carry baby, groceries etc)
- Reduce the pressure on your lower back, for example by learning how to disassociate the spine from the hips through movements such as the ‘hip hinge’. Lower back pain is very common during pregnancy, as the weight of the uterus can increase the lordotic curve in the spine, compressing the vertebrae and nerves within the spine.
- Strengthen the core. The muscles of the core stretch and weaken as the abdomen expands to accommodate the growing embryo. By staying connected to the transversus abdominis (TA) muscles, you will maintain strength in the core and reconnect more easily with them after birth. We train the core in such a way that does not restrict us from enjoying our work out (i.e. we do more then lying on our backs doing kegels) but is mindful of not putting pressure on the Linea Alba, which is the connective tissue between the rectus abdominis (6 pack muscles), and can impact the shape of the tummy after birth.
- Strengthen -and relax! – the pelvic floor muscles. Much like the the stomach muscles, the pelvic floor gets weakened by the weight of the uterus which sits on a ‘sling’ of muscles in the pelvis. It’s important to maintain strength in these muscles for urinary continence and to avoid issues such as pelvic organ prolapse. It’s also important for the birthing process that we learn how to relax these muscles too.
- Reduce the effect that pregnancy can have on the upper back. Our bodies become out of balance with the weight and changes to the anterior -or front – of the body (increase in breasts and abdomen) so often we risk having more rounded shoulders. So we work on strengthening the back to help prevent pain which could result from poor posture.
The main thing to keep in mind is that your body is the environment in which your baby will grow. That includes activity, nutrition and stress. In addition to promoting healthy body composition (body fat and lean muscle mass). Your exercise programme is designed to improve posture and alignment, increase strength and prepare the core and pelvic floor for pregnancy. It also promotes a positive body image and releases feel good hormones to level out all those other psychological changes. Exercising and staying active when trying to conceive can help ease stress and improve sleep which is essential for keeping hormone levels where they should be.