At Made for Women Workouts, our mission is to provide exercise solutions and guidance to those with prolapse at all stages. There is one group of women who we feel need a little extra guidance due to the lack of information currently available. These are women who are pregnant and have prolapse. Finding exercise programs that are suitable for women with prolapse is challenging enough, let alone, exercise programs that are geared specifically for pregnant women with prolapse (Don’t worry, we’re on it!).
When it comes to staying fit and strong in your pregnancy, there are FOUR KEY GUIDELINES that pregnant women with prolapse should follow:
1. Don’t Hold Your Breath
If there was ever a time to follow this one prolapse-specific guideline, it would be during your pregnancy. Now that there is added weight inside of your core, there will be more load placed on the pelvic floor and pelvic organ connective tissue. Holding your breath during exercise has the tendency to create a downwards pressure that strains the pelvic floor and supportive tissue. Let’s not make it any easier for downwards pressure to occur.
Here is our previous video on how to breathe if you have prolapse, more specifically, how NOT to breathe when exercising with prolapse.
2. Alignment, Alignment, Alignment
Similar to number one above, if there was ever a time to be more aware of you’re alignment, it would be during pregnancy, especially if you have prolapse. What we know from anatomical models is that the pelvis is naturally tipped forward. This is great because it allows for bony support of our pelvic organs. The bladder sits directly behind the pubic bone, followed by the uterus, followed by the rectum. We really want to take advantage of this support because there is no better support for our organs than the solid structure of bone.
In pregnancy, changes in centre of gravity can easily alter your alignment and tip your pelvis the other way. With a posteriorly-tipped pelvis (one in which the buttocks appears to flatten out), we lose the solid support of our pubic bones and the pelvic organs are now centered over the pelvic floor, including the uterus which is growing weekly. Keeping your pelvis in a forward-tipped position by maintaining a neutral and “untucked”alignment can reduce pelvic heaviness and make exercise during pregnancy more comfortable.
Notice how the pelvic organ (jar of coconut oil) rests on the pubic bone when the pelvis is forward and then loses that support when the pelvis tips backwards:
3. Use Your Deep Core Muscles
Using your pelvic floor, transverse abdominis, and diaphragm throughout your workouts is especially important if you’re pregnant with prolapse.
If you’re not already familiar with the Foundation Breath which coordinates the recruitment of your deep core muscles, take a look at our Foundation Training Series that teaches you how to locate these core muscles and then use them inside of exercise.
4. Exercise in Supportive Positions
Try to find exercises that are done in positions that directly support your perineum and/or off-load your pelvic floor. Examples are:
*In the second and third trimesters, we strongly recommend wearing light
abdominal support/compression and/or using pillows under the belly when in forward leaning and hands-and-knees positions to support against diastasis recti abdominis.
Now that we have covered those four fundamentals, here are some of our exercise suggestions for women with prolapse who are pregnant:
Upper Body Strengthening Exercises
When possible, do these exercises in a seated position, either on a ball or a chair. Un-tuck your pelvis (create a gentle curve in your lower back) to take advantage of the support of your pubic bones. Use your Foundation Breath with every repetition.
Examples of Upper Body Strengthening:
Lower Body Strengthening Exercises
Most of the large muscles in the lower extremities can be targeted in the seated, forward-leaning, and side-lying positions. Consider adding weight by using a resistance band or a hand-weight as shown in the first exercise below.
Here are some examples:
Here are some examples of core strengthening during pregnancy. Keep in mind that any exercise done on an exercise ball will also involve your core. Remember to activate your deep core and use your Foundation Breath!
For a great cardio workout, we recommend the stationary bike. Alternatively, swimming is another excellent option. Buoyancy off-loads the weight of the pelvic organs on the pelvic floor which is wonderful for prolapse.
Resistance machines are great for women who are pregnant and have prolapse because most of them are in a seated position which supports the perineum. They also allow you to work out large muscle groups such as your quads that are harder to target on a chair or a ball. While using the machine, continue to follow the same four key guidelines for exercising with prolapse during pregnancy.
Summing It All Up
By now, you can see there is lots you can do during your pregnancy to stay strong and fit. If you don't feel symptomatic, you can also include squats and lunges into your routine as they are extremely functional and will help support your body in an upright stance.
In conclusion, we know that exercising in pregnancy if you have prolapse seems like an impossible feat, but we hope that our four fundamental guidelines as well as our exercise examples show you that IT IS POSSIBLE! Take advantage of supportive positions, breathe, maintain neutral alignment as best as possible and use your Foundation Breath. Always listen to your body and don't do any exercises that increase your prolapse symptoms. One last recommendation is to work alongside a Pelvic Floor Physiotherapist to help you manage your prolapse during pregnancy.