As your client approaches the final stretch of their pregnancy journey, it’s common for them to experience  an abundance of emotions. 

On top of excitement, joy, stress, and anxiety, the growing baby brings about increasing physical discomfort—from backaches to shortness of breath to heartburn. 

Plus, birth is a physically demanding experience, testing a mother’s strength, endurance, and mental health.

The good news is that, as a fitness professional, you can help your client better cope with the physical and emotional challenges experienced during the third trimester of pregnancy.

By encouraging your client to stay physically active throughout their third trimester, they may experience:

• Less back and pelvic pain
• Better sleep quality and energy levels
• Lower risk of pregnancy and delivery complications

That said, not all types of exercises are recommended for the third trimester of pregnancy. Continue reading to learn more.

Third Trimester Exercises to Prepare for Birth

Doing the following exercises during the third trimester of pregnancy may help your client through the birthing process. Note that your client should always get approval to exercise from their primary healthcare provider.

Any Form of Aerobic Exercise

Regular aerobic exercise during pregnancy could improve your client’s physical fitness and, in turn, their maximal oxygen uptake or VO2 max—the maximum amount of oxygen they can breathe in during physical exertion (labor and birth, for instance).

Research consistently shows an association between higher VO2 max and shorter duration of labor.

According to a 2021 meta-analysis of 16 studies, researchers found that prenatal aerobic exercises can help shorten vaginal labor time and reduce the frequency of cesarean section (c-section).

Aerobic exercises you could suggest to your client include brisk walking, riding a stationary bike, yoga, and water aerobics or swimming.

Birth Prep Exercises

Generally, the most effective position for the baby to journey through your client’s pelvis is the occiput anterior (OA) position.

In the OA position, the baby is head down with their face looking at your client’s spine.

Other positions, including the occiput posterior (OP), where the baby is head down, facing the naval, or breech position, where the baby is lying bottom or feet first, are known to lengthen labor time, increase pain, and may even necessitate assisted delivery and c-section.

Exercises that may encourage your client’s baby to engage in the OA position include:

• Wide child’s pose
• Seated pelvic circles
• Cat cow
• Pelvic tilts

Strength Training Exercises

With permission from their healthcare provider, your client could start or continue to strength train even as they progress into their third trimester of pregnancy.

A large body of evidence shows that resistance training could encourage a healthy pregnancy and lower the risk of complications—from preeclampsia to pre-term birth to stillbirth—and c-section.

Strength training exercises particularly worth focusing on include:

Core and Pelvic Floor Exercises

Research shows that strong abdominal muscles may play an important role in the voluntary pushing mechanism triggered during the final phase of vaginal delivery.

That said, there are specific core exercises your client should avoid to help prevent abdominal separation or diastasis recti and we’ll explore this in more detail later.

Pelvic floor exercises, including kegels, heel slides, and diaphragmatic breathing could help produce strong and well-controlled pelvic floor muscles to facilitate labor.

Posterior-Strengthening Exercises

The further your client gets into their pregnancy, the more their pelvis gets pulled into an anterior tilt.

This results in a more kyphotic posture where the abdominal muscles are overstretched, and hip flexors get incredibly tight.

Beyond potentially causing lower back pain, this can also make it difficult for your client to get into their preferred birthing position, like the squatting position. Thankfully, posterior-strengthening chain work—i.e., exercises that strengthen the “backside” of the body—could help counteract your client’s posture and increase their comfort during birthing. Examples include squats and deadlifts.

Breathing and Relaxation Exercises

According to a 2022 systematic review, researchers found evidence that practicing breathing and relaxation exercises during pregnancy reduces the need for pharmacological support (specifically, epidural anesthesia). Lower labor pain levels are also reported.

Examples of breathing and relaxation exercises you could include in your client’s exercise program during the third trimester of pregnancy include slow, rhythmic, and shallow breathing.

FAQs About Exercising During Third Trimester of Pregnancy

Here are some commonly asked questions about exercise during the third trimester.

How Much Should Your Client Exercise During the Third Trimester?

According to The American College of Obstetricians and Gynecologists pregnant individuals should get at least 150 minutes of moderate-intensity physical activity each week accumulated over a minimum of three days per week. This should be distributed between a variety of aerobic and resistance training activities.

That said, how little or much your client should exercise during the third trimester also depends on the following:

• Their fitness level: If your client is relatively new to working out or it’s been a while since they last exercised, you’ll want to start on the low end of what you feel they’re capable of, then slowly work your way up the scale on their exercise program.
• How they feel: As your client’s baby gets closer to their birth weight during the third trimester, your client’s fatigue levels can increase. So, let their body guide them on how frequently and how intensely they should exercise. 

What Movements Should Be Avoided in the Third Trimester?

In the absence of contraindications, exercise during the third trimester of pregnancy is generally safe and recommended for your client’s and their baby’s health. However, this doesn’t mean all movements are safe.

Here are a few you may wish to avoid recommending.

Unstable Exercises

It’s common for balance to be affected during pregnancy. Avoid unstable training methods such as standing on a BOSU ball or rear foot elevated split squats to minimize the likelihood of injury.

Supine Exercises

Although there is conflicting advice on this, most current guidelines state that pregnant individuals shouldn’t do prolonged exercise in the supine position during the final trimester.

This is because the baby’s weight could compress the inferior vena cava (a large blood vessel responsible for transporting deoxygenated blood from the lower extremities and abdomen back to the heart), which will sometimes result in a sensation of dizziness or nausea.

So, to reduce this risk, avoid exercises performed with the client on their  back, such as leg lifts, glute bridges, crunches, and dead bugs.

Olympic Lifts

These two lifts require your client to move the bar explosively past the mid-section.

Even if your client is familiar with these movements and has been training with them pre-pregnancy and in the first two trimesters, a growing belly could make accurate judgment of the barbell’s distance from the body challenging, increasing the risk of fetal trauma from impact.

Heavy Resistance Training

Any load that requires your client to use the Valsalva maneuver (straining while holding the  breath) is too heavy.

Beyond affecting your client’s blood pressure, the Valsalva maneuver may also cause excessive downward pressure on their pelvic floor, which is already under strain during pregnancy. 

Any Exercises That Cause Excessive Pressure on the Linea Alba

Diastasis recti refers to the separation of the rectus abdominis muscles.

The rectus abdominis muscles are divided into left and right sides by a band of tissue called the linea alba that runs down the middle.

As your client’s uterus grows to accommodate the baby’s increasing size, their abdominal muscles are stretched. This may cause thinning and pulling apart of the linea alba.

To minimize the occurrence of diastasis recti or prevent it from worsening, exercises that put unnecessary pressure on the linea alba should be avoided. 

Common culprits include crunches, planks, and other high-load abdominal exercises performed in a front-loading position.

Exercises That Cause Pelvic Floor Discomfort or Pain

Be cautious of exercises that cause your client to feel sensations of heaviness, discomfort, or pain in the pelvic region.

High-Impact Exercises

Exercises such as running, jumping, or rebounding are generally not advised in the third trimester of pregnancy because of the impact they may have on the pelvic floor. 

Instead, you may wish to opt for low-impact cardio options like brisk walking, water aerobics, and stationary cycling.

Plyometric Exercises

Plyometric training involves quick, powerful, and explosive movements.

Examples of plyometric exercises include box jumps and lateral hops. Beyond increasing your client’s risk of falling, plyometric exercises are also generally not advised for pregnant individuals because the body releases the hormones relaxin and progesterone throughout pregnancy to loosen muscles, ligaments, and joints.

Because of this potential decrease in stability, performing explosive movements may increase your client’s risk of injury.

Is Planking Dangerous During the Third Trimester of Pregnancy?

Planking is not inherently dangerous during the third trimester of pregnancy.

That said, as mentioned earlier, it may cause pressure on the linea alba. So, if you notice any bulging along the midline of your client’s abdomen, you may wish to instruct them to perform planks on an incline or skip this exercise entirely.

The good news is that you have many other third-trimester-friendly core exercises to choose from, including the suitcase carry or the half-kneeling palloff press.

Should Your Client Do Squats in the Third Trimester?

Yes, in general, as long as your client:

• Has gotten the go-ahead from their primary healthcare provider
• Doesn’t experience any pain or discomfort while performing the movement
• Avoids excessively heavy loads that require them to perform the Valsalva maneuver

Any Third Trimester Workouts to Avoid?

In addition to the specific exercises worth avoiding mentioned earlier, you may also wish to instruct your client to avoid the following:

What At-Home Third Trimester Workouts Should Your Client Try?

The types of at-home third-trimester workouts your client could try are virtually endless. This is because there are so many pregnancy-safe exercises and activities to choose from.

Just be sure that your client gets clearance from their primary healthcare provider to exercise and steer clear of movements and activities that should be avoided.

Takeaways

In general, it is beneficial to exercise even into the late stages of pregnancy. Sticking to a regular cardio and resistance training routine could help lower your client’s risk of pregnancy-related complications and make their birthing experience easier. 

However, there are some exercises and activities that should be avoided during pregnancy.  It’s crucial for your client  to get approval to exercise from their primary healthcare provider.

References