This is the first post (Weeks 5-8) in the series "What you don't expect when you're expecting".
“I’m so nauseous I can’t even think about exercise.”
Ah the magic of the first trimester; you feel the crappiest, but you can’t tell anyone why.
(Honestly? Go ahead and tell people if you like. The whole “keep quiet until the second trimester” is an antiquated notion keeping us from normalizing miscarriage. But I digress.)
This blog is about what you can do if movement and exercise are important to you, but the thought of doing it makes you want to throw up...again...for the third time today...oh right now? You go. I’ll be here when you get back.
I know how you feel.
Here’s how I felt during those early weeks of my second pregnancy, taken straight from my journal:
Symptom I’m feeling the most: Fatigue
We’re talking 2 hours naps at 9am
UPDATE - week 6 - nausea. No wait, fatigue...nausea? I should just take a nap - that’ll take care of both.”
So yes, I’ve been there (twice) and here is what I found:
My 9 best tips for if you’re too sick to exercise in the first trimester.
1. Replace your morning coffee with lemon water
When I was pregnant with my second, I kept a big pitcher of lemon water (sometimes with mint or cucumber too) in my fridge and started off my day with a glass to replace my usual ritual of coffee. Excess caffeine consumption in the first trimester has been linked to miscarriage, but up to 200 mg is considered safe - that’s about 12 - 16 oz of coffee. I personally just didn’t want a hot beverage first thing in the morning in July. I saved my caffeine budget for the afternoon slump since I couldn’t always nap like I did during my first pregnancy - thanks toddler!
I’m also a fan of the old “Saltine’s on the bedside table” trick. Nibble on a couple while you’re still horizontal to get the jump on nausea.
Speaking of tiny, frequent meals...
2. Get on the Hobbit eating schedule (Breakfast, Second Breakfast, Elevensies, Luncheon, Afternoon Tea, Dinner, Supper)
For me, smaller and more frequent meals were the ticket. The following smoothie was my first breakfast since the fat and protein content is practically nonexistent. However the quick carbs and fresh ginger were just what I needed first thing in the morning to get my energy up and nausea down!
Ginger Peach Smoothie
2 peaches - fresh or frozen
1 banana - fresh or frozen
2 inch piece of fresh ginger
¾ almond milk
1 T maple syrup
3ish ice cubes if using fresh peaches AND banana
About an hour after my smoothie, I would have something more substantial (re: full of good fats and protein). Usually involving peanut butter...or whatever that week’s craving was.
3. Try Sea Bands, or, if you’re feeling adventurous, acupuncture
When the nausea hit me full force at week 6, everything went a bit downhill. By mid-week 7, I was at the end of my rope. I went to see the acupuncturist who works in the same integrative health center where I teach Pilates (shout out to The Restoration Space). I felt GREAT after a quick 20 minute session. She also outfitted me with little acupuncture “bandaids” for my wrists (same trigger point as Sea Bands) and an acupressure ball for my upper ear. I didn’t realize how well they were working until they fell off mid-week 8. For the 2 days after I kept thinking “ugh, why am I feeling WORSE?” Then it dawned on me that my little bandaids had fallen off. So give it a try! If the idea of needles is unappealing, try Sea Bands for some relief, combined with the next tip.
4. Deep breathing
Technically, this is a meditation technique. But honestly, who is more deserving of some mental relaxation than your glorious, teeming with life self?
Sit comfortably somewhere you won’t be disturbed for few minutes
Place your palms in your lap and relax your shoulders
Inhale through your nose for a slow count of 5. Get as much air in as you can.
Hold for 2-5 counts
Exhale through your nose for a slow count of 5. Again, get out as much air as you can.
Repeat until nausea has abated
Why does this work?
Your diaphragm is in communication with your vagus nerve which is the main “circuit” connecting your brain to your abdomen. Although the mechanics aren’t fully understood yet, deep breathing has shown anecdotal relief of morning sickness. Worst case scenario is you’re still nauseous but at least you’ll be relaxed!
5. Stick to low- to moderate- intensity
In the first trimester, the physical changes are so minimal that you don’t need to make any significant changes to your workout routine (*always listen to you doctor*). However, if you haven't noticed, you’re running a little hotter these days (meow). The main thing to watch out for regarding exercise in the first trimester is to avoid overheating and dehydration. Also be mindful of the seasons. Considering my first trimester happened in July, I was especially careful the second time around.
Here are the exercises deemed “safest” by the American College of Obstetricians and Gynecologists (ACOG):
Walking (see #7)
Modified Pilates (whoop whoop!)
If you were doing other forms of exercise before pregnancy, you’re probably okay to continue but always check with your OBGYN. Here are some prenatal exercise FAQs from the ACOG.
6. Keep it simple
Just like your eating schedule, try to inject a little movement multiple times a day. A 10 minute walk here, some deep breathing there. Then, try taking tip #4 (Deep Breathing) to the next level. On your exhale, encourage some gentle pelvic floor and transverse abdominis activation, aka “Hug the baby” with your belly. Think of it as toning your internal Belly Band. And whaddya know - you’ve just exercised a little!
Try this same “Hug the Baby” breathing in different positions:
On your back with your knees bent
On all 4’s
If you’re trying it on your back, add some slow knee lifts on the exhale. If that goes well, bring up both knees and try toe taps. Add a reach with the opposite arm if you’re feeling good!
Keep the breath/pelvic floor/transverse abdominal work gentle for now. I’ll be discussing the mechanics of it all later in this series.
Being on your back making you nauseous? Check out #7!
7. Identify positions that make morning sickness worse
Even if you were the inversion queen before you got pregnant, you do NOT want to mess with gravity when you are suffering from morning sickness.
The same may go for lying on your back. Seeing that most of the Pilates matwork is done supine (on your back) you may need to get a little creative.
Assume a more upright position by using a bolster or fluffy pillow at your bra line to give you a boost.
Pretend the wall is the floor and try pieces like The 100, Roll Up, and Swan standing against the wall.
Play with gravity in general. How else can you achieve the same shape in space? Check out my Instagram Highlights for modification ideas.
8. Walk it out
Walking is hands down the best form of prenatal exercise. It’s functional movement (clearly), low risk, low impact, and the fresh air and increased heart rate will give you a boost of energy. Walking also helps keep the joints surrounding the pelvis lubricated and helps keep the muscles that support those joints toned and supple. This means less aches and pains later in pregnancy when you start moving a little less gracefully and a little more waddly.
When going for your daily walk (yes, daily - I believe in you), keep tip #5 in mind. If you live somewhere that gets hot, schedule your walks for the morning or evening as opposed to the peak of the day.
If you take anything aways from this list of tips, let it be this:
Get into the walking habit now. It will carry you through the fourth trimester, helping to both heal your body and clear your mind.
9. Don’t exercise
There. I said it. You may honestly feel so unwell that you need to pause exercise for a few weeks. AND THAT’S OKAY. You and only you can make that call. I want you to make a decision you feel GOOD about. Just promise me you won’t feel guilty with whatever choice you make, okay? You have your whole life to work out.
Today, you’re building an eyeball - and that’s way cooler.
I hope one or more of these tips works for you. Morning sickness isn’t an exact science - be sure to talk to your doctor if it’s severely affecting your day to day life. They can prescribe specific types of prenatal vitamins (B6 sometimes helps) and they can keep an eye out for a more serious condition called hyperemesis gravidarum.
You’ve got this! Remember - you’re stronger than you think.