The Barbell Mamas Podcast | Pregnancy, Postpartum, Pelvic Health
The times are changing and moms have athletic goals, want to exercise at high-intensity or lift heavy weights, and want to be able to continue with their exercise routines during pregnancy, after baby and with healthcare providers that support them along the way.
In this podcast, we are going to bring you up-to-date health and fitness information about all topics in women's health with a special lens of exercise. With standalone episodes and special guests, we hope to help you feel prepared and supported in your motherhood or pelvic health journey.
The Barbell Mamas Podcast | Pregnancy, Postpartum, Pelvic Health
Prepping for Baby #2: What Changes?
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Motherhood transforms our bodies, our fitness routines, and our expectations – especially when we're thinking about adding another baby to the mix. That second pregnancy truly "hits different," and preparing for it requires special consideration if you're an active woman who loves to exercise.
Drawing from my experience as both a pelvic floor physical therapist and an athlete who has competed in CrossFit and weightlifting through multiple pregnancies, I explore the crucial elements of preparing your body for baby number two (or three!). We examine the science behind the recommended 18-month interpregnancy interval and how musculoskeletal readiness might influence your experience. Rather than focusing solely on the urogenital system's recovery, I highlight how core strength, pelvic floor rehabilitation, and overall fitness create a stronger foundation for subsequent pregnancies.
The reality of juggling exercise with an existing child presents unique challenges. That post-workout fatigue that was manageable during your first pregnancy takes on new meaning when a toddler needs your attention! I offer practical strategies for adjusting workout intensity to preserve energy while still maintaining strength. Most encouragingly, I share the positive trend I've observed among athletic women who approach their second pregnancies with significantly less fear around movement. Many find they can maintain higher training intensities longer, resulting in better physical experiences and faster recoveries.
Whether you're actively trying for another baby or simply contemplating your future family expansion, this episode provides thoughtful guidance for stacking the deck in your favor physically. Subscribe to the Barbell Mamas podcast for more conversations at the intersection of motherhood and athletic performance!
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Hello everyone and welcome to the Barbell Mamas podcast.
Speaker 1:My name is Christina Previtt. I'm a pelvic floor physical therapist, researcher in exercise and pregnancy, and a mom of two who has competed in CrossFit, powerlifting or weightlifting, pregnant, postpartum or both. In this podcast, we want to talk about the realities of being a mom who loves to exercise, whether you're a recreational exerciser or an athlete. We want to talk about all of the things that we go through as females, going into this motherhood journey. We're going to talk about fertility, pregnancy and postpartum topics that are relevant to the active individual. While I am a pelvic floor physical therapist, I am not your pelvic floor physical therapist and know that this podcast does not substitute medical advice. All right, come along for this journey with us while we navigate motherhood together, and I can't wait to get started.
Speaker 1:Hello everyone and welcome to the Barbell Mamas podcast. In today's episode, we are going to be talking about things to consider if you are going to be trying to conceive again, if it is going to be your second, third, fourth child, things that I would recommend personally to try and set yourself up for success with coming up, pregnancy or being pregnant again. I always joke to my clients that the second pregnancy hits different because when you are pregnant the first time, you do not have another child at home, right, and so your family dynamic is very different, and so there can be a lot of changes, a lot of changes in expectation in the second pregnancy or the third, and that can make that second or third pregnancy just that little bit more challenging. What brought about this episode was I was kind of thinking about this with respect to kind of curating my social media feed I have noticed, especially in the last couple of years, that you know there's a lot of debate online about, you know, influencers saying we have the same 24 hours in a day and every parent is saying influencers saying we have the same 24 hours in a day and every parent is saying no, we don't.
Speaker 1:And I have found myself gravitating towards influencers in the fitness and health space who kind of have a family dynamic that is similar to mine, right, and that makes a lot of sense. You get a lot more like, you relate a lot more to the content when you are in a very similar family dynamic, and I think it's fairly natural for you to gravitate more towards that content or say anything negative about individuals who aren't in the same dynamic window that their heart is less than my heart, but it's more that when you have two little kids at home and you're running a business and you're traveling for work, when your circumstances and scenarios are just so different from someone, for example, who works in a gym that doesn't have any kids, it can be hard to feel like you can take their advice personally, or it's very easy, at least for me, to discredit that advice and be like oh well, yeah, it must be nice. Like you know, you don't have X, y or Z, and so because of that, I started thinking about, you know, fitness-related content and some of the people that I follow that have two kiddos and who I really respect in those spaces, and that kind of got me thinking about how we try and maintain a fitness routine when there are multiples or how we help set ourselves up for success for following pregnancies, and so one of the first things is talking about the timeline between pregnancies. Now, ultimately, this is a hugely personal decision around when you decide to try and get pregnant again. Sometimes there are oopsies that happen and you get pregnant a lot sooner than you were expecting. To.
Speaker 1:The flip side can be true where you thought that you were going to have babies X amount of months apart, or try for a baby X amount of months apart and then you have secondary infertility that ends up taking a lot longer. So while I'm going to be talking about interprensy window, I think it's really important for me to acknowledge, first and foremost, that it doesn't matter if you have the best laid plans, if there are things with fertility or oopsies that happen. But many people talk about trying to wait 18 months or more between subsequent pregnancies and I want to talk about where this is coming from, when data has been looking at the amount of time in between subsequent pregnancies and they've placed it into quartiles, so individuals who get pregnant less than six months from giving birth six to 12 months, 12 to 18 months, 18 to 24 months, etc. And they compare that interpregnancy window with health outcomes. What they noted was that rates of preterm delivery were higher when you compared those that got pregnant again less than six months after delivery compared to those who waited 18 plus months. And so when we look at the relative risk look at the relative risk waiting that 18 plus months seems to be the marker or the time point where the relative risk of complications is lowest.
Speaker 1:Now why that is is still up for debate and understanding like what that mechanism is is still, again, not fully understood. But there's a kind of hypothesis or belief that your body is going through a lot of recovery and that is in the urogenital system, so uterus, cervix, that system is all recovering from a very heavy stress which is going through pregnancy and labor and delivery, from a very heavy stress which is going through pregnancy and labor and delivery. I am really interested in understanding the influence or the role of the musculoskeletal system and the pelvic floor system in some of those relative risks and my thought process or my hypothesis, is that there is a contribution of the musculoskeletal system in readiness to go through a big stress again which is a subsequent pregnancy. When we think about the stress of pregnancy on the body, it's really significant. Right, we have the increased weight of the body. Your back arches more, abdominal wall lengthens, pelvic floor is under more strain, butt muscles are under more strain and when you go through labor and delivery if you've had a vaginal delivery then those pelvic floor muscles are injured and the higher amount of tearing, the more damage that happened to that system, the longer it's going to take to recover and the more intention it's going to take for recovery from that injury, and that takes time. And so, when we think about that interpregnancy window, what I would love to see is to see if there's any contribution or if we see a relative change, okay, the amount of muscular recovery that you have.
Speaker 1:So what do I mean by that? I mean from a zoomed in perspective, right. Like, how do you, how does your core and pelvic floor feel? And then how close are you postpartum to your pre-pregnancy fitness? Now, I am not saying that you are always going to return to pre-pregnancy strength, to fitness. Our bodies go through and our lives go through different stages and phases. Like when I was pregnant or became pregnant with my daughter, I was a national level weightlifter. I was weightlifting 10, 11 hours a day. When I was postpartum with my son, I was competing in CrossFit. I was training 10, 11 hours a day. I am not doing that right now, and so I probably returned to about 75 to 80% of my preconception fitness, but my expectation is never that I'm going to get to 100%. I am, however, attempting to get close, and this is going to be kind of my first advice If you were thinking about having another kiddo is what does your fitness look like now and how much fitness do you have going into this, the second pregnancy, compared to your first?
Speaker 1:Again, this is a reflection point. When I talk about things, for example, like pelvic girdle pain, I talk about how our hormones make our ligaments more loose to enable the body to get ready for birth and delivery, which means that we rely more heavily on our muscles, and when we think about that, that means that we need to have more gas in the tank from the muscle side of things in order to help take up the slack. When our hormones are loosening the ligaments in preparation for labor and delivery. And we're seeing that in some of the new literature that is coming out around pelvic girdle pain and how fitness is a protective factor for severe pain in pregnancy, what I have seen clinically can happen is that there is a loss of fitness with each pregnancy and again, this is not to shame or blame, it is just truly a reality of life in many ways.
Speaker 1:Right, you are older, you have kids to take care of, you aren't able to access the gym as easily. Right, there's lots of very tangible, very real barriers where your fitness habits will change. But if you are in that pre-pregnancy window, trying to prioritize effortful resistance training, for example in the several months prior to getting pregnant, may stack the deck in our favor in terms of making that stress on our muscles and bones a little bit easier to carry because we created a bigger bucket leading into pregnancy. So kind of going into that then the idea that we have to be thinking about is going into that subsequent pregnancy. How can we do things to set ourselves up for success Because, as I said, that second or third pregnancy hits different. So for some individuals in subsequent pregnancies I will counsel on changing expectations around exercise.
Speaker 1:Right, when you do a very effortful bout of exercise, your body is tired. After I was trying to train for a marathon and I think I made it to like 31 or 32 kilometers I don't even know what that is in miles, but I think like 15 or 16 miles, something like that. Like 15 or 16 miles, something like that and what I noticed I was not pregnant, but what I noticed was that I was just pooched the rest of the day because I worked out so hard in the morning on those long runs on the weekend that it kind of ruined my weekend and so you know I so much, so much praise for those people who have worked towards doing a marathon For me. It just didn't fit where I was within my family dynamic right now. I didn't like the fact that I felt really tired and that I felt like I wasn't showing up like the parent that I wanted to be afterwards. But that was just me and my circumstance.
Speaker 1:But what I'm meaning by this is that that post-exercise residual fatigue, right, is your body going into recovery mode from that heavy bout of exercise when you are exercising in your first pregnancy, right? I always joke that take that exercise residual fatigue and like three times it, especially if you're in the first trimester or the third trimester. You get this boost of energy in the second, and why that is is because the metabolic demand of being pregnant, in combination with the residual fatigue of exercise, can make it that you feel totally dusted after you exercise In your first pregnancy. If you go to work, if you are working and you go to the gym and then you're super tired, you can lie on the couch the rest of the day. In that subsequent pregnancy, that second or third, there's a toddler at home that is hoping to get your attention. And so what that means is is that if you have absolutely no gas in the tank, you might make yourself a little bit more miserable, that sometimes.
Speaker 1:I'll counsel my mamas who are in second or third pregnancies to just trial, instead of maybe going in a crossfit workout at an RPE of 10 out of 10, start at like a seven or eight out of 10, still work really hard. I'm not saying, you know, do nothing or stay to low intensity, but maybe dial it back like 10% and see how you are the rest of the day and figure out if that sets yourself up for success. And this is especially true on the aerobic cardio Metcon side of the spectrum. A lot of times this isn't as true on the resistance training side of the equation with exercise, but definitely something to be thinking about and considering kind of going into that subsequent pregnancy, kind of along that same line.
Speaker 1:The third thing that I think is really important to be thinking about kind of going into that pregnancy is how recovered do you feel like your abdominal wall and your pelvic floor are? This is again not to scare. I feel like I'm going to say this a lot of times. It's more as reflection points. If you're thinking about getting pregnant again, do you feel like you have strength that has returned to the core wall? Do you feel like you have done your rehab from the pelvic floor perspective? Because, again, what I can see sometimes is when we don't have full recovery, moms can say to me things like man, I felt like I was feeling really good throughout my first pregnancy and this pregnancy feels harder, or postpartum, after their second or postpartum yeah, after second or third baby versus first pregnancy. Like I feel like my symptoms have gotten so much worse, so much faster, or they're not resolving as quickly.
Speaker 1:And that's a multifaceted. There's a multifaceted reason for that. Right, like the second and third pregnancy, your body is going through that big stress for a second or third time. So there is some exacerbations, for example, of the change in vaginal wall range of motion with each delivery and things like that, with the first one being the biggest change in range of motion. I talked about that in a previous pregnancy or a previous podcast episode on expected changes after a vaginal delivery. And what we want to think about is, again, how do we stack the deck in our favor, right, we cannot control many of the times what happens during labor and delivery, if baby goes into distress, if baby is stuck and it requires an instrumented delivery. But again, we want to set ourselves up where we are trying to ensure that we have as much baseline fitness, especially in the areas of the body that are going to be under the most amount of stress right, which is butt, abdominal wall and pelvic floor that we can going into a subsequent birth.
Speaker 1:And then the fourth and final kind of thing that I wanted to mention, or theme that I wanted to mention, that I see a lot and I'm going to end on something really positive, is I find, especially in my active individuals, their fear of exercise and movement is worst or highest in their first pregnancy. And this is something that I've thought about a lot and I'm thinking about it from a research perspective too. What I have noticed is, especially my individuals who really enjoy exercise the first pregnancy. They feel like they have to modify a lot, and on my personal page and on the Barbell Mamas, I just posted about four controversial takes about exercise and pregnancy and one of them was how we don't need to modify as much as we think we do right, and that's going to be personalized and individualized and we don't have blanket statements. And two, I was talking about coning and how, as healthcare providers, we can unintentionally create fear of movement, and there was a lot of people who were talking about their physicians and their endocrinologists who really put the fear of God in people about exercising and pregnancy and how their mental health just really suffered because of that.
Speaker 1:And so what I'm seeing a lot is that modification will be way more intense in the first pregnancy and then you've kind of gone through it before and you are experiencing it again and you're trusting your body to know the signs and symptoms to look out for. And I'm seeing that in a group of individuals in their second pregnancies they don't modify as much and they feel a lot better because of it. And now, of course, pregnancy related complications and things come up that are outside of our control. Right, and this is not everybody's story, but one of the things that I want to try and instill maybe some hope. Right, a lot of times you can think about how the second pregnancy is just so much worse, or the third pregnancy is so much worse, but in some ways it can be better. Where I have had a lot of people tell me, for example, that they kept strength training a lot more intensely all the way through and their body felt better. Their labor and delivery was better.
Speaker 1:I talk a lot about trying to limit deconditioning in pregnancy and try and maintain your fitness for as long as you can, given your personal circumstances and how. What I see clinically is that that leads to better postpartum outcomes and people feeling like their recovery is so much faster, and so that switch in. I got the understanding of how, if, when I need to modify and now I'm going to adjust it for me and my personal story in this pregnancy, and that often means that people modify a bit less or a bit later than they did in previous pregnancies and they actually feel a lot better. That is really kind of a hope story to finish off, because I think there's been a big shift in the space Hopefully I've been a little bit of a positive influence there around removing blanket statements of like after 20 weeks you can't do this, or after 24 weeks you can't do that, because it's just so individualized and if you are running the entire time, your body is adapting to those changes and so you don't all of a sudden become unable to adapt because you are 20 plus two days versus 19 plus six, and so I think that is a really bright light that a lot of people experience, where the fear is just a lot less because they have done it before. The fear is just a lot less because they have done it before and they realized that they probably modified a little bit more than they needed to.
Speaker 1:And it's interesting because I've seen some really high level athletes feel this way, for example, kenzie Riley. I noticed that she modified a lot less in her second pregnancy versus her first, and she had said that how she modified a little bit more. I saw the same thing in Annie Thoris' daughter. Desiree is a semifinals athlete in Nashville. I'm watching her through her second pregnancy. She's doing the same thing. She just snatched 175 pounds at like six months pregnant, and she had removed statues a lot earlier in her first pregnancy, and so it's an interesting trend and I think it's multifactorial right. A lot of the advice online, and sometimes by providers who are well-meaning, can be quite fear-centric, and I think that that is starting to change, and so individuals who felt a little bit more fear are feeling a little bit more empowered in their second pregnancy. And so if that is you and you are listening to this podcast, getting ready to maybe get pregnant for the second or third time.
Speaker 1:I hope I kind of cap off this episode and think about how a lot of times people don't feel like they need to modify as early for the sake of modifying. They may have to modify certain exercises earlier because it doesn't feel as good as it did in prior pregnancies. That's totally different and the exercise that you do is the exercise that feels good for you and you can still see progress within modification and I think that's also a really important point to have. But it's kind of cool to think about how that might change in pregnancies to come. So kind of thinking about kind of bringing this full circle, thinking about your interpregnancy window and what that means. You know, within the boundaries that are within your control, right, and you know.
Speaker 1:To extend on that, I will also tell my clients who want to get pregnant really close together to be very aggressive about their recovery because I want their body to feel as strong as possible going into a second pregnancy, especially if they're really close together, if you're thinking about getting pregnant again, kind of reflecting on your amount of recovery from a fitness perspective in general strength and aerobic and then zoomed into that core canister to again have a body that feels strong and supported, going into a stressful physiological event which is pregnancy. Thinking about exercise modifications, because that pregnancy hits different when you have littles at home to take care of, and what that means by maybe edging in slowly to vigorous intensity exercise and see how your body responds to the increase in demand that you have in your day, because you have the same work, the same exercise, but you have an added component of parenting a little at home. And then the final thing is this message of hope that many people feel like they don't have as much fear around exercise, having gone through that experience themselves, and sometimes that means that they modify a little bit less and because they modify less they don't lose as much fitness across pregnancy and they can feel a bit stronger in their postpartum recovery. And so hopefully that is you and that you're kind of feeling good thinking about or in a subsequent pregnancy, and that is wonderful for postpartum recovery. All right, I hope you all found that helpful.
Speaker 1:Let me know if you are the same as me, where you tend to follow people that are kind of in the phase of life of yours or are close to that phase of life. I know we're kind of like Instagram friends now it's kind of funny, it's like internet friends. I know we're kind of like Instagram friends now it's kind of funny, it's like internet friends, but like influencers like Alexandra Skutnik are incredible. She's a mom of three and I want to be a mom of three, but she, you know, figures out this fitness at home and I just really enjoy following her. So you know, I tend to curate my fitness page around family dynamics that are relatable to me. All right, I hope you all have a wonderful week and we will see you all next time.
