I have seen countless articles and guidelines stating that it is unsafe for pregnant women to squat below parallel due to a loosening of supportive tissues (ligaments and tendons) caused by an increase in the hormone relaxin. However, this recommendation creates a complicated conundrum, in that squatting to exactly parallel (a 90-degree knee bend) actually places the knee ligaments in their least stable position, whereas squatting to less than parallel (higher) doesn’t allow you to use your glutes and hamstrings to their full extent, which can result in injuries due to over-developed quadriceps in relation to the glutes and hamstrings.
Neither the Canadian Society of Obstetricians and Gynaecologists, the Canadian Society for Exercise Physiology, nor the American College of Obstetricians and Gynaecologists have addressed the issue of squatting in any of their recent publications on exercise and pregnancy.
In her 2008 article, Full Squat During Pregnancy – To Do or Not To Do, Jacqueline Gradish, BSc., a pre/post-natal exercise specialist, explains some of the potential pitfalls of deep squats during pregnancy:
“The majority of people have muscle imbalances and are unable to maintain neutral spine position. Performing a full squat with an imbalance can further pull your pelvis to one side and may exacerbate pelvic shearing forces in the pubis symphasis (front join of your pelvis) and put strain on your sacroiliac joint. As your pregnancy progresses, your pelvis is opening and widening from the front of your pubis symphasis. This makes more space and allows for your growing uterus to house the baby. This growth puts more strain on your pelvic floor muscles. As you squat to neutral where your knees are at 90 degrees to the floor, the pressure of your uterus increases on your pelvic floor muscles and your pelvis tilts anteriorly. If you squat lower, you are at risk of going into a compromising anterior pelvic tilt position due to the extra front load of your protruding belly and your relatively inefficient abdominal muscles. This can put undue strain on your back.”
However, she goes on to explain that one of the biggest limiting factors against full squats during pregnancy is in fact a lack of proper technique. Most women in Western countries do not squat as a matter of course in their day-to-day lives, and as such, do not know how to execute the movement correctly. “This exercise is great if you can perform it correctly,” she says. “If you are confident you do not have a muscle imbalance and can maintain neutral spine, do not suffer from any pelvic shearing forces, and have particularly strong pelvic floor musculature, you can perform a full squat. This is an ideal exercise for fitness and to prepare you for labour.”
So for strong, healthy athletes who have been trained in proper squat technique, this may not be such a “dangerous” movement after all.
Squatting through the full range of motion during pregnancy can greatly help to prevent or counteract pregnancy-related gluteal tightening caused by the constant engagement of the glutes while in the standing position (this continuous muscle firing is the body’s way of compensating for additional front-end weight). It also helps to relax the pelvis and provide pressure for waste elimination (which can help prevent constipation and hemorrhoids), and may reduce the need for medical intervention during birth.
I have personally chosen to continue squatting through my full range of motion — with weight — for as long as I can comfortably and safely do so. Now, to further qualify that statement, I have not squatted anything remotely close to my maximum weight (210 lbs) in recent history, and am keeping loads down to a level where I am capable of squatting a minimum of five consecutive reps at a time. I am also spending a lot more time practicing overhead squats, squat snatches and squat cleans, for which I tend to forego heavy weights in favour of honing my technique. I will continue to reduce the amount of added weight as necessary throughout the pregnancy.
Evidence abounds in favour of labouring and/or birthing in the squat position. It is a natural pushing position that is thought to reduce the duration of labour by opening the pelvic area and working with gravitational forces to help the baby descend more quickly and effectively. It is also, as previously mentioned, correlated with reduced need for medical interventions, such as epidurals, episiotomies, forceps use and caesarian sections.
The general guidelines for labouring and birthing in this position suggest squatting throughout the duration of each contraction (several minutes), which could become extremely strenuous and uncomfortable for a woman otherwise unaccustomed to spending so much time in a squat. Weighted squats, in particular, may be helpful, since most women will be an average of 30 pounds heavier than their pre-pregnancy bodyweight by the time they give birth.
In addition to working on moderately heavy weighted squats, I also spend at least five to ten minutes post-workout just “hanging out” and stretching in a low squat position, in the hopes that it will become a comfortable “resting” position for me, and a natural and desirable option when it comes time for my baby’s birth.