Your Guide to What’s Safe

Pregnancy is a miraculous time of changes for your body. Maintaining an exercise routine throughout can help improve overall health and wellness for you and your baby.

Although many fitness activities and movements are considered safe to continue during this time, there are some exercises to avoid during pregnancy.

Staying active during pregnancy is good for your mind and body. Unless you’re considered high-risk or have a health condition that prevents you from exercising, your doctor will likely encourage you to remain active throughout your pregnancy.

If you’re generally healthy and experiencing a typical pregnancy, the American College of Obstetricians and Gynecologists (ACOG) recommends participating in regular exercise with the following guidelines (1):

  • Aim for a minimum of 150 minutes of aerobic exercise each week. This is equal to 30 minutes per day, 5 days per week. Add resistance exercises with weights, bands, or kettlebells at least 2 days a week.
  • Includes activities like brisk walking, light jogging, swimming, water aerobics, prenatal Pilates, prenatal yoga, resistance training with weights and bands, and cardio machines like elliptical trainers and recumbent bikes.
  • Skip high-intensity activities or contact sports that carry an increased risk of falling or injury, such as horseback riding, rock climbing, boxing, skiing, competitive soccer, rugby, basketball, and ice hockey.
  • Avoid activities that can cause you to overheat. This includes running, cycling, or doing other exercise in extreme heat or participating in a hot yoga class.
  • Avoid exercise routines that require lying flat on your back for too long, especially during the last 3–4 months of pregnancy.
  • Stay hydrated and eat before exercise. Always have water with you when working out.
  • Wear clothing that is comfortable yet supportive. Consider sweat-wicking fabric that breathes. This is definitely the time to invest in a quality sports bra.
  • Talk to your doctor about any concerns you have about exercise. When in doubt, review your workout routine with them during a regular appointment. They will tell you whether the activities you’re doing are safe to continue throughout pregnancy.

Summary

Unless your doctor tells you otherwise, follow the ACOG exercise guidelines. Aim for at least 150 minutes of cardiovascular exercise and at least 2 days of resistance exercise each week. Stick to low-risk, low- to moderate-intensity activity.

Although movement and physical activity are beneficial both physically and mentally, some types of exercises should be avoided during pregnancy.

According to board certified OB-GYN and brand founder of Mommy Matters Taraneh Shirazian, MD, avoiding exercises that put you at high risk of injuring yourself is the most important factor when choosing physical activity during pregnancy. These activities include:

  • contact sports like dodgeball, football, and basketball
  • activities that increase the risk of falling, such as skiing and horseback riding
  • exercises that involve a change in oxygen levels, such as skydiving and scuba diving

Summary

Avoid exercises that increase the risk of falling, are contact sports, or involve a change in oxygen levels. Also remember to listen to your body. If an activity hurts, stop doing it.

Pregnancy guidelines are clear about the exercises to avoid and those with a green light. But what about the ones in the middle?

Exercises with the “proceed with caution” label are a bit more challenging to identify. Often, they’re unique to each pregnant person and may be influenced by what you were doing for exercise prior to that positive pregnancy test. That said, there are some general rules to follow.

First, if you exercised a little before becoming pregnant, Shirazian recommends starting slowly and increasing by 5 minutes each time. Pregnancy is not the time to go full speed ahead.

If you’re new to a workout routine, consider a prenatal class that will address specific needs and keep you safe.

She also cautions against exercising in high temperatures, such as doing hot yoga, since it can cause you to feel overheated. Most importantly, says Shirazian, make sure you feel comfortable while exercising and avoid shortness of breath and chest pain.

Peace Nwegbo-Banks, MD, a board certified OB-GYN, says to avoid exercises in which you lie in a supine position (on your back) for a long time, as this decreases blood supply to your uterus.

Be careful when doing activities that require floor time, such as yoga, Pilates, and stretching.

Bicycling should also remain in the “proceed with caution” category. It’s not the exercise itself that’s dangerous – it’s the risk of falling. Because of this, Nwegbo-Banks recommends stationary cycling since it reduces the risk of falling as compared to outdoor cycling.

Summary

Proceed with caution when it comes to exercises that require lying on your back for too long or may present a risk of falling. Also, remember to take it slow, especially if you’re new to working out.

In general, most exercise recommendations don’t change drastically in each trimester. However, there are some things to be aware of as your body changes.

“You may need to modify exercises as the baby grows, such as yoga and Pilates,” says Shirazian. The size and weight of your belly can cause strain on your back in certain positions.

Also, says Shirazian, activities such as jogging and walking may create more low back and muscle strain as your pregnancy advances.

Morning sickness and fatigue may make it challenging to keep up your regular routine in the first trimester. If you’re struggling with either of these, go easy on yourself. Use this time to do gentler exercises and get the sleep you need.

The ACOG says to avoid exercises that cause overheating. Otherwise, unless your doctor has told you to avoid certain exercises, your first trimester workouts may look similar to those in your prepregnancy days.

The second trimester is when you want to put the high-risk activities on the back burner. Anything that increases your chance of falling or having direct or forceful contact with another person (contact sports) should be minimized or avoided.

You may notice increased fluid and weight, widening hips, and your growing baby and may feel more pressure in your pelvis. This is an excellent time to focus on prenatal Pilates and yoga and exercises that support your pelvic floor muscles.

Your center of gravity will also shift, which can make balance and coordination a bit tricky.

The last 3 months are the homestretch. You may be feeling the effects of relaxin, a pregnancy hormone that relaxes ligaments and softens the cervix. This could increase your risk of joint injuries and pain (2).

Pay attention to any discomfort in your lower back and pelvis. A 2019 research review found that vigorous-intensity exercise in the third trimester seems to be safe for most low-risk pregnancies. But it’s also OK to use this time to focus on gentle exercises like swimming and walking (3).

Summary

You may need to modify your routine as your pregnancy progresses and your body and belly grow.

Low- to moderate-impact cardiovascular exercise like swimming, walking, and jogging, along with strength training, prenatal Pilates, and yoga, are all excellent forms of exercise when you’re pregnant. That said, any physical activity can carry risks.

Here are some warning signs not to ignore (4):

  • chest pain
  • headache
  • bleeding from your vagina
  • regular contractions of your uterus
  • rapid heartbeat different from what you usually experience when exercising
  • painful contractions
  • dizziness
  • fainting
  • fluid leaking or gushing from your vagina
  • calf swelling or pain
  • shortness of breath different from what you usually experience when exercising
  • muscle weakness
  • changes in fetal movement
  • pain in your hips, pelvis, or abdominal area

If you experience any of these symptoms, stop what you’re doing. Some warning signs, such as dizziness and muscle weakness, may subside after you take a break.

Always call your obstetrician if you experience bleeding or fluid leaking from your vagina, calf swelling or pain, painful contractions, chest pain that does not go away, pelvic or abdominal pain, or any changes in fetal movement.

Summary

Don’t ignore warning signs. If you experience any of these symptoms, stop what you’re doing and contact your doctor.

Staying active throughout your pregnancy requires some consideration on your part. Although most low- to moderate-intensity exercises are OK to do, there are some tips to keep you safe and moving through work and beyond.

If you’re a runner, you might be wondering whether you can continue hitting the pavement or trails. The good news is: Yes, running during pregnancy is safe.

That said, if you’re not accustomed to running, pregnancy is not the best time to start.

As a general rule, if you have a solid base of running technique, form, and endurance and your doctor gives you the green light, there’s no reason to hang up your running shoes for the next 9 months.

However, as your belly grows and your baby gets bigger, you may need to modify the duration of your runs and the surface you choose to run on. Also, make sure to wear a supportive sports bra, especially during your second and third trimesters.

Another consideration for exercising when pregnant is minimizing rectal diastasis, which is a widening gap or space between your left and right rectus abdominis muscles. This separation happens as your belly expands (5).

While you can’t necessarily stop it from happening, you can choose exercises to minimize the effects. For example, avoid full situps and opt for pelvic tilts, Kegels, and prenatal Pilates abdominal exercises.

If you run, Shirazian says belly bands that stabilize your abdomen may help with running and preventing rectal diastasis.

During pregnancy, you may also experience joint pain, low back pain, difficult breathing, and balance issues (4).

Additionally, doing activities that require bouncing or jarring may prove challenging, especially as your joints get looser from pregnancy hormones.

Summary

Modifying your running routine, wearing a belly band, adapting your core work, and avoiding jumping and jarring movements are all considerations for exercising when pregnant.

Many pregnant people experience both the physical and mental health benefits of exercise. Some of the physical benefits of exercise during pregnancy are (6):

  • shortened duration of labor
  • reduced risk of cesarean delivery
  • improved tone of abdominal and pelvic floor musculature
  • improved aerobic fitness
  • better management of gestational diabetes
  • reduced risk of large-for-gestational-age newborns
  • improved overall fitness
  • reduced back pain
  • constipation prevention

One 2017 research review found that pregnant people who participated in 30–60 minutes of exercise 2–7 days a week showed a significant reduction in cesarean deliveries and gestational hypertension as compared to participants who were more sedentary (7).

Studies also point to physical activity during exercise as a preventive or protective factor against depressive disorders in the postpartum period (8).

Summary

There are many important physical, mental, and emotional benefits of exercise during pregnancy. So keep moving, even if you need to adapt what you’re doing!

Exercising during pregnancy is beneficial for both you and your and baby. The key to staying safe is following the guidelines set by the ACOG, avoiding high-risk activities, and listening to your body.

Getting some form of low- to moderate-intensity physical activity most days of the week is a great place to start.

Just remember to leave the skiing, basketball, horseback riding, scuba diving, and dodgeball for after your baby is born. And, as always, stop if something hurts or doesn’t feel right and contact your doctor with any questions.

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