Exercise During Pregnancy — What's Safe, What to Avoid

Exercise during pregnancy is not just safe — it's one of the most beneficial things you can do for yourself and your baby. ACOG recommends that women with uncomplicated pregnancies get at least 150 minutes of moderate-intensity aerobic activity per week (about 30 minutes on most days). Research consistently shows that exercise does not increase the risk of miscarriage, preterm birth, or low birth weight in healthy pregnancies.

The evidence-backed benefits are impressive. Regular exercise during pregnancy reduces the risk of gestational diabetes by 25-30%, lowers the risk of preeclampsia by up to 40%, decreases the likelihood of cesarean delivery, helps manage healthy weight gain, improves mood and reduces symptoms of anxiety and depression, promotes better sleep, reduces back pain and constipation, builds stamina for labor and delivery, and leads to faster postpartum recovery.

The 'talk test' is a simple way to gauge intensity — you should be able to carry on a conversation while exercising. If you're too breathless to talk, dial it back. Your heart rate will naturally be higher during pregnancy, so the old guideline of staying under 140 bpm is outdated and no longer recommended. Instead, use perceived exertion and the talk test.

If you were active before pregnancy, you can generally continue your routine with modifications as needed. If you're starting exercise for the first time during pregnancy, begin gradually — even 10-15 minutes of walking daily is a great start, working up to 30 minutes over several weeks. Always get your provider's clearance, especially if you have any complications or high-risk conditions.

The best exercises during pregnancy are low-impact activities that you enjoy and will actually do consistently. Walking is the most accessible option — it requires no equipment, can be done anywhere, and is safe throughout all trimesters. Aim for 20-30 minutes at a brisk pace, adjusting speed and distance as your pregnancy progresses.

Swimming and water aerobics are often called the ideal pregnancy exercise. The buoyancy of water supports your extra weight, reduces joint stress, relieves swelling, and naturally keeps you cool. Studies show that swimming during pregnancy reduces back pain and improves physical function without any adverse effects on the baby.

Prenatal yoga builds flexibility, strength, and body awareness while teaching breathing and relaxation techniques that can be used during labor. Look for classes specifically designed for pregnant women, as they avoid poses that aren't safe during pregnancy (like deep twists and lying flat on your back after the first trimester).

Stationary cycling is a safe cardiovascular option because there's no fall risk (unlike outdoor cycling in later pregnancy). Adjust the seat and handlebars for comfort as your belly grows.

Low-impact aerobics and dance-based fitness classes keep your heart rate up while being gentle on your joints. Strength training with moderate weights maintains muscle tone and prepares your body for carrying and lifting your baby. Focus on form over heavy loads, avoid holding your breath (which increases abdominal pressure), and skip exercises that require lying flat on your back after the first trimester.

Pilates (prenatal-modified) strengthens the core, pelvic floor, and back — all critical during pregnancy and recovery. Elliptical machines provide a low-impact cardio alternative when walking becomes uncomfortable.

Your pelvic floor is a hammock-shaped group of muscles that supports your uterus, bladder, and bowel. During pregnancy, these muscles bear increasing weight as the baby grows, and the hormone relaxin causes them to stretch and soften in preparation for birth. Without targeted strengthening, the pelvic floor can weaken significantly, leading to problems both during pregnancy and after delivery.

Strong pelvic floor muscles help prevent urinary incontinence (which affects up to 60% of women during pregnancy and postpartum), support the growing weight of the uterus and baby, may reduce the duration of the pushing stage of labor, speed postpartum recovery, and reduce the risk of pelvic organ prolapse later in life.

Kegel exercises are the foundation of pelvic floor training. To do them correctly, identify the right muscles by imagining you're stopping the flow of urine or holding in gas (but don't actually practice by stopping urine flow, as this can cause urinary issues). Squeeze and lift these muscles, hold for 5-10 seconds, then fully relax for 5-10 seconds. Aim for 3 sets of 10-15 repetitions daily.

Beyond Kegels, a comprehensive pelvic floor program includes 'quick flicks' (rapid contract-and-release pulses to build fast-twitch muscle response for sneezing and coughing), deep squats (which lengthen and stretch the pelvic floor — equally important as strengthening), pelvic floor relaxation and 'bulging' exercises (learning to consciously release these muscles is essential for pushing during delivery), and bridges and bird-dogs that engage the pelvic floor as part of core stability.

Consider seeing a pelvic floor physical therapist during pregnancy — they can assess your individual muscle function and create a tailored program. This is especially valuable if you experience pelvic pain, urinary leakage, or have had pelvic floor issues in a previous pregnancy.

While most exercise is beneficial during pregnancy, certain activities carry risks that outweigh the benefits. Contact sports where you could be hit in the abdomen — soccer, basketball, hockey, boxing, martial arts — should be avoided due to the risk of direct abdominal trauma. After the first trimester, a blow to the growing uterus could cause placental abruption.

Activities with a high fall risk are also off the list after the first trimester: horseback riding, downhill skiing and snowboarding, surfing, outdoor cycling on uneven terrain, and gymnastics. Your center of gravity shifts as your belly grows, making balance less reliable, and a fall could have serious consequences.

Hot yoga and hot Pilates (performed in heated rooms above 100°F) should be avoided throughout pregnancy. Elevated core body temperature, especially in the first trimester, is associated with neural tube defects. Regular yoga and Pilates in normal temperatures are safe and encouraged — just skip the heat.

Scuba diving is contraindicated at any stage of pregnancy because the baby has no protection against decompression sickness. Skydiving and bungee jumping carry obvious risks. High-altitude exercise (above 6,000 feet) should be avoided unless you're already acclimated, as it can reduce oxygen delivery to the baby.

Exercise modifications to adopt include avoiding exercises lying flat on your back after week 16 (the weight of the uterus can compress the vena cava, reducing blood flow), not holding your breath during exertion (use steady breathing throughout), avoiding deep twists that compress the abdomen, not performing exercises that cause or worsen diastasis recti (abdominal separation) such as traditional crunches and planks in later pregnancy, and stopping any exercise that causes pain, bleeding, dizziness, or contractions.

The third trimester brings significant physical changes that require thoughtful exercise modifications — but this is not the time to stop moving. Women who stay active throughout pregnancy report less third-trimester discomfort, better sleep, and often shorter labors.

Key modifications include listening to your body more than ever — reduced intensity is expected and appropriate. Walking may replace running. Swimming laps may become leisurely water walking. That's perfectly fine. The goal shifts from fitness gains to maintaining mobility, managing symptoms, and preparing for labor.

Avoid all supine exercises (lying flat on your back) — use an inclined position instead for any exercises that would normally be done on your back. Your growing belly changes your center of gravity, so widen your stance for stability during standing exercises and use walls or chairs for balance support.

Shorten your workouts if needed. Three 10-minute sessions throughout the day provide the same benefits as one 30-minute session. Stay cool and hydrated — your body generates more heat during exercise, and overheating is riskier now. Exercise indoors on hot days.

Focus on exercises that directly prepare you for labor and postpartum: pelvic floor exercises (both strengthening and relaxation), deep squats (which open the pelvis and strengthen the legs for pushing), cat-cow stretches (which relieve back pain and encourage optimal baby positioning), hip circles on a birth ball (which ease pelvic pressure and may help the baby descend), and gentle walking (which can encourage labor as you approach your due date).

Breathing exercises become dual-purpose — they support exercise and serve as labor preparation. Practice slow, deep diaphragmatic breathing during exertion. If you experience pelvic girdle pain (common in the third trimester), switch to pool exercises where buoyancy reduces joint stress, and avoid exercises that require standing on one leg or wide lateral movements.

Stop exercising immediately if you notice bleeding, regular contractions, fluid leaking, severe shortness of breath before exertion, dizziness, or chest pain. These warrant a call to your provider.

Yes — specific exercises can directly prepare your body for the physical demands of labor and potentially improve outcomes. Research shows that women who exercise regularly during pregnancy tend to have shorter labors (particularly the pushing stage), lower rates of cesarean delivery, less need for epidural anesthesia, and faster postpartum recovery.

Cardiovascular fitness matters during labor because labor is, among other things, an endurance event. The stamina built through regular walking, swimming, or cycling translates directly to the energy reserves you'll need during hours of contractions and pushing. Think of it as training for a marathon — you want your cardiovascular system prepared for sustained effort.

Core and pelvic floor preparation is equally important. Your pelvic floor muscles need to be both strong (to support the baby's weight and help with pushing) and flexible (to stretch and allow the baby to pass through). This is why both Kegel exercises and deep squats are recommended — they train different but complementary aspects of pelvic floor function.

Specific labor-preparation exercises include perineal massage starting at week 34-36 (research shows it reduces the likelihood of episiotomy and perineal tearing, especially in first-time mothers), deep squatting (which opens the pelvic outlet by up to 10% compared to lying on your back), birth ball exercises including hip circles and gentle bouncing (which encourage pelvic mobility and optimal fetal positioning), and cat-cow and hands-and-knees positions (which can help a posterior baby rotate to the optimal anterior position).

Breathing practice during exercise directly transfers to labor. Slow breathing during contractions, focused breathing during pushing, and the ability to consciously relax between contractions are all skills that improve with practice. Many women find that the mindset of pushing through discomfort during exercise helps them cope with the intensity of labor.