What exercises are safe during pregnancy?

If you have followed me on social media or read any of my previous blog posts, you likely know that I do not like blanket statements when it comes to most things in physical therapy. Exercise in pregnancy is absolutely one of those things! Over the years there have been a lot of movements and exercises deemed “pregnancy safe” or “not safe”, most of which do not have substantial evidence to support that stance. In this post, I’m going to dive into what is and is not recommended, as well as my stance on exercise during pregnancy.

A little disclaimer to start

Before we go too far, I want to be clear that what I’m discussing in this blog post is for pregnant women with uncomplicated pregnancies. There are certain situations and conditions in which your OBGYN or Midwife may recommend reducing your activity level or stopping certain activities. If that is the case, please follow their recommendation. This blog post is for educational purposes only and should not be taken as medical advice.

How much activity is recommended during pregnancy?

The ACOG (American College of Obstetricians and Gynecologists) states it is safe to continue or begin regular physical activity during pregnancy. The following is their recommendation regarding how much you should exercise during pregnancy:

“Ideally, pregnant women should get at least 150 minutes of moderate-intensity aerobic activity every week. An aerobic activity is one in which you move large muscles of the body (like those in the legs and arms) in a rhythmic way. Moderate intensity means you are moving enough to raise your heart rate and start sweating. You still can talk normally, but you cannot sing.

If you were very active before pregnancy, you can keep doing the same workouts with your ob-gyn’s approval. But if you start to lose weight, you may need to increase the number of calories that you eat.” (source: https://www.acog.org/womens-health/faqs/exercise-during-pregnancy)

I think these recommendations are a great place to start. First, because they are encouraging movement. And second, they give pregnant women a general idea of how much exercise they should shoot for each week. However, I think most pregnant women could benefit from more individualized guidance.

What types of exercise should I do during pregnancy?

This is where an individualized approach is incredibly important. I actually hate the term “safe” when it comes to exercises during pregnancy, as I feel it creates a lot of unnecessary fear in pregnant women (who have enough on their plate as it is!). There are way too many posts on social media these days recommending all pregnant women avoid certain movements or exercises, modify specific exercises without any context, or claim certain things may cause diastasis recti or pelvic floor issues. In most cases, there is simply not enough evidence to back up these claims.

Here are a few things to consider when deciding what types of exercise you should do during pregnancy:

1) What were you doing before pregnancy? If you weren’t participating in a specific sport like CrossFit or training for a half marathon, pregnancy probably isn’t the greatest time to pick up something that requires a lot of training or is highly skilled. However, if you WERE doing these things, I would encourage you to continue as long as they feel good to you.

2) What are your goals? Are you training for something you want to participate in while you are pregnant (like a race)? Do you have other kids that you are caring for (and may still require a lot of physical demand from you)? What are your goals for labor and delivery? These are all things to discuss with your pelvic floor therapist.

3) Incorporating things that will help reduce pregnancy pain, keep you strong, and help you prepare for postpartum recovery can be incredibly helpful. I encourage my patients to specifically work on hip mobility (especially internal and external rotation), core strengthening, and posterior chain strengthening (back, glutes, and hamstrings). However, any whole body functional strengthening is really great to keep you moving and feeling great throughout pregnancy, as well as prepare for postpartum recovery.

4) If you weren’t regularly exercising prior to pregnancy, it is OK to start! It is all about finding something that feels good to you. Working with a pelvic floor therapist and/or a trainer who specializes in working with pregnant women can help you feel comfortable and confident in starting an exercise routine that you can stick with throughout your pregnancy.

5) Listen to your body. Trust your intuition and know that if something feels good to you, and your doctor or midwife hasn’t given you restrictions, it is OK to continue (even if some influencer says you should be modifying).

Is there anything I need to avoid?

I mentioned above that I hate the term “safe” when it comes to specific movements and exercise during pregnancy. However, there are some activities that the ACOG recommends avoiding during pregnancy due to true safety concerns. Most of them make a lot of sense, and are probably things you aren’t considering doing during pregnancy anyway, but I still feel it is important to mention them.

The ACOG recommends avoiding the following activities during pregnancy:

1) Contact sports and sports that increase the risk of getting hit in the abdomen

2) Skydiving

3) Activities that may result in a fall

4) Exercise in hot environments that could cause overheating (such as hot yoga)

5) Scuba diving

6) Activities performed above 6,000 ft if you do not live in a high altitude

To me, these all make sense as the risk likely doesn’t outweigh the reward. If you regularly participate in an activity that may fall into one of these categories and you really wish to continue during pregnancy, I would recommend speaking with your OBGYN or midwife.

In terms of other exercises or activities you should avoid, my biggest piece of advice is the same as above: listen to your body. If you feel dizzy or faint, have vaginal bleeding, feel chest pain or headaches, experience a significant onset of muscle weakness, feel significant and consistent uterine contractions, or experience significant calf swelling or pain, you should stop exercising and let your doctor or midwife know right away. If you experience back or pelvic pain, leaking of urine, feces, or gas, or feel a lot pelvic pressure or heaviness, I would recommend letting your doctor know and also working with a pelvic floor therapist.

Also note that if certain movements or exercises simply don’t feel good to you - modify or do something that DOES feel good! In the same way I don’t recommend listening to blanket statements on social media about what exercises are “bad”, I also think it is important to remember that even if an exercise is deemed “good for pregnancy” by someone on social media, doesn’t mean it is the right exercise for you.

With so much mixed messaging out there, I hope this blog post clears up your concerns and helps you feel more empowered in your pregnancy journey. If you’re interested in learning more about working with me virtually or in person, you can set up your FREE 15 minute phone consult here.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS