Your Guide to Exercise in Pregnancy

As a pelvic health physiotherapist, one of the most commonly asked questions I receive from women is ‘I’m pregnant, how much exercise should I be doing?’. This is a crucial time when women want to make sure they’re following the right advice and not putting themselves or their baby at any risk. 

This blog will take you through some of the latest guidelines for exercise in pregnancy, so you feel well informed and confident to exercise. 

What do the guidelines say?

Current Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANCOG) guidelines encourage the many well established benefits of exercise during pregnancy for women who have been advised they are safe to exercise. These include benefits for mum’s fitness, the prevention of excessive weight gain and psychological benefits which include reduction in symptoms of depression (RANZCOG, 2023). Taking part in regular exercise during pregnancy has also been associated with shorter and less complicated labour, as well as fewer neonatal complications for your baby (RANZCOG, 2023). 

There is no evidence that regular exercise in an uncomplicated pregnancy has any detrimental effect to mum or baby (NICE, 2019). If you have any complications in your pregnancy or have any medical conditions that prevent you from exercising, please talk to your doctor or midwife for recommendations specific to your situation. 

How often should I exercise?

Pregnant women should try to be active on most if not all days of the week. If you have previously not been very active, try gradually building up to this - for example 3 or 4 non-consecutive days per week.

For how long?

30 minutes per day is recommended with a maximum of 60 minutes. If you’re new to exercise, start with less i.e. 15-20 minutes and build up gradually to 30 minutes. 

How hard should I work?

This will depend on your current baseline level of fitness. If you have been inactive, maintaining a moderate intensity should be enough to get the benefits from exercise for health and well-being. If you are used to a high level of fitness and regular vigorous exercise there is no evidence that continuing with this level of exercise is in any way harmful to mum or baby. This being said, it’s really important to ensure you are not overheating and that you’re well-nourished and hydrated. Monitoring your breathlessness a good way to gauge intensity. Imagine you’re exercising with a friend, ideally you would want to be able to continue a light conversation while you’re exercising. If you can’t because you’re too breathless, this a sign the intensity is too high, take a break, reduce the intensity of your exercise.

What type of exercise should I do? 

The guidelines encourage women to perform both aerobic and strength-based exercises. Popular aerobic exercises include walking, swimming and static cycling. If you aren’t used to running, pregnancy isn’t the best time to start. However, if you’re a seasoned runner there is no reason to stop so long as you feel comfortable and you are adjusting your routine appropriately to accommodate for changes in comfort, tolerance and suitable intensity. 

Strength based exercise should be aimed at the main muscle groups of the body and ideally 2 sessions per week on non-consecutive days. Resistance could be resistance bands, light weights or body weight this could include Pilates. Women without prior experience can aim for 1-2 sets of 12-15 repetitions for each exercise. A gradual warm up and cool down are recommended.

Some things to avoid in pregnancy include: laying on your back for prolonged periods of time after your first trimester, any form of exercise where you might lose your balance or sustain a blow to the tummy; for example, horse riding and contact sports. If you experience any unusual symptoms while you’re exercising such as abdominal pain, chest pain, sudden shortness of breath or dizziness, calf pain, sudden swelling in the hands or feet, vaginal bleeding, concerns about your baby movements, stop and always contact your doctor or midwife immediately to seek medical attention. 

Anything else to consider?

As well as the aerobic and strengthening exercises the guidelines discuss, you might like to consider Pilates and yoga for pregnancy. A clinical trial looking at pregnancy Pilates and its effect on childbirth outcomes found pregnancy women performing pilates 2 x per week for 8 weeks from 26 weeks of pregnancy reported improved maternal satisfaction of childbirth and improved the labour process with itself (Ghandali et al. 2021). A class is also a great opportunity to take some relaxing time for yourself and to meet other expectant mums. As a pelvic health physiotherapist, I also stress the importance of functional pelvic floor exercises during pregnancy and in the postnatal period. These will ensure your pelvic floor muscles are working optimally for you - ensuring they are strong to support your continence and the increased pressure on this area from your growing baby as well as making sure you are able to relax and lengthen the muscles adequately ensuring you’re comfortable day to day and able to release the pelvic floor muscles as you prepare to birth your baby.

To summarise…

In an uncomplicated pregnancy, try to aim for 30 minutes of moderate intensity exercise on most days of the week. Importantly, find something you enjoy and take this time for yourself. Step outside your busy schedule and reap all the health benefits for you and that of your baby. Don’t forget to think about your pelvic floor muscles and consider some exercises to ensure you are able to correctly squeeze and relax these muscles.

If you would like some more tailored advice or an appropriate exercise programme for pregnancy, a pelvic health physiotherapist is an ideal person to design a programme for you. As well as exercise advice in pregnancy, they can help to treat pelvic girdle pain, low back pain, pelvic floor problems including incontinence and issues with abdominal muscle separation. 

Bethany has a fully online Pregnancy Pilates programme available on her website. The programme combines 4 x 30 minute pilates workouts focussed on your core and pelvic floor as well as full body strengthening and relaxation. It’s packed full of pelvic health physio information on pelvic floor exercises and birth preparation. The ideal way to stay fit in pregnancy and prepare your body and mind for labour and birth. Check out the ONLINE section of the website at bethanyford.com/online and enter NURTURE10 at the checkout for 10% the programme price.

Bethany 

References

1.     Ghandali, N., Iravani, M., Habibi, A, Cheraghian, B. The effectiveness of a Pilates exercise program during Pregnancy on childbirth outcomes: a randomised controlled clinical trial. BCM Pregnancy and Childbirth 21:480(2021)

2.     National Institute for Clinical Excellence (NICE) Guidelines; Antenatal care for uncomplicated pregnancies. 2019

3.     Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Exercise During Pregnancy. March 2023 

4. American College of Obstetricians and Gynaecologists (ACOG) Exercise during pregnancy. 2024