Exercise During Pregnancy: How Much, What to Keep, What to Stop

Pregnancy used to arrive with a long list of things to stop doing, and exercise was near the top of it. Advice has moved a long way since then. It now points firmly in the other direction.

Recommended, not just permitted#

Major guidelines advise pregnant people to be active. The wording matters. Activity is treated as part of good antenatal care, in the same way as folic acid or blood pressure checks.

The reasons are practical. Regular activity lowers the chance of gestational diabetes. It lowers the chance of high blood pressure in pregnancy and preeclampsia. It reduces excess weight gain, eases back and pelvic pain, improves sleep and helps mood. Some studies also show shorter labor and fewer cesarean births.

One caveat runs through all of this. If you have a pregnancy complication, your own maternity team comes before any general guide. That includes bleeding, a short or weak cervix, placenta problems, preeclampsia, a multiple pregnancy, or a history of early birth.

How much, and what counts#

The target is 150 minutes of moderate activity a week. That is about 30 minutes on five days, and it can be split into 10 minute pieces.

Moderate means your breathing and heart rate are up while you can still hold a conversation. Brisk walking, swimming, stationary cycling and low impact classes all count. Our cardio guide explains how to build that base.

Add muscle strengthening on two days a week. That part has been in the guidelines for years and it is still the piece most people skip.

If you were not active before pregnancy, do not start at 150 minutes. Start at 10 or 15 minutes a few days a week, then add a few minutes each week. If you were already very active, you can usually carry on with adjustments.

Any amount beats none. Even a 10 minute walk after a meal does something useful.

What changes, trimester by trimester#

Body temperature deserves a line of its own. The old worry was overheating early in pregnancy. Ordinary exercise does not push core temperature to a level of concern. Hot environments do, which is why saunas and hot classes are the ones to drop.

Joints do feel different. Hormone changes soften ligaments as pregnancy goes on. Balance shifts forward as the uterus grows. Neither means stop. Both mean choosing stable ground over unstable, and turning more slowly.

The talk test replaced heart rate limits#

For years pregnant people were told to keep their heart rate below 140 beats per minute. That ceiling was dropped from guidance because it was never built on good evidence.

Heart rate is a poor guide in pregnancy. Resting heart rate rises by roughly 10 to 20 beats per minute as blood volume increases. Fitness levels also differ hugely between people. The same number means different things in different bodies.

The talk test is simpler and works better. If you can speak in full sentences, you are working at a moderate effort. If you can only get a few words out, ease back. Our guide to heart rate during exercise covers the general picture outside pregnancy.

What to keep and what to stop#

Safe to continue in most pregnancies:

• Walking and hiking on even ground.
• Jogging or running, if you already ran before.
• Swimming and water classes, which take load off the pelvis and back.
• Stationary cycling.
• Strength training with weights, bands or bodyweight.
• Yoga and pilates, with positions adapted.
• Dance and low impact aerobics.

Worth stopping:

• Contact sports. Soccer, basketball, hockey, martial arts. The concern is a blow to the abdomen.
• Anything with a real fall risk. Downhill skiing, horse riding, gymnastics, surfing, mountain biking, and outdoor cycling once balance changes.
• Scuba diving. The fetus cannot clear nitrogen bubbles the way an adult can. This one is a firm no throughout pregnancy.
• Hot environments. Hot yoga, saunas, hot tubs, and hard exercise above roughly 90 F (32 C).
• Long spells lying flat on your back, from around the middle of pregnancy.
• Exercise at altitude above about 6,000 ft (1,800 m) if you are not used to it.

About lying on your back#

From around 16 to 20 weeks, the uterus can press on a large vein returning blood to the heart. In some people that drops blood pressure and brings on dizziness or nausea.

This is about long periods, not a few seconds. Prop your torso up on an incline or a wedge of pillows. Roll onto your left side if you feel unwell. Swap flat lying exercises for seated or side lying versions.

Lifting, and the breath holding point#

You can keep lifting through most pregnancies. Strength work protects your back, keeps you able to carry a car seat and a toddler, and makes the return afterwards easier. Our strength training guide covers the basics.

Two adjustments matter more than the weight on the bar.

Breathe out on effort. Holding your breath against a closed throat, known as the Valsalva maneuver, spikes pressure in the chest and abdomen. That pushes down on the pelvic floor and can drop blood pressure afterwards. Exhale as you push or lift.

Leave reps in reserve. Keep sets at a level where you could manage two or three more. Grinding maximal lifts is where breath holding creeps back in.

Watch for the abdomen coning or doming along the midline during an exercise. That is a sign to reduce the load or change position. Swap barbell work for dumbbells or machines as the belly grows and the bar path changes. Good lifting technique applies at home as much as at work.

The pelvic floor, before and after#

The pelvic floor is a sling of muscle supporting the bladder, bowel and uterus. In pregnancy it carries growing weight for months. In a vaginal birth it stretches a long way.

Training it before birth lowers the chance of leaking urine in late pregnancy and in the months after. Continuing afterwards helps recovery. This is one of the best supported things on the whole list.

How to do it: squeeze and lift as if stopping yourself passing wind and urine at once. Buttocks and thighs stay still. Then let go completely, because the release matters as much as the squeeze.

Mix two kinds. Long holds of several seconds build endurance. Quick squeezes build the reflex that stops a leak when you cough or sneeze.

Do not practice by stopping your urine flow mid stream, which can upset bladder emptying. If squeezing hurts, if you feel nothing, or if you cannot relax the muscle, ask about a pelvic floor physical therapist. Our guide to urinary incontinence in women goes further into this.

Exercise and gestational diabetes#

Gestational diabetes is high blood sugar that first appears during pregnancy. Placental hormones make the body less responsive to insulin. Some people cannot make enough extra insulin to keep up.

Exercise helps in a direct way. Working muscle pulls glucose out of the blood using much less insulin than usual, during the activity and for hours after.

Two practical points follow. Regular activity before and during pregnancy lowers the chance of developing gestational diabetes. And if you already have it, activity is part of treatment alongside diet and glucose monitoring.

A 10 to 15 minute walk after meals is the highest value habit here. Our guides to walking after meals and blood sugar spikes after eating explain why timing works so well.

If you take insulin or any glucose lowering medicine, ask your team how to time exercise and snacks around it.

Stop and call#

Stop exercising and contact your maternity team for any of these:

• Bleeding from the vagina, or fluid leaking.
• Regular painful contractions.
• Chest pain.
• Breathlessness that does not settle with rest.
• Dizziness or fainting.
• Headache with blurred vision, or new swelling of the face and hands.
• Pain, swelling or warmth in one calf.
• Any clear change in the baby's usual movements.

Getting back to it after birth#

Gentle walking and pelvic floor exercises can usually start within days if you feel up to it. Bleeding, tiredness and healing set the pace.

The six week check often gets treated as a starting gun. It is better seen as a review point. Some people are walking well before it. Others need longer, especially after a cesarean birth or a significant tear.

A rough order suits most people. Pelvic floor work and walking first, then gentle strength work, then higher impact activity. Running is commonly suggested from around 12 weeks, guided by symptoms rather than the calendar.

Symptoms that mean back off include leaking urine, heaviness or dragging in the vagina, and pelvic or back pain. Any of those is a reason to see a pelvic floor physical therapist rather than push through.

Breastfeeding and exercise sit together fine. Eat and drink enough, and wear a supportive bra. Activity also helps mood in the months after birth, which our guide to exercise and mental health covers.

What I get asked most#

The question I hear most is whether exercise can shake the baby loose. It cannot. The uterus, the fluid around the baby and the pelvis do a thorough job of protecting it.

The next most common comes from people who were very active before. Well meaning family has told them to sit down for nine months. Stopping is not a neutral choice. Nine months of detraining makes birth and the year afterwards harder.

The pattern I would like to see less of is skipping strength work entirely. Lifting a car seat and a stroller is heavy work for a deconditioned back.

I also meet people who feel they failed a 150 minute target during a week of nausea. A bad week is just a bad week. The plan is the average across months.

At work#

Long standing at work causes more trouble in pregnancy than exercise does. It is linked with back pain and swollen legs, and it stacks up over a shift.

Practical steps: a footrest to shift weight, a change of position every 30 minutes, compression stockings, and sitting whenever you can. If your job involves heavy lifting, heat, night shifts or chemical exposure, ask for a workplace risk assessment early. Our guide to heat at work covers the temperature side.

The bottom line#

Exercise in pregnancy is recommended rather than tolerated, and 150 minutes a week with two strength sessions is the usual target. Use the talk test rather than a heart rate number. Keep most of what you were doing, and drop contact sports, fall risks, scuba diving, hot environments and long spells flat on your back. Pelvic floor training before and after birth is one of the highest value things you can do. Bleeding, leaking fluid, contractions, chest pain, fainting or reduced movements mean stop and call.