Is exercise safe during pregnancy?

I often get asked, is exercise safe during pregnancy? Not only is it generally safe, it's usually better than being sedentary during pregnancy. There are of course exceptions to that, but lets discuss...

What does the research say? 

1. Benefits of exercise in general for pregnancy:

   1. may reduce risk of pre-eclampsia (high blood pressure, which can be life threatening!)

   2. may reduce risk of gestational diabetes

   3. may reduce risk of c-section birth

   4. helps with managing stress and anxiety

   5. can improve sleep

2. It's good for the baby too! (2019 study)

3. Vigorous exercise into the 3rd trimester can be safe for mom (2019 review)

   1. Vigorous exercise in the 3rd trimester is also safe for the baby (2021 study)

Bottom Line: exercise is good!

So, exercise is good, but what are the practical suggestions?

• Drink plenty of water. Staying hydrated it always important, but especially so during pregnancy.

• Avoid overheating (it will be easier to overheat while pregnant!), that means think about workout timing and location (outside in the middle of the day during the summer? There are better options!). It can also mean decreasing intensity to keep body temperature in a safe range.

• Monitor your blood pressure - while there is evidence that pre-eclampsia risk is reduced with exercising, there are other factors that play into blood pressure. Some folks won't have significant symptoms, so being aware of the measurement is a nice way to stay safe.

Do I need to modify anything in pregnancy?

Odds are, yes at some point. Many things need to be modified because of the change in size and shape of your abdomen. Some examples of when and why to modify:

1. Your belly gets in the way and it's uncomfortable.

2. Certain positions not feeling good (laying on your stomach or your back).

3. If you don't feel as strong doing a movement, you will have to change how much resistance or how many reps you do.

4. When your form has to change, but you worked really hard on your form!

   1. For example, if you do olympic lifts, while it's not unsafe, you have to change your form, and for some athletes it can be hard to break the bad habits after pregnancy. I've seen folks do it before and have no problems, while I've seen others create bad lifting habits that persist postpartum.

What should I avoid? (according to ACOG)

Biggest thing is you don’t want to cause trauma to your abdomen - it is related to a lot of bad things. When picking exercise to do during pregnancy, and determining when to modify exercise, you want to do a risk-reward analysis. 

Running: there is always a risk of falling, but how many times have you fallen before? Can you take a smooth route on the road or track vs going on a trail? The benefits will probably outweigh the risks.

Things that include a high fall risk or risk of trauma to the abdomen (contact sports or sports that have a high risk of contact) are recommended to be avoided. For example, horseback riding: while perfectly safe if you are on the horse, falling from the horse can be catastrophic even when you aren’t pregnant. For my CrossFit athletes, rope climbs aren’t inherently dangerous and it's a great strengthening exercise, but falling off the rope can make this exercise very risky. 

Warning signs to STOP exercise and seek medical attention:

If you are experiencing any of these symptoms with exercise, talk to your OBGYN ASAP!

• Bleeding from the vagina

• Feeling dizzy or faint

• Shortness of breath before starting exercise

• Chest pain

• Headaches

• Muscle weakness

• Calf pain or swelling

• Regular, painful contractions of the uterus

• Fluid gushing or leaking from the vagina

Overall - exercise is a good thing! Many folks don't get enough exercise, and the recommendations for weekly activity levels don't change when you're pregnant. If you are looking for guidance of how to exercise during pregnancy, give us a call!

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About the author: Dr. Caitlyn Hauswirth-Varis, PT, DPT, OCS, CFMT, CF-L1

Caitlyn is board certified as an orthopedic specialist and an expert in pelvic floor physical therapy. She is a pregnancy and postpartum exercise specialist, and has helped countless individuals navigate exercise during pregnancy, as well as return to activity postpartum.

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.