The Ultimate Guide to Exercise During Pregnancy

A new pregnancy doesn’t mean pressing pause on your fitness. Meeting and exceeding the current physical activity guidelines produces profound health benefits in the general population – but what about during pregnancy? A growing body of evidence tells us that exercise in the peripartum window is not only safe, but provides numerous health benefits for mother and child. Unfortunately, there are mixed messages about exercising during this stage of life from physicians and social-media influencers alike. Various guidelines from different organizations can be confusing and appear contradictory, while containing unnecessary restrictions that may not be based on evidence.

There were over 3.5 million births in the United States in 2023.⁵ Most US adults do not meet the current physical activity guidelines for both resistance training and conditioning, with only an estimated 24% doing so.⁶ Rates of exercise among pregnant women are even lower, as low as 20%, while many women stop exercise altogether during this time even if they have previously been active.⁷ 

Why aren’t pregnant women exercising? Common barriers to exercise during this time include a lack of encouragement, a lack of adequate counseling, and a lack of understanding of the benefits vs. the risks. According to one study, only 58% of pregnant women received exercise counseling during their pregnancy. Of those women, 91% did not recall being counseled on the specifics of exercise such as frequency, intensity, or type of exercise.⁸ Another study found that pregnant women were only counseled about exercise 17.9% of the time, compared to 22% of the time for non-pregnant women.⁹

There is a clear need for actionable guidance regarding the benefits and safety of physical activity during pregnancy. This article aims to offer evidence-based recommendations for exercise during pregnancy, to cut through the myths and misconceptions surrounding exercise at every stage of pregnancy, and to empower expecting mothers to stay strong and fit while promoting good health outcomes for themselves and their babies.

Why exercise during pregnancy? 

Meeting or exceeding the physical activity guidelines during pregnancy is associated with benefits for both the exercising mother and her baby, including improved maternal health outcomes and fewer newborn complications. To explore the benefits of physical activity at this stage, let’s divide things up into benefits for the mother, and for the child.

Benefits for the exercising mother 

Participating in an exercise program that contains both conditioning exercise and resistance training has demonstrated numerous health benefits to the mother, ^3,4,14 including:

• Reduced risk of excessive gestational weight gain
• Reduced risk of gestational diabetes
• Reduced odds of perinatal mood disorders
• Reduced symptoms of postpartum depression 
• Reduced risk of gestational hypertension, or high blood pressure
• Reduced risk of preeclampsia
• Preservation of physical fitness throughout the pregnancy
• Decreased duration of labor
• Improved postpartum recovery
• Higher incidence of vaginal birth

Benefits for the child

The benefits of exercise are passed on to the baby of the exercising mother as well. ^4,14 They can include:

• Lower risk of preterm birth 
• Reduced risk of heart conditions 
• Improved fetal brain development
• Improved fetal blood flow
• Lower risk of macrosomia, or excess birth weight

Emerging research is also showing how healthy habits, like exercising, can benefit the baby later in life through genetic expression. The field of epigenetics studies how behaviors and environmental factors can impact the expression of certain genes. While not actually changing DNA, these factors could turn certain genes “on” or “off.” Early research in this field is demonstrating how habits such as following a health-promoting diet and exercising can affect gene expression related to obesity, metabolic processes, type 2 diabetes, and growth.¹⁰

There are a lot of reasons for a pregnant woman to engage in exercise, but is it safe? 

Common concerns with exercise during pregnancy

According to the American College of Obstetricians and Gynecologists (ACOG), physical activity and exercise in pregnancy are associated with minimal risks and most pregnant patients can exercise without concern for the health and safety of their baby.⁴ They argue that there are a few maternal medical conditions in which exercise should be avoided, but those conditions are rare.

Concerns that exercise during pregnancy may cause miscarriage, poor fetal growth, musculoskeletal injury, or premature delivery are not substantiated by evidence for most pregnant women with average-risk pregnancies.⁴

Types of exercise that have been extensively studied to be both safe and effective for pregnant women include walking, stationary cycling, various other types of aerobic exercise, dancing, strength training, stretching, water-aerobics, and more.¹¹

Let’s explore some of the more specific concerns many women have and the evidence behind them. 

Is lifting weights safe for my baby?

One of the fears surrounding resistance training in pregnancy is fetal decel, or deceleration. A fetal deceleration refers to a sustained decrease in the baby’s heart rate. Normal fetal heart rates are much faster than that of adults and can range between 110-160 beats per minute. It’s normal and reassuring for there to be variability in the heart rate. These fetal decelerations can happen for a variety of reasons and are often normal, transient, and not a cause for concern. More sustained decelerations occur when the baby is in distress, such as during labor and delivery. 

One theory is that these fetal heart rate decelerations occur during exercise due to a lack of blood flow to the fetus. It is thought that the increase in intra-abdominal pressure associated with lifting weights, specifically heavy weights, may cause changes or an interruption to fetal blood flow. Based on this theory, pregnant women are sometimes advised to avoid isometrics, heavy lifting, and doing sets with “too many” reps. While the evidence here is limited, the available research does not support this theory.

A 2021 study evaluated cardiac responses and hemodynamics in pregnant women while lifting weights with and without using the Valsalva maneuver – a special breathing technique used to increase intra-abdominal pressure while lifting. This study found the hemodynamic aspects were no different between groups, demonstrating that lifting weights does not alter blood flow characteristics of the pregnant mother, whether using this Valsalva maneuver or not.¹²

Stable hemodynamic measures have also been demonstrated in fetuses. A separate 2021 study evaluated 22 pregnant women who were in various stages of pregnancy while lifting weights. While lifting near-maximum loads on a chest press machine, fetal blood flow was monitored using a specialized type of ultrasound. This study found that near maximal lifting did not reduce fetal blood flow compared to resting levels.¹³

It would be impractical and is not recommended to track fetal heart rates at all times. But, the limited evidence we do have suggests that transient decrements in fetal blood supply during resistance training should not be a concern. Further, evidence supplied from the millions of women who go about their daily lives carrying groceries, their other children, and lifting weights without issue supports the safety of movement and lifting during pregnancy. In fact, a 2025 systematic review and meta-analysis, a large study of other studies, found no adverse effects on maternal health or fetal outcomes across 47,619 pregnant participants engaging in resistance training.¹⁴

Can I hold my breath?

If swimming is your exercise of choice, then holding your breath comes with the territory. But what about holding your breath while lifting weights? An unavoidable, and sometimes intentional, phenomenon while lifting heavy objects or exerting yourself in any way is the Valsalva maneuver. 

A complex reflex in response to physical exertion and the transfer of forces through the torso, the Valsalva maneuver is the act of exhaling against a closed glottis. This reflexive breath holding takes place automatically when we sneeze, cough, use the bathroom, and lift heavy weights. We can perform this maneuver intentionally, as many do with weightlifting, or reflexively many times throughout the day. The physiology and mechanics involved are basically the same and differ only in magnitude and duration when comparing intentional versus reflexive maneuvers.

The concern with breath holding maneuvers and high levels of exertion is that blood flow may be compromised to the growing baby. As mentioned in the above section regarding weightlifting in general during pregnancy, this doesn’t seem to be a concern. Clinical data on pregnant athletes demonstrates that heavy, braced lifting up to 90% of 10RM does not compromise fetal blood flow or cause fetal distress.^13,25  

Is it too hot for my baby?

There are a few environmental concerns that should be taken into account when exercising throughout pregnancy.

Pregnant women may have a harder time regulating their body temperature. It’s recommended to stay well hydrated, wear loose-fitting clothing, and avoid high heat and humidity to protect against heat stress, particularly during the first trimester. According to information from the National Weather Service, temperatures above 90°F, or 32°C, raise the concern for heat stress. High humidity affects the body’s ability to cool itself and often makes it feel hotter outside. This is where the “‘feels like’ temperature” on most weather reports comes from. Typically, humidity levels of about 60% begin to reduce the body’s ability to cool itself through sweat evaporation.

While extremes of body temperature are associated with risks, exercise does not raise the body temperature enough to be harmful. Extremes of body temperature caused by carrying a high fever, using hot tubs, or using saunas have been associated with increased risk of neural tube defects in the first trimester.⁴ Exercise, however, is not expected to cause a significant increase in core body temperature into a range of concern the same way that using a sauna or hot tub would. One study found that exercise was not associated with the same neural tube defects that one would expect from extreme body temperature changes and that it was actually associated with a 30-50% decreased risk for neural tube defects.¹⁵

A practical recommendation regarding heat stress during exercise for pregnant women is to be mindful of the weather, to exercise during the cooler parts of the day, such as early in the morning or later in the evening, and to exercise indoors in a climate-controlled environment if the weather outdoors is concerning. Additionally, having water accessible and wearing loose-fitting clothing will aid in cooling during exercise.

What does exercise do to my baby?

Research demonstrates changes to the baby in the womb during exercise. But, these changes have not been associated with any negative outcomes.

One study evaluated 45 pregnant women and their babies during their second trimester to evaluate cardiovascular effects on the fetus. The pregnant women performed a treadmill test until volitional fatigue – until they reached their perceived limit. The intensity range of the exercise bout across these 30-minute treadmill sessions were rated as moderate to vigorous. During the test, fetal well-being was assessed with umbilical artery Doppler ultrasound scans while also monitoring fetal heart rate. The researchers found that the scans were similar pre-exercise and post-exercise indicating no change in fetal blood flow during even vigorous exercise. Additionally, the fetal heart rate increased along with the mother’s by between 10-30 beats per minute and returned to baseline following the mother’s recovery and return to baseline.

Other risks to the baby & things to avoid 

The ACOG maintains that exercise during pregnancy poses no increased risk for miscarriage, poor fetal growth, musculoskeletal injury, or premature delivery for women with average-risk pregnancies.⁴

Certain types of exercise that include physical contact to the abdomen or high risk of falling should be avoided during this time. Contact sports like rugby, high speed sports like downhill mountain biking, or even certain exercises like burpees in which forcible contact is made to the abdomen should be avoided. That being said, this recommendation comes from practical, anecdotal, and anatomic knowledge as opposed to rigorous research evidence. Scuba diving is also not recommended at this time due to the pressure changes and increased risk of pulmonary embolism.¹

Finally, women living at elevations below 2,500 m (8,200 feet) should avoid physical activity at high altitude, or above 2,500 m. The baby cannot make the same accommodations that adults make to the lower partial pressure of oxygen and the risk of altitude sickness is higher. Women who live at higher altitudes above 1,800 m (6,000 feet) may be able to exercise at higher altitudes without these concerns.^1,4

Diastasis recti & exercise 

Diastasis recti refers to the separation of two bellies of the rectus abdominis muscle along its central band of connective tissue, the linea alba. This is a frequent consequence of pregnancy with varying incidence according to the literature. Approximately 66-100% of pregnant women experience diastasis recti to varying degrees. Recovery from diastasis recti also varies significantly with resolution occurring spontaneously after giving birth in some and others having continued separation years after pregnancy.²⁶

This physical separation of the anterior abdominal wall along the linea alba is thought to occur due to a blend of hormonal and mechanical factors. During pregnancy, the body secretes several hormones, such as relaxin, that can affect connective tissues, and the expanding uterus places a mechanical stretch on the abdominal musculature. These mechanical changes change the resting length of the abdominal muscles changing their leverage and potentially causing functional deficits in peripartum women with more clinically significant cases.²⁶ 

While exercise cannot entirely heal or prevent the physical gap that develops within the linea alba, non-exercising pregnant women are at greater risk of developing it. Some research demonstrates that 90% of non-exercising pregnant women exhibited a diastasis recti of 2 cm or greater compared to only 12.5% of the exercising group.²⁶ Not only does exercise reduce the risk of developing a clinically significant diastasis recti, but progressive abdominal training of the core musculature can significantly enhance torso strength, functionality, and provide pelvic-abdominal support.

The abdominal muscle group is made up of several muscles that can be trained with a myriad of exercises:

A progressive strength training plan that meets the current physical activity guidelines for pregnant women can absolutely include training of the abdominal muscles to address this issue directly. More information on how to meet these guidelines, build strength, and improve function in the sections to follow. 

The benefits of participating in exercise, both resistance training and conditioning, far outweigh any risks so long as proper care is taken to follow these guidelines for your fitness level and level of comfort. If a woman who currently exercises becomes pregnant, she may be able to continue her exercise program without modification for the majority of her pregnancy. For women who were not previously active, pregnancy is a great time to begin exercising. Let’s explore guidelines for exercise during pregnancy.

Physical activity guidelines in pregnancy

The guidelines for pregnant women with uncomplicated pregnancies are very similar to those for the general population and include both resistance training and conditioning recommendations. Every woman comes into pregnancy with a different physical fitness level, so the application of these guidelines should be individualized. Further, pregnancy represents a time where biomechanical and physiological changes to the body may make adhering to certain aspects of these guidelines more challenging for some women than others, so again there is a need for individualization and modification as needed.

Resistance training in pregnancy 

Physical activity guidelines from 19 different countries recommend resistance training – or any type of muscle strengthening activity – for pregnant women.² The general recommendation is for pregnant women to participate in some form of strength training at least two days per week, emphasizing the large muscle groups of the body.^1,2,4,17 Every resistance training prescription should include guidance on the frequency, intensity, and exercise selection.

Frequency of resistance training & training splits 

Frequency refers to how many sessions occur during a given time period, typically one week. The general recommendation is to strength train at least two times per week, but more may be tolerable to many women especially if they were lifting weights more frequently prior to becoming pregnant.

While there are no strict rules regarding the maximum frequency of strength training, as you increase the number of training days you are also increasing total volume and fatigue. You may also be displacing other beneficial forms of exercise, like aerobic conditioning. For someone currently lifting weights 6 days per week and not doing any conditioning, they would benefit greatly from removing 1 or 2 of those lifting days and replacing it with conditioning as there are unique health benefits to each type of exercise.

Exercise frequency may also affect the structure of the program. A two day per week program, where training days are more spaced out, would lend itself well to full-body training on both days. A four day per week program may serve the trainee better with an “upper/lower split”, where one day focuses on all upper body movements and the next on all lower body in alternating fashion. The training split used is largely based upon personal preference, equipment access, and schedule limitations.

Intensity of resistance training

In resistance training, intensity refers to the weight used for an exercise in either absolute or relative terms. Absolute terms are typically used in research and indicated as a percentage of one-repetition maximum (1RM). For example, perform deadlifts with 75% of 1RM for 5 repetitions. When designing programs, however, a related concept known as proximity to failure can be communicated in relative terms by using a rating of perceived exertion (RPE) or repetitions in reserve (RIR). 

Many physical activity guidelines advocate for using perceived exertion instead of prescribing absolute intensity targets.^1,2,4,17 Rating of perceived exertion (RPE) in resistance training is typically communicated as a subjective 1-10 scale that rates how hard a given set was. The advantage to using a relative measure of perceived exertion is that it takes into account the daily fluctuations in performance potential that can be affected by gym factors and non-gym factors. For a pregnant woman whose energy levels, mood, and symptoms could change from day to day, perceived exertion is a more practical way to communicate intensity.

Research in non-pregnant trainees suggests that the bulk of effective strength training can take place in the RPE 6-8 range, using loads between 65-85% of 1RM.¹⁸

Using this RPE and moderate percentage range would likely lead to most sets of a resistance training workout being between 4-12 reps. There is benefit for occasionally pushing beyond this level of intensity and training with fewer reps, however, for people who do not wish to compete in powerlifting or weightlifting, doing heavy sets of 1-2 reps at RPE 9 or 10 may not have a place in their training program. This is another place where there will be variation in what one person’s program looks like versus another, depending on their baseline fitness and goals. (More information about using RPE).

An important note on exercise intensity: the majority of physical activity guidelines in pregnancy advocate for exercising at a moderate intensity, which is considered to be in the RPE of 4-6 range.^1,2,4,17 This is not due to higher intensities of exercise demonstrating harm, but rather a lack in rigorous scientific research in pregnant women training at higher intensities. 

Emerging evidence, however, is demonstrating a benefit of exercise at higher intensities without any disproportionate risk to the mother or baby. Recent research on pregnant mothers who continue to participate in CrossFit throughout the pregnancy demonstrated safety for the mother and the baby. Evidence from elite athletes who become pregnant has demonstrated the safety of vigorous intensity exercise for both the mother and the baby. Finally, several included studies used methods that involved women lifting at or near their 1RM strength without noting any negative effects to the mother or the baby.^{4,12,13,19,21} Of course, all of these examples should be considered in the context of the person’s baseline fitness entering pregnancy.

Exercise selection

Exercise selection refers to the specific types of exercise chosen. There are a wide variety of different exercises that can produce meaningful results in pregnant women, across a wide variety of different types of equipment. Access to equipment, personal preference, and goals determine which exercises are best fit for a person. Free weights like barbells and dumbbells and machines like leg presses and lat pulldowns can all be included. It is recommended to perform exercises that work the major muscle groups of the body and this typically refers to the muscles of the back, shoulder girdle, hips, and thighs. Instead of making specific exercise-type recommendations, this framework will lay out how to build a complete training program using general movement patterns.

Upper Body Exercises 

We divide upper body exercises into “pushing” and “pulling” patterns. Pushing exercises are those that train the chest, shoulders, and triceps, while pulling exercises train the back, shoulders, and biceps.

Examples of upper body “pushing” exercises include: 

• Flat or incline barbell bench presses
• Flat or incline dumbbell bench presses
• Various types of overhead presses
• Machine based chest and shoulder presses

Examples of upper body “pulling” exercises include:

• Pull-ups or chin-ups, either bodyweight, weighted, or assisted 
• Barbell and dumbbell rows 
• Lat pulldowns 
• Machine based rows 

Lower Body Exercises

We divide lower body exercises into squats and hinges. Squats train the quadriceps, glutes, and lower back and hinges train the hamstrings, glutes, and lower back.

Examples of lower body “squat” exercises include:

• Barbell back or front squats 
• Dumbbell goblet squats
• Split squats
• Lunges 
• Machine-based squatting variations like leg presses and hack squats 

Examples of lower body “hinge” exercises include:

• Barbell conventional or sumo deadlifts
• Barbell or dumbbell Romanian or straight leg deadlifts 
• Single leg variations of Romanian and straight leg deadlifts 
• Barbell, dumbbell, or machine hip thrusts 
• Back or hip extensions 

This is not an exhaustive list – there are many others that would help pregnant women meet the current physical activity guidelines. “Isolation” exercises are those that focus on specific body parts, such as biceps curls, lateral raises, triceps pushdowns, calf raises, or side planks, and are all acceptable as well. The training split may determine how many total exercises are chosen. As detailed above, for a full body training split performed two times per week it may be more beneficial to choose “compound” movements that use more muscle mass. Training more frequently allows more time and a broader exercise selection that can include isolation exercises as well.

Summary of Resistance Training Guidelines

• At least 2 days per week, but more frequent training can be beneficial and well tolerated
• A focus on compound exercises that work the large muscle groups through a large range of motion
• Moderate to high intensity as tolerated, using RPE as a guide
• Individualized for preferences, schedule, comfort level, and fitness level

Aerobic and anaerobic conditioning in pregnancy

Physical activity guidelines from 17 different countries recommend aerobic exercise for pregnant women.² In these guidelines, the term aerobic exercise is used to describe all forms of cardiovascular exercise – including aerobic and anaerobic forms of conditioning. To be more inclusive, our recommendations will use the umbrella term “conditioning” to discuss all forms of cardiovascular exercise.

While guidelines across the world vary, a majority of public health organizations including the WHO and CDC recommend pregnant women engage in at least 150 minutes of moderate intensity conditioning each week.^1,2,4,17 There is a wide range of what this could look like, so let’s dive into the recommended frequency, intensity, type, and duration of exercise to make more specific recommendations. 

While the physical activity guidelines for pregnancy do not include a recommendation for vigorous intensity exercise, guidelines for the general population also include performing exercise at a vigorous intensity for at least 75 minutes per week – or an equivalent combination of the two. More on this in the intensity discussion below.

Frequency of conditioning 

Frequency refers to how many sessions are performed over a given time period, typically one week. Frequency is largely determined by personal preference, intensity of exercise, and scheduling considerations. While some guidelines recommend specific frequencies, what matters most is the accumulation of enough overall conditioning across the entire week. 

There are many ways to split up the recommendation of 150 minutes per week of moderate intensity conditioning. To give a few examples:

• 2 sessions per week of 75 minutes each
• 3 sessions per week of 50 minutes each 
• 5 sessions per week of 30 minutes each 

Again, the recommendation here is to find a frequency that works best for the individual as there is no “ideal” training frequency – just the one you can consistently do.

Intensity of conditioning 

In conditioning, intensity refers to the metabolic demand of the activity. Exercise intensity in conditioning can be communicated with absolute measures, like heart rate or Metabolic Equivalents (METs), or relative measures such as RPE and the “Talk Test”. The physical activity guidelines use a variety of means to communicate conditioning intensity.

METs

A MET, or metabolic equivalent, is a measurement of how much energy an activity requires as a multiple of resting measurements. 1 MET is how much energy is needed at rest, while a 4 MET activity is one that requires 4 times that amount of energy.²⁰ While METs are not a practical way to communicate intensity to a patient or client, their use is widespread in the exercise science literature and several physical activity guidelines from around the world.

Moderate intensity exercise is typically defined as a 3.0-5.9 MET activity. Common examples include a typical aerobics class, using an elliptical, indoor bike ergometer, or other cardio machine at a moderate effort, and walking briskly at greater than 2.5 mph.²⁰

Vigorous intensity exercise is typically defined as any activity > 5.9 METs. Some common examples include brisk walking at greater than 4.5 mph, jogging or running greater than 3.7 mph, or using an elliptical, indoor bike ergometer, or other cardio machine at a vigorous effort.²⁰ 

METs help to give a little more structure and practical examples to the very general guideline of moderate or vigorous. But there are other, more practical and user-friendly ways to gauge conditioning exercise intensity.

Heart Rate

Nowadays with smart watches and phones, tracking heart rate during exercise is more accessible than ever. Using heart rate as a measure of conditioning exercise intensity is a valid way to ensure the effort is appropriate for the individual and the training goals.

Heart rates are typically assigned as a percentage of an individual’s estimated heart rate max. Use our free heart rate zone calculator to figure out your target heart rate training zones.

The 5-Zone model of heart rate training that most people are familiar with places various heart rate ranges and effort targets neatly into zones that correspond to different training effects.

According to this model, moderate intensity exercise would likely fall into the Zone 2 category of heart rate and Zones 3-5 would correspond to vigorous intensity exercise.

RPE

The majority of the exercise recommendations during pregnancy advocate for using a relative measure of intensity, such as rating of perceived exertion (RPE).^4,17 RPE for conditioning efforts correlates well to heart rate and can be a practical means of communicating intensity.

The original Borg Scale rates physical exertion from 6-20 and correlates well with training heart rate. The easiest intensity is 6 and 20 is the hardest. For example, a 13 on the scale correlates to roughly a heart rate of 130 bpm. Moderate intensity exercise is typically rated as a 13-15 on this scale and a 15+ is vigorous intensity.²²

The 6-20 scale has been modified to a simpler, 1-10 scale, where 1 being minimal or “resting” effort and a 10 being maximum effort. The RPE scales here can also correlate to the 5-Zone model of heart rate training. 

The Talk Test 

The Talk Test is also recommended to determine exercise intensity in pregnancy.⁴ The Talk Test is a very simple, valid, and reliable measure for conditioning exercise intensity.²² Here is how to use the Talk Test during exercise to gauge intensity:

• Low Intensity Exercise, RPE of 1-3
  • You can talk comfortably and hold a conversation without difficulty during exercise.
• Moderate Intensity Exercise, RPE of 4-6
  • You can talk but only in short, broken sentences. You can answer questions and hold a conversation with breaks from speaking to breathe.
• High Intensity Exercise, RPE of 7-10
  • You can only speak a few words at a time, talking is disruptive to the workout, and heavy breathing dominates.

Using these different intensity measures together, the following practical guide can be used for conditioning intensity during pregnancy:

An important note on exercise intensity for conditioning: the majority of the physical activity guidelines in pregnancy advocate for exercising at a moderate intensity, which falls in the range of RPE 4-6.^1,2,4,17 As indicated above, this is not due to higher intensities of exercise being dangerous or harmful, but rather a lack in rigorous scientific research among pregnant women training at higher intensities. However, emerging evidence and anecdotal evidence have demonstrated safety with higher intensity exercise during pregnancy.

Type of conditioning 

The type of conditioning exercise refers to the conditioning modality selected. All types of conditioning are appropriate for pregnant women including running, cycling, rowing, swimming, or using a variety of exercise machines.

Exercise selection is highly individualized based on preferences, goals, prior experience and fitness level, pregnancy-related symptoms, and changing body characteristics throughout pregnancy.

As noted in the safety section above, the only types of exercise that should be avoided are those where there is a high risk of falling or physical trauma. For example, downhill mountain biking and contact sports wouldn’t be great choices to meet the conditioning guidelines. 

Duration of conditioning 

The duration of each individual bout of conditioning is largely dependent upon the overall exercise frequency, since this determines the overall amount of conditioning throughout the week. Personal preference and schedule considerations are major factors in determining conditioning frequency. Exercise duration, however, may have other limiters. While some pregnant women may be able to perform longer durations of exercise, others may not. This is where creating a program that is flexible and individualized is important.

Accumulating fatigue across a workout, and the presence of pregnancy-related symptoms such as general, non-exercise related fatigue may make it challenging to do very long bouts of conditioning. While a 2 time per week frequency of 75 minute long workouts may work well on paper, it may not work well in practice. 

An appropriate exercise duration should allow for maintenance of the desired exercise intensity throughout the whole workout. Additionally, longer conditioning workouts may require some additional nutritional and hydration considerations. Access to drinking water should be maintained for all workouts and an easily digestible carbohydrate-containing snack like fruit or a sports drink should be readily available for longer sessions. For guidance on properly fueling for training during a pregnancy, reach out to one of our registered dietitians for a consultation. 

Summary of Conditioning Guidelines

• A minimum of 150 minutes per week at moderate intensity 
• Spread across several days according to preference and schedule 
• Vigorous intensities can be well tolerated if appropriately scaled to fitness level 

Other types of exercise during pregnancy 

Many other types of exercise that may not fit neatly into the categories of resistance training and conditioning are well tolerated by many during pregnancy. Yoga, pilates, or water aerobics are part of many recommendations from around the world.²  Despite being part of many public health recommendations for exercise during pregnancy, these types of exercise may actually not be enough to meet the current physical activity guidelines. These types of exercise can have a role as “add-ons”, but not replacements for, resistance training and conditioning as detailed above. 

When & how to modify training during pregnancy

There are many physiological and biomechanical changes that occur during pregnancy that may make meeting these guidelines more challenging for some pregnant women than others.

Exercising around your symptoms

Symptoms such as morning sickness, fatigue, heartburn and many others are common during pregnancy. There is no “best time of day” to exercise. Whenever a woman feels prepared and energetic enough to engage in exercise is the best time for them. The time of day that exercising takes place is going to be highly individualized and women should feel empowered and free to do so whenever their schedule and symptoms allow. 

Body position recommendations

It is often recommended for women to avoid the supine position, lying on their back, during pregnancy, especially after the 20th week. These recommendations are primarily related to sleep position. Lying supine may result in the gravid uterus obstructing the venous return of blood to the heart, temporarily reducing blood flow. While this does not occur in all pregnant women, symptoms of lightheadedness can promptly follow this disruption in blood flow.⁴ Some women are more sensitive to this than others, and some may not experience it at all.

Common exercises like bench presses can easily be modified to avoid this supine position, if needed based on symptoms, by either doing an incline bench press, overhead press, or seated machine-based chest press to continue to train the upper body pushing movement pattern. Other supine exercises like glute bridges or hip thrusts can be replaced with various types of deadlifts, and core work can be replaced with standing or cable exercises.

The program may change as the body changes

Some of the most distinct changes to the body include weight gain and a shift in center of gravity. This change in body size and weight distribution can affect how certain exercises feel. Some simple modifications allow women to continue training with more comfort in an effort to “give more room” to the growing baby by not having the abdomen come into contact with a piece of equipment or the exercising mother’s own thighs. These modifications are not required and are highly individual. Some common examples include:

• Substituting sumo deadlifts for conventional deadlifts
• Adopting a wider stance for squats and leg presses 
• Swapping out crunches or sit-ups with planks, side planks, and standing side bends 
• Using dumbbells for power exercises like snatches or cleans as opposed to barbells
• Running, cycling, or using an elliptical instead of using a rowing machine for conditioning

Contraindications to exercise during pregnancy – when to consult a physician

A “contraindication” is a specific condition, symptom, or risk factor that makes a particular medical treatment, activity, or intervention inadvisable or unsafe, because it could cause significant harm or a severe adverse reaction. Many of the physical activity guidelines from around the world list a variety of conditions that warrant either a conversation with a physician regarding the safety of exercise or stopping exercise altogether.

Emerging evidence, however, is prompting reconsideration of contraindications to exercise in pregnancy. Many of the contraindications listed in the guidelines are the result of expert opinion, rather than direct, empirical evidence of either harm from exercising with that condition and/or a clear benefit that comes from stopping physical activity.²⁴

There are a few conditions that emerging evidence and existing guidelines suggest exercise should be stopped until the condition is managed:

It is very rare to have a hidden or undiscovered cause of concern for pregnant women, so they should feel empowered to participate in an exercise program. All guidelines recommend exercising very similarly to how exercise was performed prior to pregnancy for women with uncomplicated pregnancies. ^1,2,4,24 

Postpartum recovery – exercise during the fourth trimester

The twelve weeks following delivery are often referred to as the fourth trimester of pregnancy and research suggests that many women decrease their physical activity levels during this time.⁴ Some research, however, suggests that the postpartum window may be longer, up to 1 year, especially for breastfeeding women.²⁸ This period will look very different for every woman and the experience will vary based on everything from birth delivery method, support at home, health or surgical complications, and more. Because of each woman’s unique experience, returning to physical activity also varies greatly from woman to woman, which is why an emphasis should be placed on individualization rather than adherence to time-based return to activity guidelines. A common piece of advice shared across social media and by physicians is to wait 6 weeks for the first follow up appointment to begin exercising. This recommendation may not be entirely evidence based, however. The ACOG recommends that physical activity be resumed as soon as medically safe which, for some women, may be within just days of delivery.⁴ 

A review of 22 public health guidelines from around the world agreed that exercise in the postpartum provides many health benefits for new mothers,²⁸ including but not limited to:

• Weight control/weight management
• Reducing risk of postpartum depression or depressive symptoms
• Improving mood and well-being
• Improves birth recovery
• Improvements in health and fitness
• Reducing urinary incontinence, when pelvic floor exercises are performed 

Because every woman’s pregnancy, delivery, and postpartum experience are so unique, it is challenging to give exact time-based return to activity guidelines. A 2024 professional consensus on returning to running after childbirth agreed that how a woman returns to running is more important than when.²⁷ This holds true for any other type of physical activity. Several public health guidelines from around the world recommend a gradual progression when returning to physical activity that may go from light to moderate, then moderate to vigorous.²⁸ 

These guidelines from around the world highlight the value in returning to aerobic exercise, muscle strengthening exercise, and pelvic floor exercises in an effort to meet and/or exceed the physical activity guidelines as outlined in the above sections. The emphasis, again, is on a gradual return, a relatively slow progression, and starting conservatively.²⁸ 

Instead of a rigid time-frame, here is a general framework of how to help shape return to activity based on recommendations from the ACOG⁴  and public health guidelines from around the world.²⁸

Many women may feel comfortable returning to exercise on a faster timetable, while others may need longer. What is most important, is that women do return to exercise in ways that are meaningful to them and meet the current physical activity guidelines. The how and the when are largely dependent on the individual.

Practical Summary, Main Takeaways, and Simple Guidelines

Exercise during pregnancy is safe and health-promoting for both mother and baby. If a woman is physically active pre-pregnancy, they may be able to continue exercising without needing significant modifications for a while once pregnant. If someone is not currently physically active, starting an exercise program during pregnancy is a fantastic and evidence-supported decision. In order to meet the current physical activity guidelines, it is recommended for all pregnant women with uncomplicated pregnancies to participate in both resistance training and cardiovascular conditioning.

More conditioning than described above is well tolerated during pregnancy, especially with prior training experience.

FAQs on Exercise and Pregnancy 

References

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