One of the questions I am asked most often as a prenatal instructor is “Is it safe to exercise while pregnant?” and the short answer is YES, absolutely!
Staying active during pregnancy improves cardiovascular fitness (1), helps manage pregnancy weight gain, reduces your risk of high blood pressure and gestational diabetes (2), and can have a positive effect on our mental health. Evidence also shows that moderate physical activity poses no risk to your baby, will have no effect on their birth weight, and will not induce preterm labour (3). There is also no link to exercise and miscarriage.
So what is the current guidance on is it safe to exercise while pregnant?
The UK Chief Medical Officers’ physical activity guidelines recommend that healthy women with uncomplicated pregnancies aim to accumulate 150 minutes of moderate intensity physical activity throughout the week, and engage in strength training on two days of the week (4). The important part here is that we want both moderate intensity cardiovascular work, and strength work! We want mothers who are functionally fit – strong enough to deal with the demands of pregnancy, and then fit enough to run around after their children.
If you were active before pregnancy: you can aim to continue being active as you had done pre-pregnancy, aiming to adapt as needed to maintain a “moderate” intensity. Moderate intensity activity would be activity that makes you breathe faster, but still enables you to hold a conversation. You can use the Talk-Test: can you still talk whilst exercising? If not, slow things down a little.
If you were not active before pregnancy: aim to start gradually. Then increase the amount of time spent exercising slowly as and when you feel comfortable. Staying active during pregnancy is incredibly beneficial and there is no time too late to start exercising.
Can everyone exercise?
Whilst most women will be safe to exercise during pregnancy, there are some known contraindications to exercise (5). A contraindication to exercise is a health concern that may mean you need to adapt your exercise choices. These are broken down into Absolute Contraindications and Relative Contraindications. You can find the description of Absolute and Relative Contraindications below, as well as the lists of both.
Is there anything I can’t do?
Personally I prefer to talk about what pregnant women CAN do. But there are a few things we may want to reconsider when pregnant:
- Don’t bump the bump – this may seem obvious, and usually means avoiding high impact sports such as rugby, horse riding or anything that may cause impact to a bump
- Avoid lying in supine – after around 16 weeks it can become uncomfortable, and dangerous, to lie on your back for an extended period of time. Try changing supine exercises to side lying, standing, or 4-point kneeling.
- Avoid activities such as scuba diving or skydiving
- Listen to your body and stop if you feel unwell. The specific list of “Warning signs to discontinue exercise” can also be found below.
- Try to stay hydrated, and don’t get too hot when exercising.
Overall staying active during pregnancy is incredibly important, proven to have vast health benefits, can feel really empowering, and can also boost your mental health! What exercises are safe during pregnancy? Most women will be able to continue with the activities they enjoyed pre-pregnancy, with some simple tweaking to keep them safe. And there is some evidence to suggest an activity pregnancy can help reduce labour times, and reduce your chance of an assisted delivery. Win win if you ask me! So, Is it Safe to Exercise While Pregnant? Absolutely, if you are a healthy individual having an uncomplicated pregnancy.
Absolute contraindications to exercise
Absolute contraindications refer to conditions where moderate-to-vigorous intensity physical activity (MVPA) is not recommended as the risks outweigh the potential benefits and could result in adverse effects for the mother and/or foetus, however, activities of daily living may continue. Light activity such as walking may be acceptable however, specialist input from a medical professional is required and decisions should be made on an individual basis (5)
- Severe respiratory diseases (e.g., chronic obstructive pulmonary disease, restrictive lung disease, cystic fibrosis, asthma, shortness of breath, chronic coughing, and chest tightness)
- Severe acquired or congenital heart disease with exercise intolerance
- Uncontrolled or severe arrhythmia
- Placental abruption
- Vasa previa
- Uncontrolled type 1 diabetes
- Intrauterine growth restriction (IUGR)
- Active preterm labour (i.e. regular and painful uterine contractions before 37 weeks of pregnancy
- Severe pre-eclampsia
- Cervical insufficiency
- Pregnant with 3+ Babies
Relative contraindications refer to conditions where activity should be approached with caution and discussion with a healthcare professional is advised. The advantages and disadvantages of low-to-moderate intensity physical activity should be considered and may potentially proceed subject to modifications, supervision, and with continuous monitoring. It’s advised you speak to your Dr if you are worried about exercising (5)
- Mild respiratory disorders (see Absolute Contraindications list above for full list)
- Mild congenital or acquired heart disease
- Well-controlled type 1 diabetes
- Mild pre-eclampsia
- Preterm premature rupture of membranes (PPROMs).
- Placenta previa after 28 weeks
- Untreated thyroid disease
- Symptomatic, severe eating disorders
- Multiple nutrient deficiencies and/or chronic undernutrition
- Moderate–heavy smoking (>20 cigarettes per day) in the presence of comorbidities
- Pregnant with twins (after 28 weeks)
Warning signs to discontinue exercise when pregnant
Whilst exercising during pregnancy is very safe if you are a low-risk pregnancy, there are some warning signs to look out for that would require you to stop exercising.
- Vaginal bleeding
- Abdominal pain
- Regular and painful contractions
- Amniotic fluid leakage
- Dyspnea before exertion
- Persistent excessive shortness of breath that does not resolve with rest
- Persistent dizziness or faintness that does not resolve on rest
- Chest pain
- Muscle weakness affecting balance
- Calf pain or swelling
- Severe pelvic girdle pain that does not improve within a week or two, or interferes with normal day-to-day living
1 -University of Oxford Physical Activity and Pregnancy Study Group. Physical Activity and Pregnancy Infographic Study Interim Report. 2016. Unpublished work. University of Oxford, Oxford.
2 – Rogozińska E, Marlin N, Jackson L, Rayanagoudar G, Ruifrok AE, Dodds J, et al. Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta‐analysis and health economic evaluation. Health Technol Assess 2017 (in press)
3 – Sternfeld, B. Physical Activity and Pregnancy Outcome. Sports Med. 23, 33–47 (1997). https://doi.org/10.2165/00007256-199723010-00004
4 – https://www.health-ni.gov.uk/sites/default/files/publications/health/Physical%20activity%20for%20pregnant%20women%20infographic_FINAL.pdf
5 – Meah VL, Davies GA, Davenport MH. Why can’t I exercise during pregnancy? Time to revisit medical ‘absolute’ and ‘relative’ contraindications: systematic review of evidence of harm and a call to action. Br J Sports Med. 2020 Dec;54(23):1395-1404. doi: 10.1136/bjsports-2020-102042. Epub 2020 Jun 8. PMID: 32513676.
- The Active Pregnancy Foundation – click here
- This Mum Can Campaign – read all about it here
- The Bump Plan Pregnancy Exercise Program – Try for free here
- ‘5 Prenatal Pilates Moves to Strengthen your Core & Glutes’ – read here
- Pregnancy Books That You Need to Read
- Pilates During Pregnancy: 5 Reasons to Practice It
- Pelvic Floor Pregnancy: Everything You Need to Know
- Pelvic Girdle Pain During Pregnancy: What is it?
If found this article on ‘Is It Safe To Exercise While Pregnant’ useful and would like to discover more about prenatal fitness and your changing body I would love you to check out my pregnancy exercise program ‘The Bump Plan’ for FREE today – simply click here to get started