Exercise in Pregnancy: How Much, What's Safe and What to Skip

Why it's worth it

• Regular activity lowers the chance of gestational diabetes, high blood pressure and excess weight gain, and helps with back pain, constipation, sleep and mood.
• It does not raise the risk of miscarriage, preterm birth or low birth weight in an uncomplicated pregnancy.

How much

• Aim for about 150 minutes a week of moderate activity, for example 30 minutes on 5 days. Short 10-minute walks count.
• Moderate means you can talk but not sing. That talk test works better than heart-rate targets.
• If you were already running, lifting or doing sports, you can usually keep going at a similar level, adjusting as your body changes. If you were inactive, start with 10-15 minutes and build up.

Good choices

• Walking, swimming and water aerobics, stationary cycling, low-impact aerobics.
• Strength training with moderate weights; keep breathing (don't hold your breath while lifting).
• Prenatal yoga and Pilates, modified as your belly grows.
• Pelvic floor exercises (Kegels) daily: squeeze as if stopping gas or urine, hold a few seconds, relax fully. A pelvic floor physical therapist can check your technique.

What to skip or change

• Contact and collision sports (soccer, basketball, hockey, boxing).
• Activities with a high fall risk: downhill skiing, horseback riding, gymnastics, outdoor cycling on rough ground.
• Scuba diving, and skydiving.
• Hot yoga, hot Pilates and exercising in high heat. Drink water before, during and after.
• After the first trimester, avoid long stretches lying flat on your back; prop up or switch to side-lying versions of exercises.
• Above about 6,000 ft (1,800 m), take it easier unless you live at altitude.
• Your joints loosen in pregnancy, so go gently with deep stretches and jumps.

Adjusting as you go

• Balance shifts in the third trimester; choose stable surfaces and a support belt if it helps.
• Doming or a ridge down the middle of the belly during crunches or getting up is common late on (abdominal separation). Roll to your side to sit up and switch to deep core breathing exercises.
• Leaking urine with jumping is common but not something to just accept. A pelvic floor physical therapist can help, in pregnancy or after.
• Fuel up: a snack an hour or so before longer workouts, especially if you have gestational diabetes.

When exercise may not be right

Your provider may limit activity if you have conditions such as placenta previa after mid-pregnancy, preeclampsia, a short or weak cervix, ruptured membranes, preterm labor, severe anemia, or certain heart or lung disease. Many other conditions, such as twins or chronic high blood pressure, call for adjusting rather than stopping. Routine bed rest isn't recommended; it has little evidence of benefit.

When to check in

• Ask at your next visit if you're unsure where your sport fits or want a plan after a complication.
• Stop exercising and contact your provider for bleeding, fluid leaking, regular painful contractions, dizziness, a headache, calf pain or swelling, or shortness of breath before you start moving.
• If you have chest pain or faint, call 911.