Exercise in Pregnancy

Exercise is focused, sustained physical activity that increases heart and respiratory rate while working the major body muscles.

There are many benefits of exercise, including helping:

  • heart health
  • bone health
  • healthy weight loss
  • improved sleep quality

Exercise is also a great way to relieve stress and maintain overall wellbeing.

Regular exercise is recommended in pregnancy as it benefits both the pregnant person and the fetus, and helps make for a healthy pregnancy.

People who exercised before pregnancy are encouraged to continue exercising during the course of the pregnancy and in the postpartum period.  For those people who did not, starting an exercise regimen of as little as ten minutes a day of walking can be beneficial.  The key in this case is to start with simple exercises and add to the routine every month.

Benefits of exercise

Engaging in regular exercise decreases the risk of diabetes and pregnancy-related high blood pressure. It also lowers the risk of cesarean delivery.  Plus, pregnancy is associated with a higher risk of developing blood clots, and regular exercise will help decrease this risk. Exercise in the postpartum period helps decrease depression and helps with weight loss.

Pregnant people diagnosed with diabetes in pregnancy (as well as those who have diabetes before pregnancy) are encouraged to exercise at least 5 days a week or at least 150 minutes per week as part of the diabetes treatment plan. This regular exercise, along with healthy eating habits, improves glucose levels. It also decreases the risk of having a large newborn. This, in turn, decreases the risk of shoulder dystocia and fetal and maternal injury during the birthing process.

Obese people who are pregnant are also encouraged to exercise during the course of the pregnancy. This helps decrease the risk of developing pregnancy-related disorders like hypertension, diabetes, blood clots and excessive weight gain.

How much weight should I gain during pregnancy?

The Institute of Medicine recommends the following weight gain during pregnancy. These recommendations are based on a person’s pre-pregnancy body mass index (BMI).

Your OBGYN physician or clinician will monitor your weight through the course of the pregnancy.

Exercise Recommendations

How long should you exercise?

It is recommended that pregnant people exercise at least 30 minutes a day, five days a week.

What is the best exercise routine?

While there is no set or recommended exercise regimen in pregnancy, here are some good options:

  • Taking a 15-minute brisk walk after meals
  • Swimming or water aerobics is an excellent option, especially for pregnant people who experience back or joint pain
  • Running
  • Aerobics
  • Yoga
  • Weight lifting, for those who engaged in weight training prior to pregnancy
  • Dancing
  • Pelvic floor exercises are valuable before and during the pregnancy and in the postpartum period. In addition to strengthening the pelvic floor muscles, they help decrease the risk of vaginal tears and the uncontrolled loss of urine during and after delivery.

You should avoid contact sports, deep sea diving, or any exercise/sport that increases the risk of abdominal trauma.

Who should you not exercise?

There are some people who should not be exercising during pregnancy. These include pregnant people who experience any of the following:

  • Chest pain or have a serious heart or lung condition
  • Have an abnormal placenta or placental insufficiency
  • Vaginal bleeding
  • Loss of amniotic fluid
  • Pain
  • Shortness of breath
  • Malnutrition
  • Current blood clot
  • Increased risk of preterm labor
  • Pregnant with twins or triplets
  • Anyone who has been advised by their doctors not to exercise

All pregnant people should discuss their current or planned exercise regimens with their doctor to ensure it is appropriate, given the health of the person and the pregnancy.

Exercise in the Postpartum Period

Those who have an uncomplicated vaginal delivery or cesarean section may resume low impact exercises like walking, within about a week of delivery.

People who have a complicated vaginal delivery or cesarean delivery should consult with their obstetrician on when they are cleared to resume exercise.  Complicated deliveries are those that result in heavy bleeding during or after delivery, vaginal tears, severe anemia, severely elevated blood pressures, seizures, heart disease or failure, etc.

Breastfeeding parents should nurse prior to engaging in exercise. Wearing a well-fitting, comfortable bra is advisable.

With all forms of exercise, ensure you stay very well hydrated and take breaks as you need to. Listening to your body is key, both during and outside of pregnancy.

Take Home Points

  • Regular exercise is recommended in pregnancy as it benefits both the pregnant person and the fetus, and helps make for a healthy pregnancy.
  • It is recommended that pregnant people exercise at least 30 minutes a day, five days a week. There is no recommended type of exercise, although walking and swimming are both good options.
  • All pregnant people should discuss their current or planned exercise regimens with their doctor.
  • Exercise shouldn’t end with the delivery! Postpartum exercise is beneficial for several reasons. Consult your doctor for recommendations.

References

  • Gestational Diabetes in Pregnancy Practice Bulletin # 190, 2018. ACOG
  • Obesity in Pregnancy, Practice Bulletin # 230, 2021. ACOG
  • Exercise During Pregnancy. Frequently Asked Questions. ACOG
  • Physical Activity & Exercise During Pregnancy and the Postaprtum Period. Committee Opinion, # 804. ACOG
  • Mottola MF, Davenport MH, Ruchat S, et al. 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine 2018;52:1339-1346.
  • Institute Of Medicine; Weight Gain during Pregnancy
  • Move your way. US dept. of Health and Human Services

Author Information

Roseanne W. Gichuru, DO, MBA, FACOOG CPE, obtained her undergraduate degrees in Cellular Molecular Biology & Women’s Studies from West Chester University.  She obtained her Medical Degree from Philadelphia College of Osteopathic Medicine and her MBA from St. Joseph University.  She completed her OB/GYN residency at Crozer Chester Medical Center, PA.  She has received multiple honors, is on a number of academic committees and is a member of the Childbirth and Pelvic Floor Disorders Special Interest Group for the American Urogynecologic Society. She currently practices OB-GYN in Delaware. Dr. Gichuru has no disclosures to report.

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