Physical activity during pregnancy

Physical activity is essential for maintaining good health. This is also the case during pregnancy. Many women who were active before becoming pregnant want to remain so during their pregnancy. Those who were less active often want to do more exercise to make sure their pregnancy goes smoothly, and to ensure that both mother and baby remain healthy.

Physical activity during pregnancy: Recommendations

Current research shows that working out during pregnancy is safe as long as the mother does not have any contraindications. Physical activity is beneficial for both mother and baby.

Several health organizations, such as the World Health Organization, the Society of Obstetricians and Gynaecologists of Canada, the Canadian Society for Exercise Physiology, and the Institut national de santé publique du Québec, recommend regular physical activity during pregnancy.

The most recent Canadian recommendations for exercise during pregnancy indicate that pregnant women should do the following to fully benefit from their workout sessions:

• Do at least 150 minutes of moderate-intensity activity every week.
• Get moving at least three times a week, but preferably every day.
• Incorporate a variety of aerobic and muscle-strengthening activities. Yoga and gentle stretching can also be beneficial.
• Do pelvic floor muscle training every day (e.g., Kegel exercises). For optimal results, it’s recommended that you learn the proper exercise technique.

Women who were sedentary or overweight/obese before becoming pregnant or who have developed gestational diabetes can follow these recommendations.

The benefits of physical activity

Here are some of the research-based benefits of exercising regularly during pregnancy:

• Reduces the risk of gestational diabetes by 38 percent.
• Reduces the risk of hypertension and preeclampsia by 40 percent.
• Improves your overall physical condition.
• Reduces the risk of depression by 67 percent.
• Improves self-esteem.
• Decreases the severity of back pain.
• Decreases the likelihood of medical interventions during childbirth.
• Reduces the risk of giving birth to a large baby (weighing more than 4 kg).
• Reduces the risk of excessive gestational weight gain by 32 percent.

Exercise contraindications during pregnancy

Most pregnant women can exercise during pregnancy. However, in some cases you’ll need to talk to your doctor or midwife before starting or continuing a workout routine. In rare cases, exercise is not recommended during pregnancy.

Relative contraindications

If you have any relative contraindications, talk to your doctor or midwife about the advantages and disadvantages of moderate to vigorous physical activity. Depending on the situation, it may or may not be recommended.

Here are the relative contraindications to exercise during pregnancy:

Absolute contraindications

If you have absolute contraindications, you should continue your usual daily activities, but avoid more strenuous physical activity.

Here are the absolute contraindications to exercise during pregnancy:

Starting or continuing a workout routine during pregnancy

Once you’ve confirmed that physical activity is safe for you and your future child, where do you start?

If you were already physically active before your pregnancy, chances are you can continue your normal routine. You may need to adapt certain activities if the ones you did before are contraindicated during pregnancy.

As your pregnancy progresses, certain physical activities may become more difficult or less enjoyable. If this happens, reduce the intensity or shorten your sessions, adjust your positioning to accommodate your larger belly, or try a different activity as needed. Water-based activities and prenatal yoga are often practised in the third trimester of pregnancy.

If you are fairly sedentary, it’s recommended that you slowly increase your activity level until you are getting 150 minutes of moderate-intensity exercise every week. You may need to start with low-intensity activities or shorter sessions, then increase the duration and intensity of your workouts over time.

Whatever your fitness or activity level, there may be times during your pregnancy when severe fatigue or discomfort will make it impossible to follow exercise guidelines for pregnant women. If this happens, do what you can and try to follow the recommendations again once you feel better.

Respect your limits

Exercise is good for you and your baby, as long as you respect your limits. How can you make sure that you’re not overexerting yourself? A good test is to talk while you exercise. You should be able to hold a conversation during your workout. If you can’t, you’re pushing yourself too hard.

If you monitor your heart rate during your workout, you can use the target heart rate table below as a guide.

What physical activities should I do during pregnancy?

Since the goal is to stay active throughout your pregnancy, it’s important to choose activities that are safe, varied, and enjoyable. Most forms of exercise are safe for you and your unborn baby.

If you opt for a group class, try to choose one that’s designed for pregnant women. The instructor will be demonstrating moves that are already adapted and considered safe during pregnancy.

To get the most benefit from your workouts during pregnancy, it’s recommended that you incorporate both aerobic and resistance training exercises.

Aerobic exercise

Aerobic exercises are physical activities that are intense enough to make your heart beat faster than it does when you’re resting. They involve large muscle groups and are designed to increase cardiorespiratory endurance (i.e., strengthen your heart and lungs).

During pregnancy, you can enjoy moderate-intensity aerobic exercises such as walking, swimming, aquafit, stationary cycling, aerobic dance, cross-country skiing, snowshoeing, or running. If you weren’t exercising regularly before you became pregnant, do these same activities at a lower intensity (when possible).

If you want to engage in a high-impact activity such as running, consult an exercise and pelvic health specialist to make sure that your body, including your pelvic floor muscles, is able to handle it.

Muscle-strengthening exercises

Muscle strengthening exercises use external resistance such as light weights or exercise bands to increase your muscle mass. There are also no-load exercises you can try that use your own body weight as resistance.

The amount of weight to use and number of sets and repetitions will depend on your fitness level and experience with muscle-strengthening exercises. Start with 1 or 2 sets of 10 to 15 repetitions. Adjust the load so that the last three repetitions are difficult to complete. As you progress, add 1 or 2 sets and increase the load.

A basic muscle strengthening routine during pregnancy can help:

• Maintain good posture by strengthening the deep abdominal muscles and the upper and lower back muscles (women sometimes develop poor posture during pregnancy due to the changes to their bodies).
• Support weight gain by strengthening your leg and buttock muscles.
• Prepare you to care for your newborn by strengthening your arm and shoulder muscles.

Seek advice from a prenatal fitness specialist to make sure that you’re doing the exercises correctly.

When pregnant, it’s especially important to find positions that are comfortable during your workout. If you feel dizzy or nauseous, or if you feel unwell when exercising lying on your back, change your position.

Other types of physical activities

Some everyday activities, such as gardening and vacuuming, are also considered moderate-intensity exercise.

Physical activities to avoid during pregnancy

• Activities in an excessively hot and humid environment (e.g., hot yoga)
• Activities where you risk falling or getting hit in the stomach (e.g., horseback riding, downhill skiing, ice hockey, gymnastics, basketball, soccer, racket sports, road cycling, weightlifting)
• Scuba diving
• Activities at high altitudes (i.e., over 2,500 metres above sea level) if your place of residence is below this altitude

Dos and don’ts

Here are some dos and don’ts to follow when exercising during your pregnancy. By following these guidelines, you’ll be able to work out safely.

• Listen to your body. Little by little, your baby will take up more space and you will carry more weight, especially in the third trimester. This can make breathing and performing certain activities or exercises more difficult. Adjust the intensity, duration, and type of physical activity to remain comfortable. Feel free to take breaks as needed.
• Be careful when doing physical activities that require balance and coordination. As your uterus expands and your baby grows, your centre of gravity shifts, increasing the risk of losing your balance and falling.
• Don’t overstretch your ligaments or tendons (e.g., extreme yoga poses, intense stretching). In preparation for childbirth, your body releases hormones that relax your joints, increasing the risk of injury during exercise.
• Don’t get overheated. Wear breathable clothing and exercise in an environment that isn’t too hot.
• Stay well hydrated. Because the changes that pregnancy brings to your body make you sweat more quickly and profusely during exercise, it’s important to replace the water you lose.
• Breathe normally when doing resistance exercises. Exhale when your muscles contract and inhale when your muscles relax. This allows you to engage your abdominal muscles as you work out.
• If you plan to do intense workouts or compete in sporting events during your pregnancy, talk to your prenatal care provider. They will inform you of the risks involved and suggest that you modify your training if necessary.

Symptoms to watch for

If you experience any of the following symptoms during physical activity, stop and consult your doctor or midwife.

• Persistent, excessive shortness of breath that does not resolve with rest
• Severe chest pain
• Regular and painful uterine contractions
• Vaginal bleeding
• Persistent loss of fluid from the vagina, which may be a sign of ruptured membranes
• Persistent weakness or dizziness that does not go away with rest

Things to keep in mind

• Doing exercise during pregnancy is not only safe, but also beneficial for the mother and her baby.
• Pregnant women with no contraindications should do 150 minutes of varied, moderate-intensity exercise every week.
• Women who were less active before becoming pregnant should gradually increase their physical activity level from the beginning of their pregnancy to meet these recommendations.

Scientific review: Stephanie-May Ruchat, Ph.D., professor in the department of exercise science, Université du Québec à Trois-Rivières Research and writing:The Naître et grandir team Updated: August 2024

Photos : iStock.com/Andriy Bandurenko et GettyImages/Wavebreakmedia