Working out during pregnancy | Exercise considerations for each trimester

It is generally considered both safe and beneficial to continue exercising throughout all stages of a healthy pregnancy. An appropriate prenatal fitness plan can be helpful in several areas of health including quality of sleep, mood, and general maintenance of strength and cardiovascular fitness.

Some of the workouts you might do throughout pregnancy include:

• Cardiovascular exercise such as walking and swimming
• Resistance-based exercises such as modified weight training, bodyweight training, and pelvic floor exercises
• Mind-body exercises such as prenatal yoga and Pilates

Your pregnancy exercise plan is likely to look a bit different from your pre-pregnancy fitness program. There are several important factors to consider when exercising during pregnancy, both in general and throughout the different stages of pregnancy. Some of the main considerations are outlined below.

Physical activities to avoid

Pregnancy is not a time to launch into new types of intense exercise. Some women who have not been previously active might feel like they are more motivated to get fit now that they’re growing a small human. This is great, as long as a sensible approach that considers the pregnancy, as well as exercise history, is taken.

Generally, if you have been exercising regularly before you were pregnant, you may be able to continue on a similar program. However, there are certain high-risk activities that should be avoided during pregnancy, whether you did them previously or not.

General physical activities to avoid during pregnancy

• Exercising in very hot environments. Avoid hot yoga, saunas, and exercise in very hot weather, which can take blood away from your uterus while your body tries to cool down.
• Contact-sports and those with high accident risk. Examples include horse riding, snow sports, and contact sports like football, boxing, and hockey.
• Diving, or exercising at altitude

Exercises to avoid during pregnancy

Other exercises to modify throughout pregnancy are outlined below.

Exercises that put significant stress on the joints and could result in pain or be damaging to the body

Be careful of overstretching or putting too much impact on the joints. The hormone relaxin is released throughout pregnancy. It softens ligaments and muscles to make room for the baby. Therefore, care must be taken to avoid unnecessary pressure on the body.

Abdominal exercises that cause doming in the midsection

As a result of diastasis recti (abdominal separation), you may notice “doming” during certain exercises. Continuing to do these exercises can make your abdominal separation worse. If your abdomen is doming during an exercise it will appear to be pushing forward in a triangle shape, around the belly button area. If you are unable to avoid doming in an exercise, make sure you change to a different exercise.

Any exercise that causes you to bear down on your pelvic floor

Only do exercises where you are gently able to lift and contract the pelvic floor muscles. Some exercises present an increased tendency for people to “bear down” on their pelvic floor muscles. These include planks and heavy weightlifting. Learn to gently lift the pelvic floor muscles during exercises and modify if you feel yourself bearing down.

Additional exercise considerations for each trimester are outlined below.

First-trimester exercise considerations

For some women, the first trimester can feel the toughest.  As a result of hormone changes, some women experience severe morning sickness and/or fatigue during this stage of pregnancy. Others may not even know they are pregnant or may feel pretty much the same as usual!

During the first trimester, continue exercising if you feel good, and modify if needed. Modifications might include lower intensity workouts, decreased exercise volume, lower impact exercise, and more rest than usual.

It’s important to know that levels of the hormone relaxin are the highest in the first trimester. This is one reason why some women experience back pain this early in pregnancy. Overall, listen to your body, and change your routine as required.

Second-trimester exercise considerations

Sometimes described as the “magical middle trimester”, for many women, this is the trimester where they feel the best and can do the most. Morning sickness may have eased, energy levels may be higher, and joints and muscles aren’t feeling too overloaded. Of course, pregnancy is different for every woman. Most importantly, listen to your body and always adapt your exercise sessions accordingly.

If you are continuing with a regular exercise program during the second and third trimesters, it’s recommended to avoid exercises that involve lying flat on your back. This is because the weight of your growing uterus could restrict blood flow to you and the baby. As a result, you might end up feeling dizzy or unwell if you exercise in this position.

It’s probably obvious that you’re not going to want to lie on your stomach anymore either. A few examples of exercise modifications include:

• Using an incline bench for exercises that you might normally do whilst lying flat (e.g. a dumbbell bench press)
• Exercises on hands and knees instead of lying on the stomach (e.g. try the bird dog exercise on hands and knees instead of a superman exercise on the stomach).

Third-trimester exercise considerations

Because your center of gravity has certainly changed by this point in the pregnancy, balancing may become more difficult. This is an important third-trimester exercise consideration. Make sure you are able to balance well while exercising. If not, it’s important to modify or change the exercise.

Exercises such as lunges could become difficult from both a balance point of view and due to increased pressure on the lower body. If an exercise such as a lunge causes you to feel unbalanced, try a squat instead. You can also use a pole or wall to help with balance if required.

By this stage in the pregnancy you may also feel like you want to rest more, so adjust your routine as appropriate.

General considerations for exercising during pregnancy

Many of the general considerations for exercising during pregnancy also apply if you’re not pregnant. The following points should also be considered:

• If you have any pre-existing or pregnancy-related health concerns, talk to your lead maternity provider and general practitioner about any additional modifications and exercise considerations.
• Pay attention to any warning signs that provide an indication that it’s time to stop or ease back. These include pain, bleeding, cramps, contractions, or shortness of breath. Contact your lead maternity provider to discuss a course of action for warning signs such as these.
• Always ensure you are adequately hydrated and well-nourished. Have a snack on hand to help replace your energy after a workout.

Whether you’re pregnant or not, you should always listen to your body. Throughout pregnancy, it’s likely you will want to rest more. Lower impact and less intense activities are likely to feel more comfortable.

Adjust your exercise choices as needed on a day-to-day basis, and throughout the different stages of pregnancy. Overall, exercise in a way that is most appropriate and comfortable for you, because every woman’s pregnancy and exercise tolerance is different.