What physical activities are safe during pregnancy?

Safe Physical Activities During Pregnancy

All pregnant women without contraindications should engage in a combination of aerobic exercise and resistance training throughout pregnancy, accumulated over at least 3 days per week, with daily activity being ideal. 1

Recommended Activities

Aerobic Exercise

• Brisk walking - safest option with minimal fall risk 1, 2
• Swimming and water aerobics - excellent low-impact options that reduce joint stress 1, 2
• Stationary cycling (moderate effort) - preferred over outdoor cycling due to lower fall risk 1, 2
• Dancing - acceptable at moderate intensity 1

Resistance Training

• Strength training with moderate loads - safe when performed with proper technique 1, 2
• Bodyweight exercises - squats, modified push-ups, lunges 1
• Resistance bands - provide controlled resistance 1

Flexibility and Mind-Body Activities

• Yoga (avoiding hot yoga) - beneficial for flexibility and stress reduction 1, 2
• Gentle stretching - helps with muscle tension and joint mobility 1, 2
• Pelvic floor muscle training (Kegel exercises) - should be performed daily to reduce urinary incontinence risk by 50% prenatally and 35% postnatally, with proper instruction recommended 1, 2

Household Activities

• Gardening, window washing, and moderate household chores - count toward daily activity goals 1, 2

Exercise Prescription

Intensity Guidelines

• Moderate intensity is the target - you should be able to talk but not sing during activity 1, 3
• Heart rate should be noticeably elevated but not excessive 1, 2
• Previously active women can continue moderate to vigorous activity, though evidence on very high-intensity exercise remains limited 1, 4, 3

Frequency and Duration

• Minimum 3 days per week, but daily activity is strongly encouraged 1
• At least 150 minutes per week total or 20-30 minutes most days 3, 5, 6
• Progressive adjustment toward these goals is recommended for previously inactive women 1, 3

Activities to Avoid

High-Risk Activities

• Scuba diving - fetus is not protected from decompression sickness 1
• Contact sports - ice hockey, boxing, soccer with physical contact 1
• Activities with high fall risk - horseback riding, downhill skiing, gymnastics, non-stationary cycling, surfing 1
• Olympic lifts - excessive strain and injury risk 1
• Hot yoga - risk of maternal hyperthermia and dehydration 2

Environmental Precautions

• Avoid exercise in excessive heat and high humidity - risk of maternal hyperthermia 1, 2, 7
• Avoid high altitude above 2,500 meters for lowlanders without proper acclimatization 1
• Limit hot tub use to less than 10 minutes, water temperature below 39°C 2

Position Modifications

• Avoid supine (flat on back) exercise if experiencing lightheadedness, nausea, or feeling unwell - modify to side-lying or inclined positions 1, 7
• This recommendation is based on expert opinion due to theoretical concerns about aortocaval compression, though evidence is limited 1

Warning Signs to Stop Exercise Immediately

Seek medical attention if experiencing: 1, 7

• Persistent excessive shortness of breath not resolving with rest
• Severe chest pain
• Regular and painful uterine contractions
• Vaginal bleeding
• Persistent fluid leakage from vagina (ruptured membranes)
• Persistent dizziness or faintness not resolving with rest

Contraindications

Absolute Contraindications

Women with absolute contraindications should limit activity to usual daily living tasks only, avoiding strenuous exercise 1, 3

Relative Contraindications

Women with relative contraindications must discuss risks and benefits with their obstetric care provider before participating in moderate-to-vigorous activity 1, 3

Key Benefits Supporting These Recommendations

The evidence demonstrates that following these guidelines reduces risk of: 1, 3, 8

• Gestational diabetes (particularly in overweight/obese women)
• Pre-eclampsia and gestational hypertension
• Excessive gestational weight gain
• Cesarean section and instrumental delivery
• Urinary incontinence
• Depression and anxiety
• Lumbopelvic pain
• Large for gestational age infants

Importantly, physical activity is NOT associated with increased risk of miscarriage, stillbirth, preterm birth, low birth weight, or birth defects. 1, 3, 8

Practical Implementation

• Include warm-up and cool-down periods to accommodate ligament laxity from pregnancy hormones 1
• Maintain adequate hydration - drink water before, during, and after activity 1
• Ensure adequate nutrition to support increased energy demands 1
• Modify activities as pregnancy progresses based on comfort and body changes 1, 3
• Continue what you can during periods of fatigue - some activity is better than none, return to full recommendations when able 1, 3