Staying active in pregnancy: what is safe and what to avoid

Pregnancy is not an illness, and for most women staying active is one of the best things they can do for themselves and their baby. The right kind of movement eases common complaints, prepares the body for birth and makes recovery faster. The key is choosing activities that suit a changing body, and knowing when to slow down. If you have any doubts about your situation, ask your doctor or midwife first.

Why it is worth moving

Regular moderate activity in a healthy pregnancy is linked to:

• less back and pelvic pain, and fewer problems with constipation and swelling;
• better sleep and mood, and less fatigue;
• a lower risk of gestational diabetes and of excessive weight gain;
• better stamina for labour and an easier recovery afterwards.

In a normal pregnancy the usual target is about 150 minutes of moderate activity a week, for example 30 minutes on five days. "Moderate" means you are a little out of breath but can still hold a conversation. Two short walks a day count just as well as one long session.

Good choices

• Walking — free, safe at any stage and easy to fit around work and errands.
• Swimming and water exercise — the water takes the weight off your joints and helps with swelling.
• Stationary bike — all the benefits of cycling without the risk of falling.
• Prenatal yoga and pilates — build flexibility, breathing control and core strength; choose classes or videos designed for pregnancy.
• Strength training with light weights or resistance bands — keeps muscles strong for lifting a growing baby later.
• Pelvic floor exercises — do them every day. Tighten the muscles you would use to stop the flow of urine, hold for a few seconds, relax and repeat ten times; they help with bladder leaks now and recovery later.
• Gentle stretching — especially for the lower back, hips and calves.

If you exercised regularly before pregnancy, you can usually continue at a slightly lower intensity. Listen to your body rather than chasing previous records.

Adjusting as your bump grows

• After 16–20 weeks, avoid lying flat on your back for long periods; the weight of the uterus can press on a major vein and make you dizzy. Use a wedge or lie on your side.
• Your centre of gravity shifts and your joints become looser, so balance is less reliable. Hold on to something during standing exercises and avoid sudden changes of direction.
• Avoid heavy lifting with breath-holding; breathe out on the effort and keep weights light.
• Replace sit-ups and deep twists with side-lying or all-fours core work.
• Slow down. Your heart rate is naturally higher in pregnancy, so the same effort feels harder.

What to avoid

• Contact sports and anything with a real risk of a blow to the belly: football, basketball, martial arts.
• Activities with a risk of falling: horse riding, skiing, skating and cycling on busy roads, especially in the second half of pregnancy.
• Scuba diving at any stage.
• Hot yoga, saunas and steam rooms, which raise your core temperature.
• Exercising in the midday heat of an Uzbek summer. Train early in the morning or in the evening, drink water before, during and after, wear light loose clothing and stop if you feel overheated.
• Exercising at high altitude if you are not used to it.

When to stop and call your doctor

Stop exercising and call your doctor or the maternity hospital, or ring 103 for an ambulance, if you notice:

• vaginal bleeding or fluid leaking;
• regular, painful contractions;
• dizziness, fainting or chest pain;
• a headache that does not go away, or blurred vision;
• pain, redness or swelling in a calf;
• sudden shortness of breath before you have started exerting yourself;
• your baby moving less than usual.

Some conditions mean you should get medical advice before exercising at all: placenta praevia in the second half of pregnancy, cervical insufficiency or a cervical stitch, preeclampsia or poorly controlled high blood pressure, severe anaemia, heart or lung disease, a previous preterm birth, or twins with complications. Your doctor may still recommend gentle activity, but the plan should be made together.

Starting from scratch, and after the birth

If you were inactive before pregnancy, you can still start; just build up slowly. Begin with 10–15 minutes of walking a day, add five minutes every week or two, and aim for the 150-minute target over a couple of months. Warm up for a few minutes, cool down afterwards and never push through pain.

After the birth, give your body time. Short walks and pelvic floor exercises can start within days of an uncomplicated vaginal birth; after a caesarean, wait for your check-up and your doctor's go-ahead. Return to running, jumping and heavy lifting only once your pelvic floor feels strong again, usually not before about three months; sooner is not better. Bleeding that becomes heavier after exercise is a sign to rest.

This article is general information, not medical advice. Talk to your doctor or midwife before starting or changing exercise in pregnancy.