Safe Exercise During Pregnancy

For most people, staying active during pregnancy is good for both physical and mental health. Whether you already exercise regularly or want to start, regular moderate activity is considered safe for you and your baby in most pregnancies. It can help you sleep better, give you more energy, ease back pain, lower the risk of some pregnancy complications and help you cope with labour and recovery. In an uncomplicated pregnancy, recommended levels of physical activity do not increase the risk of miscarriage.

If you already do vigorous exercise, you may be able to continue while your pregnancy remains uncomplicated, adapting as needed. Pregnancy is not usually a good time to chase personal bests. If you compete or train intensively, seek individual advice from your maternity team and an appropriately qualified sports professional.

How much to aim for

The UK Chief Medical Officers' physical activity guidelines recommend that during pregnancy you:

• aim for at least 150 minutes of moderate-intensity activity each week, spread across the week
• do muscle-strengthening activities twice a week, adapted for pregnancy
• break up long periods of sitting

If you were not active before pregnancy, start gently with walking or swimming and build up gradually. Some activity is better than none. The NHS exercise in pregnancy page explains the guidance in more detail.

Talk to your midwife or GP about the exercise you do or plan to do, especially if you have a health condition, had complications in a previous pregnancy or are expecting more than one baby. Conditions such as heart or lung disease, or high blood pressure in pregnancy, may mean you are advised to change or limit certain activities. This does not automatically mean stopping exercise altogether. Your circumstances can change as your pregnancy develops, so it is worth raising this again at antenatal appointments.

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Exercising safely

Adjust activity to how you feel, follow any advice from your maternity team, and stop if you develop warning symptoms.

• Warm up and cool down. Start and finish with a few minutes of gentle movement. If you stretch, keep it gentle, as pregnancy hormones loosen your joints and ligaments.
• Use the talk test. You should be able to hold a conversation while exercising. If you are too out of breath to speak, slow down.
• Avoid overheating. Exercise in cool, well-ventilated spaces and avoid hot yoga or exercising in very hot weather.
• Drink plenty of water before, during and after activity.
• Eat well so your body has enough energy for exercise and your growing baby. If you feel faint while exercising, stop and rest. Get advice if it keeps happening.
• Wear supportive clothing, including a well-fitting sports bra and comfortable footwear.

Avoid contact sports and activities where you could be hit, such as rugby, boxing or martial arts that involve sparring. The NHS advises taking care with activities that carry a risk of falling, such as horse riding, skiing and gymnastics, because a fall could injure you or your baby. Many people choose to avoid them during pregnancy. Do not scuba dive, and do not exercise at altitudes over 2,500 metres above sea level because of the risk of altitude sickness.

Walking, swimming, aquanatal classes, cycling on a static bike, and pregnancy yoga or Pilates are popular choices. You may find pregnancy-specific classes at local leisure centres. Always tell your instructor you are pregnant, and look for one qualified to adapt exercise for pregnancy.

Do pelvic floor exercises every day, aiming for three sets of eight squeezes, relaxing fully between each one. They can reduce the chance of leaking urine during and after pregnancy. The NHS website explains the technique. Squeezy, a paid app developed with specialist physiotherapy input, can remind you to do them. If you have pain or find the exercises difficult, ask for a referral to a specialist physiotherapist.

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Changing your routine as pregnancy progresses

First trimester. Tiredness and sickness can make exercise hard in the early weeks. Do what you can and rest when you need to. A short walk may feel more manageable than a full workout.

Second trimester. Many people have more energy at this stage. From around 16 weeks, avoid lying flat on your back for long periods, as the weight of your womb can press on a major blood vessel. If you feel dizzy on your back, change position straight away. Exercises done lying down can usually be adapted to a seated, side-lying or inclined position.

Third trimester. A growing bump can affect your balance, so choose activities with a low risk of falling. You may need to reduce intensity and shorten sessions.

Adapted core exercises can be suitable throughout pregnancy. Modify or stop any exercise, such as sit-ups, that causes pain, difficulty or a ridge bulging along the middle of your stomach. If you develop pelvic girdle pain or back pain, ask your midwife about a referral to an NHS physiotherapist. Pelvic, Obstetric and Gynaecological Physiotherapy (POGP), a professional network of the Chartered Society of Physiotherapy, also publishes helpful information.

When to stop and get help

Stop exercising and call 999 if you have chest pain, severe difficulty breathing or collapse.

Stop and contact your maternity unit straight away, at any time of day or night, if you have:

• fewer movements from your baby or a change to their usual pattern, without waiting until the next day
• vaginal bleeding or fluid leaking from your vagina
• regular, painful contractions
• a severe headache, especially with blurred vision or pain just below your ribs, which can be signs of pre-eclampsia
• sudden, severe or unusual breathlessness, whether before or during exercise
• dizziness or feeling faint that does not settle with rest
• muscle weakness that affects your balance

Pain or swelling in your calf, particularly in one leg, can be a sign of a blood clot (DVT) and needs urgent medical assessment. Contact your maternity unit or NHS 111 the same day.

If you are unsure whether a symptom needs attention, call your maternity unit or NHS 111.

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