When Erin Cella, a dancer and choreographer in New York, got pregnant with the first of her two children, she was nervous about exercising, wary of persistent superstitions about the risks of working out while pregnant. Her doctor reassured her that exercise during pregnancy was safe as long as she felt okay, so Cella continued to perform through her second trimester. That didn’t stop other people from judging her. “I actually heard people gasp and say, ‘She’s pregnant!’ when the lights came up during performances,” she says. “It was a little sad to realize some people still see movement and pregnancy as mutually exclusive.”
Women are often bombarded with unsolicited opinions about their body, and this can reach a fever pitch during pregnancy. As a prenatal and postpartum certified personal trainer, I’ve heard all kinds of myths from concerned clients: that exercise can deprive a fetus of oxygen, that there’s a certain target heart rate you have to stay under, that jostling motions like running are inherently dangerous.
The truth is, exercising during pregnancy is highly beneficial for both mom and baby, according to a wide body of research. Regular exercise has been shown to prevent gestational diabetes, high blood pressure, and preeclampsia; it is beneficial for psychological well-being; it may even help your baby develop a healthy heart and reduce their risk of developing chronic disease later in life.
But still, mommy-shaming is rampant at the gym. I’ve seen countless other gymgoers stare at my pregnant clients—once, a stranger even interrupted my session with a pregnant client, marching over to us to say, “Are you sure that’s safe?” Then there’s judgment from family members, who suggest it’s irresponsible or selfish to continue working out during pregnancy. And many pregnant people have the frustrating experience of being told they can’t take classes at their favorite studios once they disclose they’re pregnant. What gives?
So what is the deal with working out while pregnant?
As long as it feels okay and doesn’t pose a major risk of falling or being hit in the belly—pregnancy isn’t a great time to take up wrestling, for example—you can continue exercising, with appropriate modifications as you get further along.
In fact, it’s recommended. Current guidelines say that healthy pregnant women with no preexisting conditions should aim for at least 150 minutes of moderate activity per week, incorporating a mix of aerobic activity and resistance training. That said, pregnant women do need to modify. In the first trimester, you can often continue much as you did before pregnancy, though you might need extra rest. Further along, you might take the same class but drop the weights, take more breaks, and not push yourself quite as hard.
It’s not just because your body is changing shape. The hormonal roller coaster of pregnancy causes other physiological changes that can require adjustments to your usual routine. During the first trimester, high levels of progesterone may make you feel sluggish, leading you to feel fatigued more quickly than usual. Blood volume, heart rate, and cardiac output all increase during pregnancy as your body adapts to circulate extra blood to the developing fetus, which can also lead to quicker fatigue, so it’s important to listen to your body and adjust accordingly.
The placenta also produces a hormone called relaxin, levels of which peak in the first trimester and then right before delivery. Relaxin makes ligaments, joints, and muscles a bit more—you guessed it—lax. This certainly doesn’t mean you can’t exercise, but you should pay attention and modify movements that feel unstable or uncomfortable. As your belly grows, that irregularly distributed weight can also change the way you move. Exercise can help prevent the back pain common in pregnancy, but avoid any positions that feel too uncomfortable. (Pro tip: Seeking out prenatal fitness classes or personal training sessions, even if it’s just to supplement your other workouts, can help you learn to appropriately modify.)
“The key is hydration,” says Jennifer Aquino, M.D., an ob-gyn at NYU Langone Health. Water helps form the placenta and amniotic sac, and it helps to keep you cool during exercise. Since overheating is one of the biggest concerns of exercising while pregnant, you want to hydrate well, wear breathable clothes, and avoid any hot yoga. It’s also a good idea to have a snack after working out to make sure your blood sugar doesn’t get too low.
The more athletic you are, the more intense exercise during pregnancy you can likely tolerate. “I have lots of patients who ask if they can still take their HIIT classes,” says Aquino. “Absolutely, you can continue.” Pregnant women have run marathons after all. Just be sure to check in with your doctor about your training plans, she adds—exercises that are safe and comfortable for one pregnant person may not be appropriate for another.
There are exceptions to the rule. Women with conditions like placenta previa; severe anemia; any sort of lung disease, like uncontrolled asthma; heart disease or other heart condition; a history of preterm labor; cervical issues—and even those carrying twins or triplets—should avoid exercise, says Aquino. “I tell patients to listen to their bodies,” she says. “If you’re having headaches, chest pain, cramps, contractions, bleeding, or shortness of breath, it’s time to stop or modify the activity.”
What are the best exercises to do while pregnant?
It’s particularly important to keep up your cardio routine during exercise. Swimming and walking are great low-impact options. If you’re a runner or fan of Spin classes, these should be okay to keep up as well with doctor approval. Focusing on your muscles is also important—Pilates, barre, and yoga are all great options. If you’re a weight lifter, most guidelines recommend upping your reps but reducing your weight; consult your doctor.
It’s especially important to focus on those muscles that will be most directly involved in giving birth. “Maintaining core strength throughout your pregnancy can prevent back pain and boost recovery postpartum,” says Sarah Duvall, DPT, a core and pelvic-floor physical therapist. Your pelvic floor is part of your core too and may need some extra attention while you’re pregnant. “Handling the increasing ligament laxity that comes with the hormonal changes that spread the pelvis and prepare for delivery can be hard on the pelvic-floor muscles,” she says.
Working on your pelvic-floor strength can help prevent postpartum issues. However, what most people don’t realize about pelvic-floor exercises—also known as kegels—is that relaxing the muscles fully is just as important as contracting them. “Contracting helps to make sure we maintain strength in the pelvic-floor muscles. Relaxing helps to prepare the pelvic floor for delivery,” says Duvall. This is a great reason to have a pelvic-floor physical therapist on your birth prep team.
Here’s a simple exercise Duvall suggests for working your core and pelvic floor together:
- Lie back on the couch in a comfortable position. Wrap your hands around the bottom of your belly. Inhale, fully relaxing your abdominal muscles. Then, on the exhale, contract them by thinking of drawing inward and lifting your belly up and away from your pubic bone.
- Hold through the next inhale, thinking of inhaling down into your back and sides, not up into your shoulders.
- Exhale again, lifting a little more.
- On the following inhale, relax fully.
If you feel any signs of tightness—leaking, tailbone pain, difficulty urinating, constipation, painful sex, and a shallow breathing pattern—it might be worth seeing a pelvic-floor physical therapist. If your pelvic floor doesn’t feel tight, you can do three sets of 6 to 10 reps of this exercise as often as every other day.
What exercises should be avoided during pregnancy?
As far as individual exercises, what’s safe can vary significantly from person to person. The American College of Obstetricians and Gynecology warns against hot yoga, contact sports, and any situation where you could fall (like skiing).
When it comes to your pelvic floor, Duvall says that there are two major issues you can learn to avoid in order to exercise in a way that is beneficial, not harmful, to your abdominals and pelvic floor. The first is called doming. “A great time to check for this is when doing abdominal work, like crunches or planks, or when trying to get off the couch or sit up in bed,” says Duvall. Look at your belly button area: Does it poke out like a tent instead of drawing in when your abs contract? This is something you want to learn to avoid.
Doming is a consequence of diastasis recti—a common pregnancy condition in which the two halves of your rectus abdominus (that’s the “six-pack” muscle) separate slightly. Doming places additional pressure on the thin band of connective tissue that holds the two halves of this muscle together, and learning to avoid it will help you heal. You can use the exercise above to practice drawing in, but if you’re unable to avoid doming in certain movements, change what you’re doing. This may mean eliminating exercises that cause doming, or rolling onto your side to get out of bed instead of crunching to sit up.
The second thing you want to avoid is bearing down. “Take a moment the next time you have a bowel movement to reflect on what it feels like to bear down or push,” says Duvall. This is an unhealthy habit for the pelvic floor. Bearing down during exercise can occur if you’re doing exercises that are too challenging. “Bearing down is a primary cause of pelvic-organ prolapse, an issue that affects up to 50% of women at some point over their lifetime,” says Duvall. “Take note of this feeling and make sure you don’t bear down to generate force when moving or lifting.”
What about exercising while you’re trying to conceive?
Exercise is one of the best things you can do for your overall health—the better your overall health, the more likely you are to conceive and sustain a healthy pregnancy. While extremely heavy exercise may interrupt ovulation, vigorous to moderate exercise has actually been found to reduce the risk of certain types of infertility.
Fertility treatments, however, may impact your gym routine. If you’re taking hormones to stimulate egg production, “sometimes we do limit physical activity because the ovaries are very sensitive, they’re essentially engorged,” says Aquino. You may also need to take some time off after embryo implantation. That was the case with Elyse Mock, a 35-year-old from Jackson, Wyoming, who got pregnant with her first child after undergoing IVF. “My fertility doctor advised me to take it easy the first few days after we did the embryo transfer,” she says. “For about three days I had to lay low, and then around day four or five, I was out and about, and after a week I was hiking and jogging again. I would say by two weeks, just after I found out the transfer took, I was back in the gym doing CrossFit. Maybe not quite at full intensity, but I was still getting a great workout.”
When I spoke with Mock, she was six days away from her due date and had just taken her last CrossFit class. “It has been quite the ride,” she says, “but I feel fortunate to have maintained an active lifestyle.”
Garnet Henderson is a writer in New York City, covering health, abortion access, and dance. Follow her @garnethenderson.
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