Updated: Jul 7
In the midst of a conversation on exercise during pregnancy, someone mentioned to me a pregnant gal on her Instagram page was doing box jumps into her third trimester. That alone isn’t a notable comment, but what followed it was: “Don’t you think she’s killing her baby doing that?”.
As disappointed as I was hearing that comment, I completely understood. Society and medicine for so long held up the belief that to be pregnant is to be fragile, and to exercise was to put the baby’s life in danger.
Spoiler alert: It’s not. The research has been consistent over the years to come out in support of exercising while pregnant for a plethora of reasons, such as helping to prevent postpartum depression or even gestational hypertension & diabetes.
That’s not to say that there aren’t medical considerations or things to be aware of. Let this blog post serve as one of the guides you use to exercise during pregnancy. However, I firmly recommend still seeing an OBGYN and Physical Therapist (especially a physical therapist familiar with pregnancy and postpartum therapy) to help you navigate these waters safely.
What does the research recommend?
According to the 2019 Canadian guideline[i] for physical activity throughout pregnancy, all women should be physically active throughout pregnancy (barring any contraindications, to be covered further down).
How much exercise should I get while pregnant?
Pregnant women should accumulate at least 150 minutes of moderate intensity exercise, over the course of 3+ days per week. Truly getting some form of movement in every day is the best option, but life sometimes gets in the way.
What is moderate intensity exercise?
Anything that gets your heart rate up, whether it’s weightlifting or cardio. It is okay to get your heart rate elevated while pregnant! A good spot to hang out is where you are a bit breathless but can still speak in sentences, also known as the talk test.
It is recommended that pregnant women should incorporate a variety of aerobic and resistance training.
There have been some recommendations to avoid going over 140 beats per minute with your heart rate. My expert guidance is to listen to your body instead of worrying about the number. Your body may not even want to go that high, so don’t push it. But also, if you regularly exercised at high intensities prior to pregnancy, and you feel great at 150 bpm, then don't worry about it.
Will resistance training hurt the blood flow to the baby?
The most recent research[ii] indicates that performing a Valsalva with resistance training (specifically inclined bench press) did not interrupt placental blood flow. In fact, the main conclusion was that placental blood flow increased, not decreased.
There has been a lot of controversy around this topic. My first thought is that exercise is transient. Temporarily being breathless or holding your breath for the sake of doing something healthy is not the same thing as prolonged blockage of blood flow through the placenta.
What are the contraindications to exercising while pregnant?
There are red flags (absolute no's) and yellow flags (things worth being closely watched) when it comes to exercising while pregnant. This is where working with a pelvic floor physical therapist, or a physical therapist trained in pregnancy and postpartum care, comes in. It is important to regularly check in with your providers about how you're feeling, as well as to get assistance modifying exercises as the need arises.
Red flags: Absolute no's
Ruptured membranes & premature labor
Unexplained and persistent vaginal bleeding
Placenta previa after 28 weeks
Intrauterine growth restriction
Uncontrolled diabetes, hypertension, thyroid disease. (Please note emphasis on uncontrolled, certain medical conditions that are controlled can participate in exercise).
Other serious cardiac, respiratory, or systemic disorders
Yellow Flags: Let's watch them carefully and regularly check in with our OBGYN
History of spontaneous premature birth
Malnutrition & eating disorders
Twin pregnancy after 28 weeks
Mild to moderate cardiovascular / respiratory disease
To recap, it is safe and recommended to exercise while pregnant! As your body changes, the challenges with certain exercises will arise so it's important to work with a physical therapist to help you navigate those changes. If you have any red or yellow flags present, it's always important to keep an open conversation with your OBGYN about exercise, as we are all different.
You shouldn't have to navigate this alone. With society constantly throwing negativity your way, find a strong support system that will surround you in safety and positivity. If you're in Denver, Colorado and are looking for this kind of support, I'm your gal. Don't hesitate to reach out to start a conversation about your needs and goals.
Too Long Didn't Read (TLDR)
It is safe to exercise while pregnant in the majority of circumstances. The health benefits to you and baby far outweigh the risk for doing so.
Exercising while pregnant can help prevent common conditions like postpartum depression, gestational diabetes, hypertension, macrosomia (a larger than recommended baby weight) and more.
Pregnant people should get 150 minutes of moderate intensity exercise over a minimum of 3 days per week. This should be a mix of aerobic and resistance work.
There are certain red flags and yellow flags to keep an eye on. Work with your physical therapist and OBGYN to navigate these waters.
Check out these other resources:
[i] Mottola MF, Davenport MH, Ruchat S, et al 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine 2018;52:1339-1346. [ii] Gould S, Cawyer C, Dell'Italia L, Harper L, McGwin G, Bamman M. Resistance Training Does Not Decrease Placental Blood Flow During Valsalva Maneuver: A Novel Use of 3D Doppler Power Flow Ultrasonography. Sports Health. 2021 Sep-Oct;13(5):476-481. doi: 10.1177/19417381211000717. Epub 2021 Mar 12. PMID: 33709855; PMCID: PMC8404763.
About the Author:
Caroline Gamwell, DPT is a Doctor of Physical Therapy, specializing in Pelvic Floor and Women's Health. She is the founder of Worth It PT based in Denver, Colorado, a clinic whose focus is to help others achieve their health and wellness goals through a higher quality of healthcare.