Exercise in Pregnancy: What the Evidence Says
The outdated advice to "rest and take it easy" during pregnancy has been firmly replaced by evidence-based guidelines recommending moderate exercise throughout a healthy pregnancy. Major health organisations — including the American College of Obstetricians and Gynecologists and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists — recommend at least 150 minutes of moderate-intensity exercise per week during pregnancy.
Regular exercise during pregnancy is associated with reduced risk of gestational diabetes (by up to 28%), lower risk of excessive weight gain, reduced back and pelvic pain, shorter labour, lower caesarean section rates, and better postpartum recovery.
Safe Exercise Options During Pregnancy
Most forms of moderate exercise are safe during uncomplicated pregnancies. Recommended activities include:
- Walking — the safest and most accessible exercise, appropriate throughout all three trimesters
- Swimming and water aerobics — excellent low-impact exercise that reduces joint loading and swelling
- Prenatal yoga — improves flexibility, relaxation, and breathing techniques useful for labour
- Stationary cycling — safe cardiovascular exercise with low fall risk
- Moderate strength training — safe if you were already doing it before pregnancy, with appropriate modifications
- Pelvic floor exercises (Kegels) — essential throughout pregnancy and postpartum
Exercises to Avoid During Pregnancy
While most exercise is beneficial, certain activities should be avoided:
- Contact sports (football, martial arts) — risk of abdominal trauma
- Activities with high fall risk (skiing, horse riding, gymnastics) — especially in the third trimester
- Hot yoga or exercising in high heat — maternal core temperature elevation risks the developing baby
- Exercises lying flat on your back after 16-20 weeks — can compress the inferior vena cava and reduce blood return to the heart
- High-impact exercise if you have pelvic girdle pain or a history of preterm labour
- Scuba diving at any stage of pregnancy
Physiotherapy for Pregnancy-Related Conditions
Physiotherapy plays a crucial role in managing common pregnancy-related musculoskeletal conditions:
Pelvic girdle pain (PGP) affects up to 20% of pregnant women, causing pain in the pubic symphysis, sacroiliac joints, and groin. Physiotherapy with pelvic stabilisation exercises, manual therapy, and supportive belts significantly reduces symptoms.
Lower back pain is extremely common in pregnancy due to postural changes, increased lumbar lordosis, and relaxin-induced ligament laxity. Physiotherapy, specific exercise, and hydrotherapy are the safest and most effective treatments.
Carpal tunnel syndrome becomes more common in pregnancy due to fluid retention compressing the median nerve at the wrist. Physiotherapy with splinting and nerve gliding exercises is the first-line treatment.
Pelvic Floor Health: A Priority at Every Stage
Pelvic floor exercises are arguably the single most important thing a pregnant woman can do for her long-term pelvic health. The pelvic floor supports the growing uterus throughout pregnancy and endures enormous strain during vaginal delivery. Weakness or dysfunction increases the risk of urinary incontinence (affecting 33% of women postpartum), pelvic organ prolapse, and pelvic pain.
A women's health physiotherapist can perform an internal pelvic floor assessment to determine if your pelvic floor muscles are weak (most common), overactive, or uncoordinated, and design a targeted exercise programme for your specific needs.
Postpartum Recovery and Return to Exercise
Postnatal physiotherapy helps new mothers recover safely and return to exercise without risking pelvic floor or abdominal complications. This includes assessment for diastasis recti (separation of the abdominal muscles), pelvic floor rehabilitation, and a graduated return-to-exercise programme.
At Omniphysiocare, our women's health physiotherapists provide comprehensive prenatal and postnatal care, helping you stay active and comfortable throughout pregnancy and recover fully after birth.