I’ve been passionate about physical therapy for as long as I can remember, but helping women and moms feel capable and strong in their own bodies is truly the job of my dreams. When I'm not serving women across the globe you can likely find me on a family walk with my little girl (Ava), my husband and rescue pup.
As a physical therapist and a mom, helping women understand how to enjoy pregnancy-safe exercise is a huge deal. There are so many myths and misconceptions about prenatal exercise, ranging from the idea that you can’t do it at all to a lack of modifications that can cause you unnecessary stress or pain.
For most moms-to-be, YES – you can (and should!) exercise through each trimester. But your workouts should also evolve over time, helping you stay strong and prepare for labor and motherhood while honoring your body’s changes during pregnancy. Some women may be able to continue with certain exercises longer than others, and some may need to stop certain movements earlier than others. Before we get into the specifics, I want to note that these are general guidelines from your friendly online pelvic floor physical therapist. The American College of Obstetricians and Gynecologists also released a great resource with answers to commonly asked prenatal exercise questions. Always discuss prenatal workouts with your provider. They’ll be able to speak to any of your health conditions that could be contraindications for prenatal exercise. It’s also great to seek individualized care, if you are able, from an in-person pelvic floor physical therapist or a pre/postnatal certified trainer. They’ll be able to come up with a workout plan that’s safe for your pregnancy and individual health needs.
These early weeks commonly bring fatigue and nausea, and it’s good to accommodate your body as it adjusts. Be patient with your body’s changing hormonal and energy levels — this is a massive shift for you in every way, and you’ll probably need to slow down more than you’d like to. This could look like decreasing your total workout time per week, or increasing your rest time between sessions to give yourself time to recover. Some important adjustments in your first trimester:
Limit your max efforts with lifting. This isn’t the season for new PRs, mama! Staying strong and active can look more like maintenance during these weeks.
Refrain from activities with high risk of falling or collision. It’s essential to protect your baby in these early weeks, so steer clear of workouts that have a high probability of impact or require lots of balance.
Build awareness of the relationship between your core and pelvic floor. When it’s time to deliver your baby, your core and pelvic floor work together like a dynamic duo. Build your awareness of how they’re connected, through diaphragmatic breathing and specific exercises that emphasize that connectivity.
Decrease volume. You may need to decrease your total workout time or increase your rest intervals to accommodate fatigue and/or nausea. This may not apply to everyone, and some may be able to continue with their regular volume and workload – but many are not able. Give yourself grace and your body patience as it grows your baby!
Be patient. Your body is undergoing a LOT of changes in the first trimester. Your blood volume is increasing, your hormones are fluctuating, your uterus is growing, and your blood vessels are dilating (just to name a few). Be patient with yourself as you begin to adjust to your changing body.
Your belly is growing, and your workouts will probably (literally) have to make room for it. If you were already working out before pregnancy, reduce the load (less sets or reps) from your pre-pregnancy numbers. You also may need to modify or eliminate movements with barbells if your belly is in the way and interrupts the path. Some important adjustments in your second trimester:
Reduce or modify high-impact exercises. Activities like jump roping, box jumps, and running may look different (or non-existent) from now until after baby arrives, and that’s okay. There are plenty of other ways to stay strong and active.
Switch to an incline. For prone (belly down) movements like planks and push-ups, switch to an inclined position. You also may need to perform supine (belly up) exercises on an incline if you find yourself getting nauseous, dizzy or light-headed. Otherwise, performing short bouts of exercise on your back is fine to continue! This is one of those specifics to discuss with your doctor, PT or certified trainer.
Modify core-focused exercises. Crunches, sit-ups, and Russian twists may need to exit your routine these days. Why? As your belly grows and your muscles and ligaments stretch, you may have a harder time managing your intra-abdominal pressure correctly. This can result in potential coning at the abdomen, which we should all try to avoid.
Focus on your breath. Properly managing intra-abdominal pressure is KEY to pelvic floor health. Avoid holding your breath or bearing down (pushing down into the pelvic floor) when you lift during this season of life. A cue I frequently use is to exhale with the hardest part of the effort and feel your core “hug your baby” as you exhale through pursed lips.
Reduce your load. Remember, pregnancy is not the time to strive for PRs. During this trimester I typically encourage women to reduce their load to ensure they can control their breath and form. While your body may be physically able to lift the load – your pelvic floor might not be so happy. Slow and steady is the name of the game.
By this point, you’re probably feeling very pregnant and very tired. Stay active when you can in ways that feel good to you. You may need to reduce the intensity of your workouts, the total load (less sets or reps) of your exercises, or overall workout frequency if your energy levels are zapped. It’s also important to increase recovery time between sets or circuits. Some important adjustments in your third trimester:
Pelvic floor relaxation. While you should incorporate pelvic floor mobility throughout your entire pregnancy, you really want to switch your focus to pelvic floor release work around 35/36 weeks to prepare for birth. Your pelvic floor needs to RELAX to birth your baby!
Hip stability. You will notice a lot of the common pregnancy pains such as round ligament, pelvic girdle and low back pain may start to creep in around the third trimester. It is important to continue with strengthening and stability work of the muscles of your core, pelvic and hips to alleviate your pain.
Continue reducing load. Think of strength training through pregnancy like a bell curve. In the first trimester you may not be able to tolerate much load, in the second you may be able to increase your load with an influx of new energy, and in the third trimester you may need to take it back down so as to not overstress your body before birth.
Add in meditation. This does not have to be as intense as you might be imagining – no hour long meditation class (unless of course that is your jam!) Even just 5-10 minutes of lying on your mat while performing diaphragmatic breathing can count. Try your best to focus on your breath and let other distractions float away.
Reduce or modify overhead movements. You may be able to continue these, but stay aware – if they start to cause coning in the abdomen, it’s time to take a break until after your baby is here.
Train your breathing. Include more pelvic floor relaxation movements, and focus on breathing to reduce sympathetic response. You may also want to switch to exhaling throughout the entire movement when you work out — this will help manage your intra-abdominal pressure even as your baby grows and grows.
Birth prep with a pelvic floor PT. Now’s the time to focus on childbirth prep, from labor and delivery positions to mobility and breath work. I strongly encourage every pregnant mama to work with a pelvic floor therapist to review movement and breath work for each stage of labor as well as pushing positions. You want to prepare for any type of birth whether vaginal or cesarean. You’ve got this, mama!
Still feeling overwhelmed when it comes to building safe prenatal workouts? Want more guidance throughout every single week? Check out my Movement Through Pregnancy program. It’s perfect for beginner to intermediate exercise levels. With 37 weeks of exercises, designed with minimal equipment so that you can do each workout right at home, you can follow along with me throughout each trimester. I filmed this course when I was pregnant, so you can trust that these moves have been tested and approved by a PT mama-to-be.