Exercise During Pregnancy & Postpartum: An Evidence-Based Guide

Regular exercise during pregnancy has been shown to improve both physical and psychological health

outcomes for the mother and fetus. Contrary to outdated medical advice, current research strongly

supports appropriately prescribed exercise across all trimesters and into the postpartum period for

healthy women without contraindications.

Benefits of Prenatal & Postpartum Exercise

• Reduced risk of gestational diabetes, hypertension, excessive weight gain, and preeclampsia

• Improved labor outcomes including shorter labor duration and decreased cesarean rates

• Reduced incidence of low back pain, pelvic girdle pain, and urinary incontinence

• Improved mood, reduced anxiety and depression, better sleep and stress management

• Healthy fetal growth, normalized birth weight, and reduced neonatal fat mass

Exercise Guidelines

The American College of Obstetrics and Gynecology recommends 150 minutes of moderate-intensity

exercise per week throughout pregnancy and postpartum.

Aerobic Training

• Intensity: 30–70% VO2max depending on trimester and fitness history

• First & third trimester: target heart rate 40–50%

• Previously sedentary individuals should begin closer to 30%

• Modalities: walking, running, cycling, swimming, low-impact dance

Resistance Training

• Full-body focus with emphasis on posture, pelvic floor, and core

• 2–3 sets of 12–15 repetitions

• Light to moderate loads

• Avoid prolonged supine positioning (>2 minutes)

Mobility, Balance & Breathing

• Balance training becomes essential due to postural and center-of-mass changes

• Use single-leg exercises, foam pads, or BOSU variations

• Diaphragmatic breathing and pelvic floor coordination improve labor outcomes and reduce anxiety

Trimester Considerations

First Trimester

• Emphasize low to moderate intensity

• Avoid maximal or exhaustive efforts

Second Trimester

• Incorporate balance, posture, and pelvic floor strengthening

• Address musculoskeletal changes and stability

Third Trimester

• Maintain lower intensity (40–50% THR)

• Focus on breathing, pelvic floor flexibility, and comfort

• Avoid strenuous exercise unless highly trained and medically cleared

Postpartum Exercise

• Resume exercise 6–8 weeks postpartum pending medical clearance

• Begin with light aerobic and resistance training

• Gradually reintroduce core and pelvic floor rehabilitation

• Regular exercise significantly improves postpartum mental health

Clinical Bottom Line

Exercise is safe and beneficial throughout pregnancy and postpartum when appropriately prescribed.

Programs should be individualized, progressive, and adjusted by trimester to optimize maternal and

fetal health outcomes.