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Safe Exercise During Pregnancy: ACOG Backed Guidelines
Safe Pregnancy Exercise | Image Courtesy of Lucas Favre via Unsplash

Dr. Debbie Dy, PT, DPT

Orthopedic Clinical Specialist/Pelvic Health Physical Therapist 

Once the exciting news of a new pregnancy is shared, it is common to get flooded with misinformation and “advice” from concerned family members regarding the safety of exercise during their pregnancy. Historically, it is common for people to be told to “take it easy” during their pregnancy or spend more time in bed. What we know is that exercise during pregnancy is safe and beneficial for both birthing parent and baby. 

ACOG Updated Guidelines on Exercise During Pregnancy

The American College of Obstetrics and Gynecology (ACOG) in 2020 released updated guidelines regarding exercise in pregnancy which states that “exercise is both safe and desirable for birthing people in the absence of obstetric or medical complications or contraindications.” Not only is regular exercise safe for most pregnancies, exercising has immense physical and mental health benefits for not only the birthing person, but for the growing fetus as well. Birthing people who engage in regular exercise during their pregnancies have been shown to have decreased rates of gestational diabetes, hypertension, cesarean births, operative vaginal births and postpartum recovery time. It can also be preventative for the development of depressive disorders in the postpartum period.

ACOG recommended program for exercise during pregnancy

ACOG currently recommends an exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20–30 minutes per day on most or all days of the week. For moderate-intensity exercise, ratings of perceived exertion should rate between 13-15 or “somewhat hard” on Borg Ratings of Perceived Exertion scale. A simple Talk Test can be used as well: as long as one can carry on a conversation while performing exercise, they are likely not overexerting themselves. Pregnant people who were more sedentary prior to pregnancy should take a more gradual progression towards these exercise recommendations. Outside of these measures, other signs you may be overdoing it with exercise intensity include vaginal bleeding, abdominal pain, painful contractions, calf pain or swelling, dizziness, headaches and chest pain. 

Something else to consider is the climate in which you are exercising. Pregnant people should perform exercises in a thermoregulated environment to avoid prolonged heat exposure. So save your hot yoga for the postpartum period! Other types of exercise that should be generally avoided include contact sports, activities associated with increased risk of falling ie. gymnastics, downhill skiing, surfing and horseback riding.

Pregnancy and motherhood itself are extreme sports and it is important that you plan accordingly! All of our therapists at Femina Physical Therapy are well versed in providing fitness programs that are tailored to your needs during pregnancy. If you are interested in learning safe and effective ways to exercise during pregnancy to keep your body strong and flexible throughout your pregnancy from a licensed physical therapist and Pilates instructor, give us a call to schedule today! 

References: 

  1. Barakat, R., Refoyo, I., Coteron, J., & Franco, E. (2018). Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Brazilian Journal of Physical Therapy. doi:10.1016/j.bjpt.2018.11.005
  2. Berghella V, Saccone G. Exercise in pregnancy, Am J Obstet Gynecol 2017;216:335–7.
  3. McMurray RG , Mottola MF , Wolfe LA , Artal R , Millar L , Pivarnik JM . Recent advances in understanding maternal and fetal responses to exercise . Med Sci Sports Exerc 1993 ; 25 : 1305 – 21 
  4. Soultanakis HN , Artal R , Wiswell RA. Prolonged exercise in pregnancy: glucose homeostasis, ventilatory and cardiovascular responses. Semin Perinatol 1996 ; 20 : 315 – 27 .

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I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

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Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

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Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

Testimonial by Rosanna R., age 35

Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

Read more: Testimonial by Rosanna R.,...

Testimonial by P.M.

I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

Read more: Testimonial by P.M.

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