Exercise during pregnancy has many benefits, such as improving sleep, reducing swelling or backaches caused by pregnancy, making labor and delivery easier, providing endorphins that can make you feel happier and more energetic, and helping you get your figure back faster after delivery (NIH).
Your body may still look like it did before, but there are many changes taking place inside your body during the first trimester of pregnancy. Many women do not feel much different than usual at this stage of pregnancy. Since exercise carries little risk for the baby, the first trimester is a great time to begin or regulate your exercise routine.
If you are just starting to exercise, the key is to start the habit slowly – just 15 minutes per session two or three times a week. You can build up to more frequent, longer sessions as you are able. You should warm up, exercise, and slowly scale back before you complete your session (Weiss Kelly, 2005). Always stop if you feel short of breath or are in pain. It is wise to get your doctor's approval before you exercise while pregnant.
Low-impact aerobics, yoga and relaxation techniques, Pilates, weight training, stretching, and Kegel exercises can be done safely during the first trimester of pregnancy.
Aerobic exercise is any activity that raises breathing and heart rate. Examples include brisk walking and swimming. Aerobic exercise can:
- improve the body's use of oxygen
- improve the supply of oxygen to the fetus
- prevent problems like hemorrhoids, fluid retention, and varicose veins
- increase muscle strength and tone, which can prevent back pain and ease labor
- improve blood sugar control and reduce the risk of gestational diabetes
- burn calories
- improve sleep
- improve wellbeing and confidence
- reduce the risk of preterm birth (Juhl, et al., 2008)
To get the greatest benefit from aerobic exercise, sessions should last 20 to 30 minutes, several times per week (American College of Obstetricians and Gynecologists).
Walking is good exercise that poses few risks. Make sure you get properly fitted shoes that provide good support. Be conscious of the weather, and avoid overheating by not walking long distances outside in hot or humid weather. Walking for thirty minutes every day has been shown to improve birth outcomes. It is a safe and helpful exercise that can be continued throughout pregnancy (Ruchat et al., 2012).
Swimming is also a good exercise for pregnant women (Juhl, et al., 2010). It provides a cardiovascular workout that stretches and tones muscles in a nearly gravity-free environment. This minimizes joint strain and balance problems. During your first trimester, swimming at least 20 minutes three times a week will keep you in good shape. Swimming is also a great exercise to do in the second and third trimesters.
Stationary bicycles offer less risk of a fall than standard bicycles and can provide excellent aerobic exercise during the first trimester of pregnancy. Bicycling helps avoid strain on the joints, and it is often an easy exercise to begin for women who are new to exercise.
Spinning can be much more intense than regular cycling, but it is quite safe if you can maintain your balance and monitor your heart rate and body heat. As with any exercise, it is essential to stop if you begin to feel faint or dizzy. Women in instructor-led spinning classes should tell the instructor of their pregnancy and make adjustments if it becomes too hard.
Relaxation techniques help you breathe and focus, relieve stress, feel more satisfied and energetic, and let go of emotional tension. This can be very helpful during labor and delivery. Yoga, meditation, and other breathing exercises can improve your physical and mental health during the first trimester (Beddoe, et al., 2009).
Yoga can help you control your breathing, and it provides an excellent way to stretch and tone muscles. Yoga exercises the body and mind, strengthening muscles and leaving you with a sense of peace and calm.
There are many styles of yoga from which to choose. Some popular options include kundalini yoga, which focuses on breathing and meditation; iyengar yoga, which emphasizes posture, alignment, and balance; and power yoga, which uses aerobic workouts to build strength and endurance.
One of the other major benefits of yoga is the focus on breathing techniques. Learning to be aware of your breathing can help you stay calm and focused during labor (Babbar, et al., 2009).
In your second or third trimester, your doctor may tell you to avoid yoga poses that require you to lie flat on your back (Mayo Clinic).
Pilates is an excellent and safe exercise to do during the first trimester and beyond (Balogh, 2005). Join a prenatal Pilates class or ask a certified instructor for modifications to use during pregnancy. Pilates can strengthen core muscles, support good posture, and prevent back pain once you begin gaining weight. Pilates may also improve balance and stability, strengthen pelvic floor muscles to help with delivery, and speed up weight loss after childbirth.
Be sure to check with your doctor before beginning a new exercise program. Women with pregnancy complications or a history of miscarriage should avoid weightlifting during pregnancy.
For women with healthy pregnancies, lifting weights for muscle tone and strength can have many benefits during pregnancy, delivery, and postpartum (O’Connor, et al., 2011). You can use free weights, resistance machines (like those found at health clubs), or a combination of the two. If you already have a routine, try working out with lighter weights and increasing your repetitions. More repetitions with lighter weights can help prevent injuries from straining to lift weights that are too heavy.
If you use weights during pregnancy, avoid straining with your airway closed (as if you were straining to have a bowel movement). This straining is called the Valsalva maneuver and is often done unconsciously when lifting weights. Straining in this way can be risky during pregnancy because it increases pressure in your abdomen and pelvis. Focus on keeping your breathing smooth and consistent when lifting. Inhale and exhale without holding your breath.
Use controlled movements when lifting and avoid jerky movements that can cause joint injury. Do not lift heavier weights than you can manage easily for at least five repetitions. Pregnancy is not the time to push your limits. Be sure to rest for at least 60 seconds between sets of repetitions.
General stretching is a safe exercise to do in each trimester of pregnancy. It does not increase heart rate as much as walking or other gentle exercises, but stretching may reduce the risk of injury and certain complications (Yeo, 2010). Stretching is safe even for women with certain pregnancy complications.
Stretching can be done multiple times per day – even at work and without special equipment – making it a great form of light exercise during the first trimester. Stretching is also important to do before and after other forms of exercise.
Special This Trimester: Treat yourself to a massage. Having your body stroked and kneaded can help loosen tight muscles, calm your nervous system, increase blood flow throughout your body, and ease the discomforts that can accompany pregnancy. Some studies suggest that massage may even boost your immune system.
Kegel exercises are good for all women, but they have special benefits during pregnancy. They strengthen and tone pelvic floor muscles and prepare these muscles for delivery. Having strong pelvic floor muscles also helps them return to their former shape after delivery.
Try following this sample daily Kegel exercise regimen:
- Locate and contract the pelvic floor muscles.
Note: Finding the pelvic floor muscles and exercising them correctly is not always easy. The pelvic floor muscles are those that you contract if you are trying to hold back urine. They can be identified by halting the urine stream while you are urinating.
- Begin by contracting the pelvic floor muscles as tightly as you can for a count of 10, then relax.
- Repeat the contraction for a total of five contractions.
- In sets of five contractions, aim for a total of 25 to 50 contractions done as tightly as possible. Remember to breathe normally as you do the exercise.
These sets of Kegel exercises can be spread out over the entire day. Try getting through a set of five contractions while stopped at a red light, watching a television commercial, or at any other time.
Activities that put you at a high risk of injury should be avoided during pregnancy (American College of Obstetricians and Gynecologists). Examples of risky activities include downhill skiing, horseback riding, mountain climbing, and contact sports (like soccer and basketball). Racquet sports carry the risk of blunt trauma to the abdomen from the ball. They can also cause joint injury and falls from abrupt side-to-side movements.
Women should make a decision about exercise choices after talking with a doctor. In most cases, the exercises below should be avoided as of the first trimester of pregnancy.
High-impact aerobics can be dangerous, even during the first trimester. Activities like basketball and gymnastics are considered high-impact and should be avoided during pregnancy. High-impact activities include jumping, hopping, bouncing, both feet leaving the ground at the same time, and other high-energy motions. These moves are especially risky for women with a history of miscarriage or with a co-existing health condition.
Note: Jogging is often classified as high-impact. However, it is usually safe to run or jog at your own pace during pregnancy unless you begin to experience complications. Ask your doctor before beginning a jogging routine if you did not run before pregnancy.
Contact sports can be risky for women during pregnancy. Sports like football, kickboxing, and hockey can cause physical trauma to the abdomen. Forceful physical contact from pushing, hitting, or falling can cause a miscarriage or harm to the fetus. In addition, contact sports may increase the risk of general injury.
Fans of kettlebell suggest that modified workouts can be safe throughout pregnancy. However, most women should not continue or begin kettlebell workouts during pregnancy. Do not use kettlebells during pregnancy unless you are very experienced and will be working with a certified kettlebell trainer. Make sure your trainer knows strategies for safe pregnancy workouts. Otherwise, the movements, breathing, and weight bearing associated with kettlebells can be dangerous.
Warning: Do not attempt to design your own changes for kettlebell moves. Improper changes can cause dangerous tissue stretching, abdominal pressure, blood pressure increases, and overheating. In general, pregnant women should not do kettlebell exercises during any trimester.
Other activities that are not safe for pregnant women – even during the first trimester – include sports and activities with a high risk of fall, changes in atmospheric pressure or altitude, and specifically contraindicated for your personal health situation.
Activities with a high risk of falling include mountain biking, rock climbing, ice skating or inline skating, downhill skiing or water skiing, horseback riding, and volleyball. Some women may experience a change in balance ability during pregnancy, which can make it hard to stay safe during these activities. These exercises are even riskier during the second and third trimesters, after weight gain causes the body’s center of gravity to shift.
Scuba diving and exercise at high altitudes can be dangerous for the developing baby. Scuba diving may increase the risk of birth defects or preterm birth. Exercise above an altitude of 7,500 feet (such as mountain climbing and high-altitude hiking) can be harmful during pregnancy as well. These activities and settings should be avoided from the first trimester, if possible. Women who live at or above 7,500 feet should discuss safe exercise options with a health professional. This can help ensure sufficient oxygen supply for pregnant women and their babies.
Many forms of exercise can be safe during the first trimester and throughout pregnancy. However, physical activity can be risky for women with little experience exercising. Exercise can also be dangerous for women with pregnancy complications. Even if you are an expert, there are certain warning signs that you should not ignore.
Stop exercising immediately if you experience any of the following symptoms:
- blurry vision
- heart palpitations
- vaginal bleeding
- new contractions
- back, abdominal, or pelvic pain
- unusual lack of fetal movement
If these symptoms do not disappear shortly after stopping the exercise, contact your doctor for advice immediately. These symptoms may indicate a problem with the pregnancy. If you often have problems during exercise, your doctor may tell you not to exercise during pregnancy.
It is important for women exercising during pregnancy to avoid getting overheated. Research shows that when a pregnant woman's core body temperature goes up by two degrees Fahrenheit, blood vessels in the skin expand to get rid of excess heat. This can shunt blood away from the uterus and deliver less blood and oxygen to the baby.
Although there is no clear proof that overheating is a cause of birth defects in humans, there is a link between the two in lab animals. Most doctors tell pregnant women to avoid overheating to be on the safe side.
The following are some tips on how pregnant women can avoid overheating during exercise:
- Do not exercise in very hot or humid conditions
- Do not use saunas and hot tubs
- Wear loose clothing and exercise in well-ventilated areas
- Stop exercise before you get overheated
- Do not push your body to extremes
- Stay hydrated – drink at least two cups of water every hour you exercise
Most women do not notice changes in energy or physique during the first month of pregnancy. If you are aware of your pregnancy during the first month, start building a habit of safe exercise while you still have the energy. Beginning a routine early will help you keep up an exercise program later in pregnancy. Start now to make it easier when you have less energy and more difficulty doing certain physical motions.
For many women, the second month of pregnancy is a time of significant fatigue. While exercising may seem too exhausting, it is important to keep doing some form of exercise at this stage in the pregnancy. Many women report that regular exercise actually reduces feelings of fatigue. Even a 20-minute walk around the neighborhood every day can make you feel more energetic, strengthen your heart and lungs, tone your muscles, and stimulate your body’s natural feel-good chemicals (endorphins). Just make sure you get a thumbs-up from your doctor on your chosen workout and don’t overdo it. Moderation is key!
At this point in your pregnancy, you may find it as easy to exercise as you did before you were pregnant. If you are still feeling fatigued, try stretching or exercising at a lower intensity than usual. You can gauge the difficulty of your workout by making sure that you can talk comfortably without stopping to breathe too much. Be sure to stretch before and after exercising, and drink plenty of fluids.
At this stage of pregnancy, most exercises are still considered safe. Jogging, swimming, low-impact aerobics, dance, and weight training are all good choices for this month’s exercise routine. You may need to change or stop some of these activities later in pregnancy, so now is the time to make the most of it. At the end of the third month of pregnancy, you should discuss potential changes to your exercise regimen with your prenatal care provider. This can help you plan for exercise during the second trimester of pregnancy.