Exercise guide
In a pregnancy without complications, exercise is safe for you and your baby, and it is recommended. The NHS, the World Health Organization and other major guidelines advise at least 150 minutes of moderate activity a week, plus muscle strengthening. It lowers the odds of gestational diabetes and of depression in pregnancy.
Tell your midwife or GP what you plan to do before you start, and ask them first if you have a pregnancy complication, such as bleeding, a low-lying placenta, pre-eclampsia or a history of early labour, or a heart or lung condition. Stop and call your midwife or maternity unit if you have bleeding, fluid leaking, regular painful contractions, chest pain, dizziness, or calf pain or swelling.
Yes, in a pregnancy without complications. The NHS calls exercise safe for you and your baby, and WHO, the UK Chief Medical Officers and the American College of Obstetricians and Gynecologists (ACOG) all recommend it. It is not linked with miscarriage, stillbirth or early birth, though the miscarriage studies are of very low quality. If you were active before, keep going. If not, start gently.
Aim for at least 150 minutes of moderate activity a week, for example 30 minutes on 5 days, plus muscle strengthening twice a week. Ten-minute bouts count. If you're new to exercise, start with about 10 minutes a day and build up. Moderate means you can talk but not sing.
Good choices are brisk walking, swimming, aqua-natal classes, a static bike, pregnancy exercise classes and strength training.
Contact sports, activities where you could fall (such as horse riding, skiing and off-road cycling), scuba diving, hot yoga or hot Pilates, and hard exercise at high altitude unless you're used to it. After the first trimester, keep time flat on your back short. The NHS also advises against taking up a new vigorous sport, such as running, in pregnancy.
Yes. Every major guideline recommends strength work in pregnancy. If you already lift, you can usually carry on, perhaps a little lighter. Breathe out on the effort rather than holding your breath, and after the first trimester move bench work to an incline or a seat.
First trimester: carry on with what you already do safely, and avoid overheating. Second: swap moves flat on your back for propped-up, side-lying or all-fours versions. Third: slow down, keep strength work lighter, do pelvic floor exercises every day, and go to sleep on your side. The trimester section below has the detail.
Stop and call your midwife or maternity unit for bleeding, fluid leaking from the vagina, regular painful contractions, chest pain, dizziness or feeling faint, or calf pain or swelling. The full list is in the next section.
Call 999 if you think it is a life-threatening emergency.
Stop exercising and get advice if you have:
Who to call: before 12 weeks, your GP surgery or early pregnancy unit; from about 20 weeks, your midwife or maternity unit; NHS 111 if you're not sure; and 999 if you think it is a life-threatening emergency.
Get help straight away for:
Source 14
These aren't emergencies, but get them checked:
The 2019 Canadian guideline lists these as reasons not to do strenuous exercise. You can usually keep up your everyday activities: ask your midwife or doctor what is right for you.
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With these, talk to your midwife or doctor before moderate or vigorous exercise. Activity is usually still recommended, sometimes adapted. ACOG advises against routinely prescribing bed rest to prevent early birth: it carries risks of blood clots, bone loss and losing fitness.
An odds ratio below 1 means lower odds with exercise; 1 would mean no difference.
Across 23 studies of 7,125 women, exercise in pregnancy was not linked with miscarriage (odds ratio 0.88) or with a baby dying around the time of birth (0.86). Guidelines agree on this, though the studies themselves are of very low quality. Exercise also didn't raise the odds of preterm birth, growth restriction or low birth weight, and it lowered the odds of a baby over 4 kg (odds ratio 0.61, high-quality evidence from 15 trials).
In trials of 6,934 women, exercise on its own cut the odds of gestational diabetes by about 38% (odds ratio 0.62). About 140 minutes a week of moderate exercise, such as brisk walking, was the amount linked with at least a 25% lower risk.
In trials of 3,322 women, exercise cut the odds of pre-eclampsia by about 41% (odds ratio 0.59). The estimate is less certain than the one for diabetes.
One meta-analysis found lower odds of high blood pressure that starts in pregnancy (odds ratio 0.61), but WHO's review found no difference in how often it happened.
In 5 trials of 683 women, exercise cut the odds of depression in pregnancy by about two-thirds (odds ratio 0.33) and eased symptoms. It didn't change rates of depression after the birth.
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Exercise cut total weight gain by about 0.9 kg on average, and the odds of gaining too much by 32% (odds ratio 0.68). It slightly raised the odds of gaining too little (odds ratio 1.32, 5 trials), a weaker signal that is less certain.
In a review of 50 studies with 47,619 participants, resistance training was linked with lower odds of high blood pressure in pregnancy (odds ratio 0.42), gestational diabetes (0.62) and mood disorders around the birth (0.48), with no sign of harm. Most programmes were light to moderate, and 90% combined strength work with other exercise.
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Exercise lowered the odds of a forceps or ventouse delivery by 24% (odds ratio 0.76). It wasn't linked with caesarean birth, the length of labour, tears or injury.
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Exercise raises your baby's heart rate a little: by about 6 beats a minute on average during exercise across 91 studies (ACOG gives a range of 10 to 30). It didn't harm the baby's heart rate or blood flow to the womb and placenta. The studies are of very low to moderate quality.
These doses are for a pregnancy without complications. If you can't manage them, do what you can: any activity is better than none.
The guidelines agree on at least 150 minutes of moderate activity a week, with muscle strengthening:
The NHS says the 150 minutes don't need to be done in one go. ACOG suggests 30 minutes on 5 days, or 10-minute bouts through the day. The Canadian guideline accepts that tiredness or discomfort will sometimes make the targets impossible: do what you can, and come back to them when you're able.
Moderate activity raises your heart rate and makes you breathe faster and feel warmer: you should be able to talk but not sing. ACOG says your sense of effort may be a better guide than heart rate in pregnancy, because your heart rate may rise less than usual; aim for "somewhat hard", about 13 to 14 on the 6 to 20 effort scale. The old advice to stay under 140 beats a minute was dropped in 1994.
No guideline sets a dose for pregnancy. A sensible starting point, in line with adult guidance, is 8 to 12 repetitions of exercises for the main muscle groups, twice a week, stopping with a few repetitions to spare (editorial). Breathe out on the effort.
Choose walking, swimming, a static bike, aqua-natal or pregnancy exercise classes, and build up slowly. Three ways to start:
If you exercised vigorously before pregnancy, you can usually continue. ACOG notes that hard or long sessions, beyond about 45 minutes, can lower your blood sugar, so eat enough beforehand or shorten the session, and suggests elite athletes consider lighter resistance loads. For athletes, the IOC advises against training above 90% of maximum aerobic capacity.
Experienced lifters who kept lifting at least 80% of their one-rep maximum reported typical pregnancy and pelvic floor outcomes in a survey of 679 women. That is reassuring but weak evidence: the women chose to take part, and there was no comparison group.
Some of these rules rest on evidence and some are precautions. Each note says which.
From the end of the first trimester, keep moves on your back short, prop your upper body up, or switch to side-lying, all-fours, seated or standing versions. If you feel dizzy, sick or unwell lying down, roll onto your side.
Every guideline below fits this rule, though they differ on timing. It starts a little earlier than the NHS's "later pregnancy" because WHO says to avoid exercise on your back after the first trimester. The grade is for the guidance: the evidence of harm from short bouts is thin.
After about 20 weeks, the womb can press on the large vein that returns blood to the heart, which can lower your blood pressure. In one study, blood flow to the womb fell 13% when women moved from lying on their left side to exercising on their back.
The evidence of harm is thin. A review of 7 studies found no link between exercise programmes that included moves on the back and low birth weight, and no harm to mothers, though 31% of babies showed unusual heart-rate patterns during a single bout. Its authors concluded there isn't enough evidence to say whether exercise on your back is safe or should be avoided. The guidelines say:
This is a separate question from exercise. Going to sleep on your back from 28 weeks is linked with late stillbirth: in a pooled analysis of 851 stillbirths and 2,257 comparison pregnancies, the odds were about 2.6 times higher. Sleeping on either side appeared equally safe.
The NHS says to go to sleep on your side from 28 weeks, and not to worry if you wake up on your back. The concern is long, unbroken sleep, not a few minutes of exercise.
Drink water, wear loose clothing, and avoid hard exercise in hot, humid weather or the midday sun, particularly in the first trimester. Skip hot yoga and hot Pilates, and don't exercise on an empty stomach.
The evidence is reassuring. Across 12 studies of 347 women, no one's core temperature reached 39.0°C, including women exercising hard for up to 35 minutes at 25°C. In a trial, 15 women cycling for 45 minutes at 32°C peaked at 37.9°C. On average, exercise raised temperature by about a quarter of a degree, and it wasn't linked with birth defects. The studies are small and mostly after 12 weeks, though, so keep to the guideline advice.
These rules are guideline advice based on the risk of a blow to the bump, a fall or pressure changes, not on trials.
WHO advises avoiding activity that might limit oxygen, such as exercise at high altitude when you don't normally live there. The numbers vary:
This is current NHS advice: "It's not recommended to start a new vigorous activity in pregnancy, such as running." There is no outcome evidence either way on starting to run. In 1,293 women who kept running through pregnancy, running wasn't linked with earlier birth or smaller babies, but they were runners already.
Brisk walking, cycling and swimming bring the same benefits without a new impact load on your pelvic floor and joints. The Canadian guideline encourages women who were inactive to become active, building up gradually. If you ran before, you can usually carry on, slowing down or switching to brisk walking as your bump grows.
The IOC advises adjusting hard lifts so you don't strain with a held breath or push down on your pelvic floor, tightening the pelvic floor before and during heavy lifts, and taking care with lifting on your back. That is expert opinion: in the survey of experienced lifters, women who held their breath or lifted on their back had similar outcomes to those who didn't. In practice, breathe out on the effort, and after the first trimester move bench work to an incline or a seat.
Heavy lifting at work is a different exposure. In a study of more than 62,000 Danish women, lifting over 20 kg more than 10 times a day was linked with preterm birth. Ask your midwife about lifting limits at work.
No trial has tested these in pregnancy, and the guidelines we read set no rules for them beyond falls and lying on your back. These are practical adjustments of our own:
These are guideline-based adjustments, not tested rules. "Keep" means carry on if it's comfortable and you have no warning signs.
Tiredness and nausea are common, and overheating matters most now. On days you feel rough, do what you can.
Your bump grows, and time on your back needs limiting.
Your balance changes, you may get breathless sooner, and pelvic girdle pain is more common. Most women slow down naturally.
The 3D figure can't show a pregnant body, so every move here is shown on the standard figure; each was chosen because it suits pregnancy. Walk or cycle at talk-but-not-sing pace, building to 30 minutes on 5 days (NHS, ACOG). For the strength moves, 2 to 3 sets of 8 to 12, twice a week, with a few reps to spare: an editorial start in line with adult guidance. Wall sit: 2 to 3 holds of 20 to 30 seconds, breathing throughout. Keep a chair behind you for squats, use a low step and a rail for step-ups, and sit for the shoulder press if your balance feels off.
3D demoTreadmill walkingBeginner · Cardio machine
3D demoStationary cyclingBeginner · Cardio machine
3D demoSit to stand from a chairBeginner · A bench or box
3D demoBodyweight squatBeginner · No equipment
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoWall push-upBeginner · A wall
3D demoIncline push-upBeginner · A bench or box
3D demoBand rowBeginner · A band + An anchor point
3D demoSupported single-arm dumbbell rowIntermediate · A dumbbell + A bench or box
3D demoShoulder press with a bandBeginner · A band
3D demoStep-upBeginner · A step
3D demoWall sitBeginner · A wallTrunk and hip work that skips lying on your back. Put a pillow under your bump for the side-lying moves. Starting doses (editorial): clamshells and side-lying leg raises, 2 sets of 10 to 15 each side; bird dog, 5 to 8 each side with a 3 to 5 second hold, one limb at a time later on; Pallof press, 2 sets of 8 to 10 each side, standing if kneeling is uncomfortable; cat-cow, 10 slow reps without letting your back sag (the NHS back exercise); open book, 5 each side.
3D demoClamshellBeginner · No equipment
3D demoSide-lying leg raiseBeginner · No equipment
3D demoBird dog, one limb at a timeBeginner · No equipment
3D demoBird dogBeginner · No equipment
3D demoHalf-kneeling Pallof pressBeginner · A band + An anchor point
3D demoCat-cowBeginner · No equipment
3D demoSide-lying Open Book RotationBeginner · No equipmentPelvic floor: 10 slow holds of up to 10 seconds and 10 quick squeezes, 3 times a day (POGP); no figure can show it, so follow the written steps. Lateral breathing: 5 to 10 breaths, sitting after the first trimester. Stretches: about 30 seconds each side (editorial); child's pose 30 to 60 seconds with the knees wide; mermaid 4 to 6 each side, sitting on a cushion or a chair. Calf stretches against a wall can help leg cramps (POGP). Balance next to a counter, 2 holds of 20 to 30 seconds each side; skip standing on one leg if you have pelvic girdle pain.
Pelvic floor exercise (Kegel)Beginner · No equipment
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoBreath reachBeginner · No equipment
3D demoChild's Pose (Balasana)Beginner · No equipment
3D demoWall calf stretch (gastrocnemius)Beginner · A wall
3D demoHalf-kneeling hip flexor stretchBeginner · No equipment
3D demoMermaid (Pilates seated side bend)Beginner · No equipment
3D demoSingle-leg standBeginner · A wall
3D demoTandem stance and heel-to-toe walkBeginner · A wallAs your bump grows, the two sides of the six-pack muscle move apart (diastasis recti). In 300 first-time mothers, a third had a gap of at least two finger widths at 21 weeks; on ultrasound, all 84 women in another study had a gap of more than 16 mm at 35 weeks. There is no proven way to prevent it in pregnancy, and exercise in pregnancy isn't linked with it. The guide to exercise after birth covers what happens next.
You can keep working your tummy muscles. ACOG notes that more than 60% of pregnant women get low back pain, and that strengthening the tummy and back muscles could reduce that risk. After the first trimester, swap sit-ups and crunches on your back for side-lying, all-fours and standing work.
POGP teaches a deep tummy contraction: draw in your lower tummy as you breathe out and hold for 2 to 3 breaths, propped up on pillows or lying on your side. If the middle of your tummy bulges into a ridge during a move, make it easier. That is a practical teaching cue, not a tested rule.
In women without leaks, pelvic floor training from early pregnancy cut the risk of leaking in late pregnancy by 62%, and at 3 to 6 months after the birth by 29% (Cochrane review, moderate to high-quality evidence). Guidelines recommend it daily, ideally with the technique taught by a professional. NICE suggests considering a 3-month supervised programme from 20 weeks if your mother or sister has had pelvic floor problems.
The move page explains how to find the right muscles. Two doses:
Pelvic floor training in pregnancy hasn't been shown to treat leaking that has already started, but that evidence is of low to very low quality. Leaking is common and treatable: tell your midwife or GP. NICE recommends at least 3 months of supervised pelvic floor training for leaking with coughs, sneezes or effort, including in pregnancy.
More than two-thirds of pregnant women get low back pain, and almost one in five pelvic pain. Across 15 trials, exercise made the pain less severe but didn't stop it starting. A Cochrane review found that an 8 to 12 week exercise programme reduced the number of women reporting low back and pelvic pain by about a third, and their sick leave by about a quarter (moderate-quality evidence).
Pelvic girdle pain (PGP, once called SPD) affects up to 1 in 5 pregnant women to some degree. It isn't harmful to your baby, and most women with it can have a vaginal birth. You may feel pain over the pubic bone, across one or both sides of your low back, in the area between your vagina and anus, or spreading into your thighs. It is often worse when you walk, climb stairs, stand on one leg, turn over in bed or move your legs apart.
Keep active, but avoid what makes it worse:
With pelvic girdle pain, skip or shrink the step-up, lateral band walk, standing on one leg, bound angle pose, goddess pose and split squats. Favour sit-to-stands with your feet hip-width apart, small clamshells, cat-cow and pelvic floor exercises.
Call your midwife or GP if it's hard to move around, it hurts to get out of a car or turn over in bed, or stairs are painful. NICE says to consider physiotherapy for exercise advice, a non-rigid pelvic support belt, or both. In RCOG's words, "PGP is not something you just have to put up with."
Contact your GP or midwife urgently if you have back pain in the second or third trimester (it could be early labour), or back pain with a fever, vaginal bleeding, pain when you pee, or pain in one or both sides under your ribs. Call 999 or go to A&E if you lose feeling in one or both legs, your bottom or your genitals.
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On all fours, pull in your stomach muscles and raise your back towards the ceiling, hold for a few seconds, then return to a flat back. Do it 10 times, slowly. It is the cat-cow above, without letting your back sag.
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ACOG set this limit in 1985 and dropped it in 1994. There is no evidence-based heart-rate ceiling in pregnancy: use the talk test, or aim for "somewhat hard". ACOG's 2020 example plan still has a footnote saying effort is "usually not exceeding 140 beats per minute", which is partly why the number lingers. If you were already fit and your midwife agrees, harder sessions can continue.
In 23 studies of 7,125 women, exercise wasn't linked with miscarriage, and the NHS calls exercise safe for you and your baby. The honest caveat: the evidence is of very low quality, and little is known about extreme amounts of exercise.
Every major guideline recommends muscle strengthening in pregnancy, and resistance training was linked with lower odds of gestational diabetes and high blood pressure in a review of 50 studies. Experienced heavy lifters reported typical outcomes. What changes is how: breathe out on the effort, avoid long sets flat on your back after the first trimester, and choose lifts you can control without risk of falling.
ACOG says no credible evidence supports bed rest, which carries risks of blood clots, bone loss and losing fitness.
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The gap is a normal part of pregnancy: on ultrasound, every woman in one study had one at 35 weeks. Exercise in pregnancy isn't linked with it, and nothing has been shown to prevent it. Keep training your trunk in positions that suit your bump.
Moderate exercise doesn't raise your core temperature into the range of concern. Still skip hot classes, very hot and humid weather, and long hard sessions in the heat.
Easy cardio suits every trimester: keep cool and drink water. In the beginner home workout, swap the dead bug for the bird dog after the first trimester, and the step-up for sit-to-stands if you have pelvic girdle pain. In the pelvic floor routine, do the settle breathing sitting or on your side once lying face down is uncomfortable. In the low-impact leg workout, swap the glute bridge for clamshells or a wall sit after the first trimester. Beginner Pilates suits the first trimester, or later with its side-lying and all-fours swaps.
A steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallPelvic floor exercises in 5 minutes: slow holds and quick squeezes, three times a day, with how to find the right muscles.
5 minBeginner2 movesNo equipmentA gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.
20 minBeginner7 movesA bench or box, A stepA 20-minute mat Pilates workout for complete beginners. It covers breathing, spine position and the foundation moves, each with an easier option.
20 minBeginner13 movesNo equipmentThe workout plan for women has a sourced section on pregnancy and after birth. After the first trimester, swap its floor moves on your back for standing or side-lying ones.
Yes, in a pregnancy without complications. The NHS calls exercise safe for you and your baby, and WHO, ACOG and the UK Chief Medical Officers all recommend it. Exercise isn't linked with miscarriage, stillbirth or early birth. If you have a pregnancy complication or a condition such as heart disease, ask your midwife or doctor first.
Aim for at least 150 minutes of moderate activity a week, for example 30 minutes on 5 days, plus muscle strengthening twice a week. Moderate means you can talk but not sing. If you're new to exercise, start with about 10 minutes a day and build up. Any activity is better than none.
In the first trimester, carry on with what you already do safely and avoid overheating. In the second, move exercises on your back to propped-up, side-lying or all-fours versions and stop contact sports. In the third, slow down, use smaller ranges and a support for balance, and keep up daily pelvic floor exercises. Walking, swimming, a static bike and strength training suit all three.
Contact sports, activities with a high risk of falling (such as horse riding, skiing and mountain biking), scuba diving, hot yoga, and hard exercise at high altitude unless you're used to it. After the first trimester, avoid long periods lying flat on your back. The NHS also advises against taking up a new vigorous sport such as running.
Yes. Strength training is recommended by every major guideline. If you already lift, you can usually continue, lighter if your midwife or your sense of effort suggests it. Breathe out on the effort rather than holding your breath, and after the first trimester avoid long sets lying flat on your back.
If you ran before, you can usually continue, slowing down or switching to brisk walking as your bump grows. In 1,293 runners, carrying on wasn't linked with earlier birth or smaller babies. If you didn't run before, the NHS advises not to start in pregnancy; there is no evidence either way on harm, and walking, cycling and swimming give the same benefits. Stop for any warning sign, pelvic pain, leaking or heaviness.
In the first trimester, yes. After that, keep it to a few minutes, prop yourself up, or use side-lying or all-fours versions. Guidelines differ on the timing, from the end of the first trimester to 28 weeks, but all fit this rule. If you feel dizzy, sick or unwell lying flat, roll onto your side. Separately, from 28 weeks go to sleep on your side.
There is no evidence-based limit. The old 140 beats a minute rule was dropped in 1994. Use the talk test, so you can talk but not sing, or aim for an effort that feels "somewhat hard".
Yes. Keep working your tummy muscles, but after the first trimester swap crunches on your back for side-lying, all-fours and standing work, and ease off if your tummy bulges into a ridge. A gap between the tummy muscles is normal in pregnancy. Start pelvic floor exercises now and do them every day: they cut the risk of leaking later in pregnancy and after the birth.
Stop and call your midwife or maternity unit for vaginal bleeding, fluid leaking, regular painful contractions, tummy pain, chest pain, feeling dizzy or faint, breathlessness before you start, a headache, muscle weakness affecting your balance, or calf pain or swelling. Call 999 if you think it is a life-threatening emergency.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
