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Dear Stephanie:  Since each trimester comes with potential complications, what are your recommendations for modifying exercise throughout pregnancy? – Adenike A., via Instagram

Dear Adenike,

This is a very thoughtful question because it shows you’re considering the anatomical and physiological changes that occur throughout pregnancy. All athletes need to scale their workouts to safely fit their body’s abilities, and pregnant women are no exception.

Here are some common concerns you may experience:

  • Common pregnancy complaints (such as nausea, back pain, fatigue) are impacting your desire to exercise.
  • You’re a fitness enthusiast and feel like you’re not “doing enough” if you scale back your workouts.
  • You’re afraid of harming the baby, so you work out less frequently or intensely than you’d like.
  • You may be completely confused about what’s safe.

If you ask around, either in your community or on social media, you’ll likely find that everyone has their opinion about exercise during pregnancy and they’re more than willing to share it. But, it’s important to for you to make a decision that fits your own context, not someone else’s.

In the last post, we discussed a template you can use to make informed, educated decisions about tough questions during your pregnancy. I encourage you to take that framework and apply it to this question. I don’t think there’s one “best” exercise for every trimester. Instead, a prenatal fitness plan that includes a mix of strength training, cardio, and mobility will serve you well throughout your pregnancy.

Simply focus on whatever you enjoy doing within these categories. Walking, dancing, swimming, yoga, pilates, and weight-training (especially squats!) are all excellent options. For me, this combination includes walking, kettlebell training, foam rolling, and mobility exercises.

Here is a trimester-specific breakdown of considerations that might affect the decisions you make about exercise throughout your pregnancy.

First Trimester

There’s a lot happening in the first trimester! Your mind, body, and growing baby are working overtime, which may leave you with little energy and desire to workout. Some moms find themselves running to the bathroom multiple times during their workout because of nausea and frequent urination (myself included!). However, some moms seem to feel just fine continuing their normal fitness routine despite these physical changes.

If you’re having an uncomplicated pregnancy and have been working out prior to becoming pregnant, most health professionals agree that you can continue doing what you were doing prior to becoming pregnant. Of course, that’s assuming you’re avoiding activities that put you at increased risk of becoming overheated, falling, or getting hit in the stomach. Save skydiving for when your life after baby comes.

If you were very active before pregnancy, you can keep doing the same workouts with your health care professional’s approval. The American Congress of Obstetricians and Gynecologists

Some providers are more enthusiastic about exercise than others. If you’re healthy and your pregnancy is normal, but you’re receiving push back about your desire to exercise, it may be worth seeking another opinion. Check out our blog series about finding your ideal birth provider (part 1 and part 2).

“Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery. However, it is important to discuss exercise with your obstetrician or other member of your health care team during your early prenatal visits.”  The American Congress of Obstetricians and Gynecologists

If nausea and fatigue are getting the best of you this trimester, sticking to something low-impact like walking may be your best solution. Fresh air and light movement may help you feel much better. Having a small snack before your workout can also help settle your stomach and combat nausea.

Whatever you do, don’t feel bad about taking a break from your fitness plan. Do what you can when you’re feeling up to it and know that you’ll likely feel much better once you’ve reached your second trimester.

First Trimester Considerations

  • If you’re new to exercise, ease into it.
  • Listen to your body’s cues.
  • See a pelvic floor specialist if you’re experiencing incontinence, pain or other pelvic floor discomfort.
  • Make walking a part of your daily routine. Shoot for at least two miles a day.

“If you are new to exercise, start out slowly and gradually increase your activity. Begin with as little as 5 minutes a day. Add 5 minutes each week until you can stay active for 30 minutes a day. The American Congress of Obstetricians and Gynecologists

Second Trimester

At some point during your second trimester, you may receive a well-deserved “second wind.” If you experienced nausea, fatigue, or other issues in your first trimester which prevented you from hitting the gym as much as you’d like, this is your chance to start exercising again. During my first pregnancy, I remember feeling superhuman in the second trimester. My workouts seemed much easier than they did in the first trimester. I also enjoyed the extra energy I received after a good workout.

Continuing to workout during the second trimester can help you avoid common pregnancy complaints (such as back pain and constipation) and boost your confidence as you navigate all of the changes happening in your body.

While you may have more energy during the second trimester, there are a few other things happening that may make exercise uncomfortable and undesirable. These physical changes include: a larger belly, back pain, constipation, heartburn, leg cramps, and round ligament pain.

I highly recommend working with a personal trainer that specializes in prenatal fitness. Because your body is changing, you need to learn how to safely modify your current fitness plan. The modifications you need may be different than other pregnant woman that you see in your gym or fitness class, so this customized advice is extremely valuable. If you’ve been participating in group fitness classes and your instructors know your background, they may be able to give you pointers during class.

To help alleviate things like constipation and leg cramps, make sure you’re staying well hydrated and consider taking a magnesium supplement, specifically magnesium citrate for constipation and magnesium glycinate for leg cramps. This is especially true if you’re working out on a hot day or pushing yourself.

If back pain is dragging you down, consider taking a prenatal yoga or pilates class. If there aren’t any prenatal classes in your area, ask your instructor about proper modifications since things like holding bends/twists can reduce blood flow to your baby.

Second Trimester Considerations

  • Don’t hold your breath.
  • Invest in a supportive sports bra and breathable, stretchable workout clothes.
  • ACOG recommends that women avoid the supine position during exercise after the first trimester; however, this may not apply to you. If lying on your back is something you or your provider prefer to avoid, you may be able to lie on your left side to allow easier blood flow or use a more inclined stability ball or bench, or you may wish to choose a different exercise entirely.
  • Watch your form and alignment.
  • Be conscious of relaxin, a hormone that helps “relax” tissues and joints in the body to prepare you for delivery.  Relaxin can increase instability of your joints and increase your likelihood of overstretching.

Third Trimester

If you experienced increased energy during your second trimester, it may start to dwindle at some point during the third trimester. The extra weight you’re carrying can also make certain exercises harder to safely perform. While you should be keeping an eye on your alignment throughout your pregnancy, it’s even more important now.

At this point, many mamas decide to take things easy at the gym or change gears completely. You may feel better reducing the number of days you’re at the gym, scaling back your workouts, or focusing mostly on walking or other lower-intensity exercise. Whatever you do, don’t feel guilty if you choose to scale back during this time. The third trimester is a time of steady growth for your baby, so it makes sense that your body wants more rest.

If you’re feeling good and still enjoying your workouts, feel free to continue what you’re doing with proper modifications. Some mamas workout all the way up until their “due date” or even on their due date. There’s no right or wrong way, just what feels right to you!

Third Trimester Considerations

  • Workout with a friend, especially as your due date nears.
  • Continue focusing on your alignment and pelvic floor.
  • Pelvic tilts and squats are great for strengthening your pelvic floor.
  • Consider scaling down your workouts as your due date nears. You don’t want to enter labor exhausted.
  • Stay hydrated and well-fueled. Exercise burns additional calories on top of the additional 450 calories recommended in the third trimester.
  • Check out spinningbabies.com for exercises to help get your baby in proper position

If you’re looking for specific modifications for each trimester, check out birthfit.com and jessiemundell.com. If you’re continuing your strength or high-intensity training plan, I’d encourage you to work with a prenatal fitness specialist. Properly modifying exercises will help you avoid injuries and pelvic floor dysfunction as you approach the big day and beyond.


Steph(hi)-6Stephanie Greunke is a registered dietitian with a master’s degree in nutrition who specializes in women’s health. She is a certified personal trainer and prenatal and postnatal corrective exercise specialist. Stephanie guides and supports women locally and globally through her web-based private practice, RockYourHormones.com.

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