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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 .

What Our Patients Have to Say

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Testimonial by Julie T.

Femina PT (née Fusion Wellness & Physical Therapy) has honestly changed my life. Before receiving treatment at Femina, I was going doctor to doctor to try and find the answer to my pelvic pain. It has taken me YEARS to find someone that can help fix this. It wasn't until my gynecologist recommended your clinic that I finally felt relief. My pelvic pain is almost gone, and granted I still have a lot more to work on with Laureen (my PT), my original problem is nearly cured. I am so grateful to her.

What is even better is she gave me practical exercises to do at home that were not tedious and provided instant (and lasting) relief. Although I mainly work with Laureen, my interaction with the owner (Heather) has been great. She is very generous, kind, and committed to her business.

It hurts to know there are women out there suffering who will never know or have the opportunity to work with women like Laureen and Heather because this issue is hardly talked about and this field is so rare. I hope more doctors and physical therapists see the value in this work and can relieve more woman of their pain.

-- Julie T., 12/4/16 via Yelp!

Testimonial by Jackie W.

I was in multiple car accidents a decade ago, and I have been to many physical therapists through the years without success. They found the root of my lower back pain problems and after nearly a decade of barely being able to walk I finally can again without pain. They are also the best pelvic floor pts and the only ones who found the connection between my pelvic floor and lower back problems. If you need help with physical pain, they are your answer.

-- Jackie W., 1/19/17 via Yelp!

Testimonial by Fritzette H.

I went to Heather after the birth of my third child. It was lucky, really, that I was referred to her, because my doctor had referred me to a surgeon for a possible hysterectomy or pelvic wall rebuild. Thankfully, I went to Heather before undergoing either surgery, she was able to fix the problem. She has studied extensively in women's health--even written a book about it--and was able to diagnose my problem, suggest a course of treatment (6 weeks), and then follow through with said treatment. By the end, as she said, I was as good as gold. Boy, was it worth it! Though uncomfortable to talk about, much less write about, it is worth getting the word out there. If you have painful intercourse, especially after birth or other trauma, the treatment may be as simple as Physical Therapy (with Heather, of course). I highly recommend her.

-- Fritzette H., 3/24/16 via Yelp!

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 Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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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