Women’s health · 8 minute read

Exercise in pregnancy used to come with a long list of “be careful”. The research is much more reassuring now. For most pregnancies, moving is good for you and good for your baby.

If you’re in the first trimester and all you want is the couch, that’s completely normal. Later on it’s heartburn, getting up to wee three times a night, and a bump that turns getting out of the car into a three-point manoeuvre. Exercise slides down the list, and there’s often a small worry at the back of your mind about whether it’s OK for the baby.

For most pregnancies, the answer is a reassuring yes. RANZCOG, the college that sets the guidelines for obstetricians in Australia, says there’s no evidence that regular exercise in an uncomplicated pregnancy harms you or your baby. And the benefits go to both of you.

What moving does for you

Lower odds of gestational diabetes and high blood pressure. These two come up a lot in our women’s health appointments. A 2018 review of 106 studies found women in exercise programs had 38% lower odds of gestational diabetes, 39% lower odds of high blood pressure in pregnancy and 41% lower odds of preeclampsia. You don’t need to live at the gym, either. About 140 minutes a week, roughly 20 minutes a day, was linked to at least 25% lower odds.

A real lift in your mood. Women who exercised had 67% lower odds of depression during pregnancy. If you’re feeling flat most days, in pregnancy or after the birth, please tell your GP, midwife or obstetrician. Moving helps, and so does support.

Back and pelvic pain that’s easier to live with. Exercise didn’t stop women getting low back or pelvic girdle pain, but the women who exercised found it less severe, during pregnancy and in the weeks after birth.

A pelvic floor that’s ready for what’s coming. Women without any leaking who did structured pelvic floor training in pregnancy were 62% less likely to leak late in pregnancy, and 29% less likely three to six months after birth. Technique matters a lot here, and that’s where a women’s health physio comes in.

A small edge on the day. Exercise was linked to 24% lower odds of needing forceps or a vacuum. It didn’t change caesarean rates or how long labour lasted.

And what it does for your baby

Lower odds of gestational diabetes and preeclampsia are good news for your baby too, but researchers have also looked at babies directly. A review of 135 studies found women who exercised had 39% lower odds of macrosomia, a baby born over 4 kilograms. Their babies weren’t more likely to be born early, small or with low birth weight, and there was no link with problems as newborns or later in childhood. The researchers concluded that exercise in pregnancy is safe and good for babies.

Another review found no rise in miscarriage or stillbirth in women who exercised, though the evidence there is thinner. RANZCOG says research on the longer-term effects in children is still in its early days.

Where our women’s health physios come in

Every pregnancy is different, and RANZCOG recommends a check of your medical and pregnancy history before you start an exercise program. Our women’s health physios start with your history too, and work alongside your doctor or midwife.

They all have postgraduate training in pelvic health. Your appointment begins with your story and an assessment that suits your trimester, and you walk out with a written plan. We can look at your pelvic floor on real-time ultrasound, so you can see it working on the screen instead of guessing. We also help with the things that make moving harder, like pelvic girdle pain, sciatica, rib pain and abdominal separation.

Prenatal Pilates works the same way. It’s run by a physio, you start with a one-on-one assessment, there are only four people in each class, and your program changes as your pregnancy does. No Pilates experience needed.

Book a pregnancy physio appointment

How much to aim for

If you and your baby are healthy, Australia’s guidelines suggest 2.5 to 5 hours of moderate activity a week, spread over most days. That’s about 30 to 60 minutes on most days, plus some strength work on at least 2 days and your pelvic floor exercises every day. Moderate means you can still chat while you’re doing it.

If that sounds like a lot, start small. A walk around the block counts. On the days you’re exhausted or nauseous, do what you can and pick it up again when you feel better.

Small changes as your bump grows

RANZCOG advises that exercises “should not be performed lying flat on the back after the first trimester”, so from about 12 weeks. As your uterus grows it can press on the big vein that carries blood back to your heart. We swap those exercises for versions on your side, sitting, standing or propped up at about 45 degrees. If you ever feel light-headed or a bit off on your back, roll onto your side.

Keep cool, drink plenty of water, and wear loose layers and a supportive bra. On hot days, a swim or an air-conditioned class beats a walk in the sun.

As your balance changes, leave contact sports and anything with a good chance of a fall, like horse riding, until after the baby arrives. Swap heavy lifting and holding your breath for steadier strength work, breathing out as you push.

The takeaway

For most pregnancies, moving is safe and good for both of you, with lower odds of some of the most common pregnancy complications and no sign of extra risk to your baby in the research. You don’t need to train hard. You need to keep moving in a way that suits your pregnancy, and if you’d like help working out what that looks like, our women’s health physios would love to see you.