Pregnancy (Prenatal Exercise)

ACOG (Committee Opinion 804, 2020) and U.S./WHO guidelines for uncomplicated pregnancy and postpartum:

• ≥150 minutes/week of moderate-intensity aerobic activity, spread across the week (e.g., ~30 min on most days). Those who were vigorously active before pregnancy can often continue under guidance.
• Include muscle-strengthening activity.
• Use the "talk test" to gauge moderate intensity (able to converse) rather than relying on target heart rate, since HR responses change in pregnancy — see talk-test.
• Activity should be reviewed/cleared during prenatal care; people with complications need individualized medical guidance.

Benefits: reduced risk of excessive gestational weight gain, gestational diabetes, preeclampsia, gestational hypertension; improved mood, reduced low-back/pelvic pain; may ease labor and postpartum recovery. No increased risk of miscarriage, preterm birth, or low birth weight in uncomplicated pregnancies.

Good activity types: walking, stationary cycling, swimming/aquatic exercise, low-impact aerobics, modified strength training, prenatal yoga/Pilates (modified), pelvic-floor training (pelvic-floor).

• Avoid supine (lying flat on back) exercise after the first trimester for prolonged periods (potential vena cava compression / reduced venous return) — modify to incline/side-lying. ACOG notes caution but acknowledges evidence is limited; modify if symptomatic (dizziness, nausea).
• Avoid activities with high fall risk or abdominal-trauma risk (contact sports, downhill skiing, horseback riding, off-road cycling) and scuba diving (decompression risk to fetus).
• Avoid exercise in extreme heat/humidity; stay hydrated and well-fueled; avoid overheating, especially first trimester.
• Account for shifted center of gravity and ligament laxity (relaxin) → balance and joint-stability caution; avoid extreme ranges.
• Maintain awareness of diastasis recti and pelvic-floor load (see diastasis-recti, pelvic-floor); modify high intraabdominal-pressure work as it progresses.

• See pregnancy-contraindications for ACOG absolute and relative contraindications.
• Warning signs to stop and seek care: vaginal bleeding, regular painful contractions, amniotic fluid leakage, dyspnea before exertion, dizziness, headache, chest pain, calf pain/swelling, muscle weakness affecting balance.

Educational only and not a substitute for obstetric care. All exercise during pregnancy should be discussed with the obstetric provider; individualized medical guidance overrides general statements here.

• ACOG: ≥150 min/wk moderate aerobic + strength for uncomplicated pregnancy.
• Use the talk test, not target HR, for intensity.
• Benefits: lower GDM, preeclampsia, excessive weight gain; no increased miscarriage/preterm risk.
• Avoid: prolonged supine after 1st trimester, fall/contact/trauma sports, scuba, overheating.
• Stop for: bleeding, leaking fluid, painful regular contractions, chest pain, dizziness, calf pain/swelling.

• pregnancy-contraindications — absolute/relative contraindications and red flags.
• postpartum — return to exercise after birth.
• diastasis-recti / pelvic-floor — core/pelvic-floor considerations.
• talk-test — recommended intensity gauge in pregnancy.