Exercise during pregnancy: what guidelines say

Check with your OB or midwife before you start, or before you carry on with exercise you did before pregnancy. This matters most in a high-risk pregnancy, where the advice can be very different. Everything below is general guidance, not medical advice, and the health disclaimer explains what these pages can and cannot do.

For most people with an uncomplicated pregnancy, though, the guidance is encouraging: moving regularly is widely recommended, not just allowed. If you would like a teacher beside you for part of it, prenatal yoga at home with a certified teacher is adapted week by week to what your OB or midwife has said.

What do the guidelines say about exercise in pregnancy?

The World Health Organization’s 2020 guidelines on physical activity recommend that pregnant and postpartum women without contraindications do at least 150 minutes of moderate-intensity aerobic activity through the week, with some muscle-strengthening and gentle stretching. The American College of Obstetricians and Gynecologists gives the same figure in its committee opinion on exercise in pregnancy and the postpartum period.

“Moderate” means you are breathing faster but can still hold a conversation. If you cannot talk, ease off. If you were not active before pregnancy, you do not need to reach 150 minutes straight away: start with ten minutes and build up.

Which activities suit most pregnancies?

• Walking. Easy to start, easy to fit into a day, and gentle on the joints. A mall loop or a covered walkway works when it is hot or raining.
• Swimming and water exercise. The water takes the weight of the belly and keeps you cool, which helps in Manila.
• Light strength work. Bodyweight exercises, bands or light weights, with steady breathing and no straining.
• Prenatal yoga. Slow, supported movement, breathing and rest. The page on whether yoga is safe in pregnancy covers what to adapt.
• A stationary bike. A steady way to raise your heart rate with no risk of falling.

What changes from trimester to trimester

In the first trimester, tiredness and nausea often decide more than any plan. Some days a short walk is plenty. The page on exercise in the first trimester looks at those early weeks in detail.

In the second trimester, many people feel more energy. It is a good time to settle into a routine, while starting to avoid lying flat on your back for long.

In the third trimester, balance changes as the belly grows, and breathlessness comes sooner. Shorter workouts, more support and more rest are normal. The guide to prenatal yoga poses by trimester shows how the shapes change as you go.

What to avoid

• Contact sports and anything with a risk of being hit in the belly.
• Activities with a high risk of falling, such as horse riding, skiing or climbing.
• Lying flat on your back for long periods, especially after the first trimester.
• Overheating. Skip hot yoga and exercise in the midday heat; use the aircon or a fan and drink water.
• Holding your breath or straining hard, including with heavy weights.
• Scuba diving, which is not advised in pregnancy.

Warning signs: stop and call your OB or midwife

Stop straight away and contact your OB or midwife if you notice:

• Bleeding or fluid leaking from the vagina
• Regular, painful contractions
• Dizziness or feeling faint
• Chest pain, or a racing or uneven heartbeat
• Shortness of breath before you have started any effort
• A headache that will not go away
• Pain or swelling in one calf
• Your baby moving less than usual

If it feels severe or you cannot reach them, go to the nearest hospital.

Where prenatal yoga fits

Prenatal yoga is not a replacement for walking or swimming; it sits beside them. Where walking keeps your heart and legs working, yoga gives time to the parts that pregnancy strains: the upper back, the hips, the pelvic floor, and the breath. It also gives you a quiet hour to rest, which counts for a great deal.

I am certified in prenatal and postnatal (postpartum) yoga through Doula School International. I am not a medical professional, so before our first lesson I ask what your OB or midwife has said, and we work inside that. I teach prenatal lessons at home across the city, from a garden in Ayala Alabang to a house in Forbes Park.