“Can I exercise?” is a question I hear at almost every first visit. The answer is: yes, if your gynaecologist has not identified contraindications — and that list is shorter than most women assume.
Movement in pregnancy is not about your figure. It is preparation for the physical effort of labour, which in terms of load is often compared to running a marathon.
Where to start
With breathing. It sounds dull, but it is the foundation everything else rests on: the diaphragm and the pelvic floor work together like two pistons. If you breathe shallowly, high in the chest — and in pregnancy that happens by itself, because the growing uterus pushes up against the diaphragm — the pelvic floor loses its rhythm.
The second thing is learning to contract and release the pelvic floor consciously. For birth, releasing matters more than contracting, and almost nobody practises it.
What makes sense in each trimester
First trimester. If you exercised before, in most cases you can carry on at reduced intensity. If you did not, this is not the moment to take up a new and ambitious sport. Start with walking and breathing.
Second trimester. The best window for work. Nausea usually passes and the belly is not yet in the way. This is when stabilising exercises for the pelvis, hip stretching and postural work come in.
Third trimester. Less load, more releasing and positions that take weight off. After week 35–36, birth preparation is added: work with the perineum and learning to relax the pelvic floor during a contraction.
What I advise against
- Classic sit-ups and “bracing” the abdomen — they encourage diastasis recti and raise pressure inside the abdomen.
- Exercising while holding your breath, and heavy loads with straining — that pressure goes straight down into the pelvic floor.
- Sports with a risk of falling or a blow to the abdomen — skiing, riding, contact sports.
- Sudden intensity if you did not train before. Pregnancy is not the time to build new fitness, only to maintain it.
When to stop and contact a doctor
Bleeding, leaking amniotic fluid, regular contractions, dizziness, severe pain in the lower abdomen or pubic symphysis, clearly reduced fetal movement. These are not signals to “wait and see” — they are signals to contact your doctor.
The most common mistake
Exercises taken from the internet and done blind. Not because they are all bad, but because you do not know whether your pelvic floor is weak or overactive. Those two states give similar symptoms and require opposite treatment. Strengthening an already tight pelvic floor makes things worse.
One visit with a functional examination settles it in a quarter of an hour and saves months of exercising the wrong thing.
- pregnancy
- exercise