Should I Exercise in my First Trimester?

(Video available here!)

A lot of women are really nervous about exercising during their first (or subsequent) pregnancy. If you have questions about what’s safe and what’s smart, you are in the right place!

The good news is there is now a LOT of research and evidence about exercise during pregnancy. Additional good news is that almost nothing is off limits in your first trimester! If you have an uncomplicated pregnancy, then as long as you feel good it is safe (and recommended) to exercise! Barring any complications, the current recommendation of the American College of Obstetrics and Gynecology (ACOG) is a MINIMUM of 30 minutes, five times a week of moderate intensity exercise. Moderate intensity means you’re breathing hard and you feel like you’re working, but you can still carry on a conversation.

(Disclaimer: you always want to talk with your OB or midwife about your exercise plans just in case they have any concerns specifically pertaining to you.)

If you’re already exercising at a high intensity level, it is considered completely safe to continue, again barring any specific complications. One thing to bear in mind is that you need to listen to your body. Remember, you are growing a human!! Your body is BUSY, and some days it may NOT want to do much else. In your first trimester, the biggest limitations are typically tummy troubles (nausea) and fatigue. You may also experience shortness of breath and lightheadedness due to changes in blood volume and cardiac output. When you try to push into a high intensity activity, you might find that you are more short of breath, nauseous or lightheaded than you were the day before. If this happens, listen to your body and slow down.

Take a break for a few minutes, drink some water, let your heart catch up, then go ahead and try your activity again.

ACOG also recommends a mix of cardiovascular and strength training.

Training your cardiovascular system by periodically getting your heart rate up is good for you and it’s good for your baby. Babies placed under regular exercise-induced cardiovascular stress have been shown to physiologically tolerate the stress of labor better! (research by Dr. James Clapp, MD). It is also beneficial to build strength to help you better adapt to your growing belly. Core strength is very important, as is hip strength to prevent low back and hip pain. Shoulder girdle strength is important in counterbalancing the weight of lactating breasts and in preparing to carry that baby around all day long. You want to stay strong and even get stronger throughout your pregnancy! As Prenatal PTs who are all about injury prevention, we advise you to do that in a way that makes your body happy and does not promote injury or distress. You never want to exert to the point where you’re feeling really short of breath, seeing spots, feeling weak, actually vomit or have pain (abdominal pain or otherwise). Feeling abdominal cramping is also a big warning sign to stop.

If your body is having this sort of intense stress response, it is telling you you’re pushing too hard, and that is not good for you or your baby at any stage of your pregnancy. For competitive or elite athletes who really want to keep doing high intensity exercise, it is still important to exercise safely and keep your doctor apprised of your activity intensity and symptoms. If you have to modify for a while, remember that it is only temporary!

High intensity exercise like running, sprinting, distance running, jump squats, burpees, heavy lifting – it’s all  fair game in the first trimester as long as you feel good doing it.

If this is your second or third pregnancy, and especially if you did not intentionally and carefully restore your core and your pelvic floor between your pregnancies, you may notice some differences.

You may notice bulging in your abdomen, that your abs don’t feel as strong, or maybe that your vagina starts to feel heavy or you start to leak urine even as early as the first trimester. It is very common (especially if you didn’t restore your core the first time) for women to have increased symptoms of weakness in the deep core and in the pelvic floor during a subsequent pregnancy much earlier than in a first pregnancy.

Any feelings of laxity, heaviness, bulging or instability through the pelvis and the core is your body telling you that it’s not tolerating that activity well. Remember, you already have the hormone relaxin in your system, even in the first trimester. Things are starting to loosen. They’re starting to get ready to expand. NOW is the time to get your core strong, and  in a way that is supporting it and not further damaging it. Be careful to identify signs that your musculoskeletal system or your nervous system are not tolerating your exercise well and seek help to modify.

If you are having symptoms or if you just have questions about exercise during pregnancy, pelvic floor PT is the best place to start! Your OB or midwife may be able to give you general guidelines, but your pelvic PT is the one who will thoroughly test your strength, assess your movement patterns, walk through every movement with you and find the best exercises to strengthen your core and pelvic floor throughout your pregnancy.

We know how to dial in your exercise program to build up your core system, help you avoid pain and bladder problems, and prepare for labor.

The big picture: you can keep exercising, and you can keep doing it intensely! You can keep doing heavy lifting as long as you’re not overly short of breath, feeling too nauseous, vomiting, or showing any signs of pelvic instability, urinary incontinence, laxity, feelings of falling out, heaviness or pain. Listen to your body, and be sure to stop and take a break if you need to.

If you’re in the San Diego area, you can schedule an appointment by calling us or online on our scheduling site.

Connect with us online for more tips on safe exercise and workout ideas through every stage of pregnancy. Here’s to a happy, healthy pregnancy and beyond!