For most women with a healthy pregnancy, staying active is safe and good for both mother and baby. Regular exercise can reduce back pain, improve sleep and mood, help control weight gain, and lower the risk of gestational diabetes. It can also make labour and recovery easier, though no one can promise that.
This post gives general guidance only. Every pregnancy is different, so speak to your doctor or midwife before you start or continue a programme, and follow their advice if it differs from what you read here.
How much and how hard
Health authorities including the WHO recommend that pregnant women without a medical reason to avoid it should aim for at least 150 minutes of moderate activity across the week. That is about 30 minutes on 5 days, and it can be split into shorter blocks of 10 minutes if that is easier.
If you were very inactive before pregnancy, begin gently, for example 10 to 15 minutes of walking a few times a week, and build up slowly. If you were already training regularly, you can usually continue at a lower intensity with guidance from your doctor.
Use the talk test
Moderate effort means you are breathing harder but can still speak in full sentences. If you can only gasp a word or 2, slow down. This is more reliable than heart rate targets during pregnancy, because your resting heart rate rises naturally.
Good activities for pregnancy
- Walking. The easiest and most useful choice. Walking to the market, taking stairs, or a loop around the neighbourhood early in the morning all count.
- Swimming and water exercise. The water supports your weight and keeps you cool.
- Stationary cycling. Safer than road cycling once balance changes and the risk of falling rises.
- Low impact classes. Antenatal yoga, pilates, or dance suited to pregnancy.
- Strength training. Using light to moderate weights with good technique keeps you strong for carrying and lifting a baby.
- Pelvic floor exercises. Practise them every day, and ask a physiotherapist if you are unsure how to do them properly.
A sample strength session
Do this 2 or 3 times a week, around 30 to 40 minutes. Keep the effort at 5 to 7 out of 10.
- Warm up with 5 minutes of walking and gentle joint circles.
- Squat to a bench or chair: 2 sets of 10 to 12.
- Seated dumbbell row or band row: 2 sets of 10 to 12.
- Wall push up or incline push up: 2 sets of 8 to 12.
- Glute bridge: 2 sets of 10 to 15. After the initial trimester, use a pillow wedge or do this with your upper back raised instead of flat on the floor.
- Standing band pull apart or shoulder press with light weights: 2 sets of 10.
- Cool down with slow breathing and gentle stretching.
Breathe out on the effort, and never hold your breath while lifting. Stop each set well before you feel you are struggling.
Changes to make as pregnancy progresses
- Avoid lying flat on your back for long periods after the initial trimester. The weight of the womb can press on a large blood vessel and make you feel dizzy or faint. Use an incline or lie on your side.
- Take care with balance. Your centre of gravity shifts, and joints get looser. Avoid jumping, sudden direction changes and activities with a risk of falls or a blow to the abdomen, such as contact sports.
- Reduce intensity gradually. Many women find that by the third trimester, walking and gentle strength work are plenty.
- Listen to your body, not to the calendar. Some women feel wonderful at 30 weeks, others are exhausted at 12.
Heat, hydration and food
Kampala can be hot and humid, and overheating is a particular concern in pregnancy. Train in the early morning or evening, wear light clothing, and avoid hot gyms, saunas and hot yoga. Drink water before, during and after exercise, and keep a bottle with you.
Eat regular meals that include protein and carbohydrate. Matooke, rice, sweet potatoes, beans, fish, eggs, groundnuts, milk and plenty of fruit and vegetables are all good choices. Carry a banana or some groundnuts if you plan to exercise, because low blood sugar can make you dizzy. Pregnant women need a little more energy, but not "eating for 2".
When to stop and get medical help
Stop exercising and contact your doctor or go to a health facility if you notice any of the following:
- Vaginal bleeding.
- Fluid leaking from the vagina.
- Regular, painful contractions.
- Dizziness, faintness, or a bad headache.
- Chest pain or unusual shortness of breath before you start.
- Swelling, pain or redness in 1 calf.
- Muscle weakness that affects balance.
- Reduced movements from the baby.
When exercise may not be advised
Some conditions mean you should be given specific advice, or told to avoid exercise. These include severe heart or lung disease, a low placenta that persists late in pregnancy, risk of premature labour, persistent bleeding, a weak cervix, pre eclampsia, and a multiple pregnancy in some cases. If you have high blood pressure, diabetes, anaemia or a previous miscarriage, ask your doctor what is safe for you.
Common mistakes
- Starting too hard after being inactive. Begin small and build.
- Following social media workouts made for non pregnant people.
- Doing crunches and heavy core work. As the belly grows, abdominal muscles can separate a little. Focus on breathing, gentle core control and pelvic floor work instead.
- Ignoring back and pelvic pain. Mild aches are common, but pain that is sharp, constant or travels down the leg needs a physiotherapist's review.
- Skipping rest. Tiredness in pregnancy is real. A rest day is part of the plan.
Key takeaways
- Most healthy pregnant women should be active, aiming for around 150 minutes of moderate activity each week.
- Use the talk test: you should be able to hold a conversation while exercising.
- Walking, swimming, cycling indoors and light strength work are good choices.
- Stay cool and hydrated, and avoid contact sports, falls and lying flat on your back for long.
- Stop and seek help for bleeding, fluid leakage, regular contractions, dizziness, chest pain or reduced baby movements.
