Pregnancy requires mindful adjustments to exercise and daily movement. As the body adapts, certain activities and positions introduce risks related to joint stability, maternal circulation, and abdominal muscle integrity. Understanding which movements to modify or avoid is essential as pregnancy progresses. Before starting or changing your exercise routine, consult with a healthcare provider for guidance specific to your health status.
Activities That Carry High Risk of Falling or Trauma
Pregnancy profoundly alters the body’s biomechanics, increasing the risk of traumatic injury. The hormone relaxin acts to loosen ligaments throughout the body, particularly in the pelvis. This joint laxity, combined with a shifting center of gravity as the uterus expands, compromises stability and balance, making the mother more susceptible to sprains, strains, and falls.
Activities with an inherent risk of falling or abdominal impact should be avoided completely, particularly after the first trimester. These include contact sports like soccer or basketball, downhill skiing, horseback riding, and gymnastics. Any fall onto the abdomen carries a risk of placental abruption, a serious condition where the placenta prematurely separates from the uterine wall. Vigorous racket sports or outdoor cycling can also become hazardous due to risk of a fall or loss of balance.
Environmental conditions also pose risks. Strenuous exercise in extreme heat or activities like hot yoga, saunas, or hot tubs should be avoided, as they can cause maternal hyperthermia. An elevated core body temperature, especially in the first trimester, may increase the risk of congenital abnormalities. Similarly, activities involving rapid altitude changes, such as scuba diving, are contraindicated because pressure changes can cause decompression sickness in the fetus. Unacclimated travel to elevations above 6,000 feet may also be discouraged due to concerns about oxygen availability.
Positional Restrictions After the First Trimester
Prolonged positioning flat on the back (supine position) is discouraged typically after 20 weeks of gestation, though discomfort may occur sooner. When lying supine, the weight of the growing uterus can compress major abdominal blood vessels, specifically the inferior vena cava and the aorta. This compression can lead to Supine Hypotensive Syndrome, reducing the return of blood to the maternal heart, causing a drop in blood pressure, and potentially restricting blood flow to the placenta.
Symptoms of this circulatory compromise include dizziness, nausea, lightheadedness, or shortness of breath. To alleviate compression, the preferred position for rest or exercise is side-lying, particularly on the left side, which shifts the uterus away from the major vessels. If a supine position is required for a medical procedure, the torso should be tilted 15 to 30 degrees to the side using a wedge or pillow.
Beyond the supine position, other static postures require caution. Avoid prolonged periods of deep, unsupported stretching or inverted yoga poses, which can lead to blood pooling in the extremities or place pressure on the body’s new center of gravity. The increase in joint laxity from relaxin means that deep, passive stretches can overextend the ligaments, increasing the risk of injury. Maintaining a neutral spine and avoiding unstable positions are practical ways to manage these risks.
Abdominal Exercises and Movements to Avoid
Certain core movements place excessive strain on the abdominal wall, which is already stretching to accommodate the growing fetus. A primary concern is preventing or minimizing diastasis recti, the separation of the rectus abdominis muscles at the midline connective tissue (linea alba). Avoid exercises that cause the abdomen to “dome” or “cone” along this midline, as this signals excessive pressure.
Traditional abdominal flexion movements, such as full sit-ups and crunches, should be stopped as the belly grows because they directly strain the linea alba. Similarly, rotational movements that torque the midsection, like bicycle crunches or Russian twists, place uneven tension on the separating muscles. Front-loading positions, including full planks and standard push-ups, may need modification or replacement with side planks or kneeling variations to manage pressure.
In addition to formal exercises, modify daily movements to protect the core. When getting up from a lying position, avoid sitting straight up and instead use the “log roll” technique: roll onto your side, then use your arms to push yourself up while keeping your torso rigid. Be mindful of the Valsalva maneuver, which involves holding the breath and straining, often used for heavy lifting. This action creates high intra-abdominal pressure that can exacerbate diastasis recti or contribute to pelvic floor strain, making it advisable to exhale on exertion instead.