October 17, 2026
Exercise During Pregnancy: A Guide for Personal Trainers
How to support clients safely and effectively through pregnancy and the postpartum period, working alongside their healthcare team.
Sooner or later a client will tell you: “I’m pregnant. Can I keep training?” Your answer can make the difference between a client who stays active and confident for the next nine months and one who stops out of fear and misinformation.
Pregnancy is not an illness. The American College of Obstetricians and Gynecologists (ACOG Committee Opinion 804, 2020), the 2019 Canadian guideline for physical activity throughout pregnancy and the WHO 2020 guidelines agree that, in an uncomplicated pregnancy, regular moderate exercise is safe and beneficial for mother and baby; the WHO and ACOG suggest at least 150 minutes of moderate activity a week. Training a pregnant client still requires specific knowledge, sensitivity and good communication with her healthcare team.
Why specialize in pre- and postnatal training
Steady demand
Every pregnancy means months of prenatal training and a postpartum period in which many women want guidance from someone they trust. Many trainers don’t feel prepared for this population, which leaves room for those who are.
Loyalty and referrals
Women who find a coach who understands them tend to stay for the postpartum period and recommend that coach in prenatal classes and parent groups.
Professional referral network
OB-GYNs, midwives and pelvic floor physical therapists can become referral sources when they see you work with judgment and stay within your scope.
Before you start: non-negotiables
Medical clearance
Don’t start or continue training a pregnant client without her OB-GYN’s or midwife’s go-ahead. Ask her to confirm at a prenatal visit that the pregnancy is progressing normally and that there is no contraindication to exercise, and to tell you about any restriction. A short template letter she can take to the appointment makes this easier.
Practical tip
Add a pregnancy section to your intake forms: clearance, known restrictions, the contraindications below and her commitment to tell you about any change in her health. Keep a written record of what you agreed.
Specific training
- Pre- and postnatal exercise: a specialization from a recognized certifying body (for example ACE or NASM, among others) on top of your general certification.
- Pelvic floor basics: not to treat it, which is the pelvic floor physical therapist’s job, but to understand its function and protect it in training.
- Diastasis recti: what it is, warning signs and how to modify exercises.
- Current CPR and first aid.
Insurance
Check that your professional liability insurance explicitly covers pre- and postnatal clients; some general policies for trainers don’t.
Contraindications: when not to exercise
Decisions about contraindications belong to her healthcare team, but you need to know them to work with judgment. The examples below come from ACOG’s list.
| Absolute contraindications (examples) | Relative contraindications (examples) |
|---|---|
| Significant heart disease or restrictive lung disease | Anemia |
| Incompetent cervix or cerclage | Unevaluated heart arrhythmia |
| Multiple pregnancy at risk of premature labor | Poorly controlled type 1 diabetes, hypertension, seizures or thyroid disease |
| Persistent second- or third-trimester bleeding | Intrauterine growth restriction in the current pregnancy |
| Placenta previa after 26 weeks | Extremely sedentary history, extreme underweight or severe obesity |
| Premature labor or ruptured membranes in the current pregnancy | Orthopedic limitations |
| Preeclampsia or pregnancy-induced hypertension, severe anemia | Heavy smoking |
Relative is not the same as forbidden
A relative contraindication means exercise needs a more detailed medical assessment and a more conservative program, not that it is prohibited. When in doubt, ask her OB-GYN or midwife.
Warning signs during a session
Stop exercising and seek medical attention if any of these appear
- Vaginal bleeding
- Fluid leaking from the vagina
- Regular, painful contractions
- Shortness of breath before exertion, or chest pain
- Dizziness or feeling faint
- Headache
- Muscle weakness affecting balance
- Calf pain or swelling
- A noticeable decrease in the baby’s movements
In an emergency, call 911. Keep her emergency contact and her provider’s number on file.
Benefits of exercise during pregnancy
The evidence is solid and growing, which helps you reassure clients, their families and anyone still hesitant.
For the mother
Lower odds of gestational diabetes, gestational hypertension and preeclampsia in meta-analyses of randomized trials (Davenport et al., British Journal of Sports Medicine, 2018), less excessive weight gain, fewer depressive symptoms, less low-back and pelvic pain, and, according to ACOG, a lower risk of cesarean birth.
For the baby
In uncomplicated pregnancies, prenatal exercise is associated with lower odds of high birth weight (macrosomia) without higher odds of low birth weight or preterm birth, according to the evidence reviewed for the 2019 Canadian guideline.
Programming by trimester
The goal isn’t to improve performance but to maintain health, function and quality of life. Every recommendation below assumes clearance and an uncomplicated pregnancy, and every number is a starting point to adapt.
First trimester (weeks 1–12)
The pregnancy barely shows, but symptoms can be at their worst: nausea, fatigue and low blood pressure are common, and many women are anxious.
- If she was already training: she can usually keep her routine with small adjustments, lowering intensity when nausea or fatigue hit. RPE is your best tool.
- If she wasn’t: start gently with 20–30 minute walks, mobility and basic patterns, and build up gradually.
- Frequency: three or four sessions a week of 30–45 minutes, with plenty of day-to-day flexibility.
- Intensity: RPE around 5–7; the talk test is a good guide: she should be able to hold a conversation.
- Avoid overheating: train in a cool environment and encourage regular drinking.
Confidentiality
Many women don’t share the news until after week 12. Respect her decision and adapt training discreetly, especially in a shared gym.
Second trimester (weeks 13–26)
Often the best period: nausea eases, energy returns and the bump doesn’t limit movement much yet.
- Lying on her back: limit long periods flat on the back and use inclined or side-lying positions, especially if she feels dizzy, nauseous or unwell in that position.
- Adapt core work: drop crunches and sit-ups; use Pallof presses, bird dogs, inclined dead bugs and loaded carries, watching for doming along the midline.
- Posture and strength: the center of gravity moves forward; strengthen the upper back, glutes and hip stabilizers.
- Frequency and intensity: three or four sessions of 30–50 minutes; strength work with moderate loads, typically 8–12 reps, keeping a few reps in reserve.
Third trimester (weeks 27–40)
The biggest physical challenges: the bump grows, breathing feels harder, joints may feel looser and fatigue increases. The aim is to keep mobility, functional strength and well-being.
- Functional movements: squats to a box or with support, light sumo deadlifts, incline presses and rows.
- Lower impact: swap jumping and running for walking, a stationary bike or an elliptical if impact becomes uncomfortable or she notices leaking or heaviness.
- Hip mobility and breathing: supported deep squats, adductor stretches, hip circles and diaphragmatic breathing.
- Frequency and intensity: two to four sessions of 20–40 minutes, RPE around 4–6, adapted each day.
In the last weeks, many women want to stay active until the end, which is fine with medical approval; others prefer to stop. Respect her choice.
| Variable | First trimester | Second trimester | Third trimester |
|---|---|---|---|
| Frequency | 3–4 sessions/week | 3–4 sessions/week | 2–4 sessions/week |
| Duration | 30–45 min | 30–50 min | 20–40 min |
| RPE | About 5–7 | About 5–7 | About 4–6 |
| Main focus | Keep the habit, manage symptoms | Moderate strength, posture, adapted core | Function, mobility, breathing |
| Avoid | Overheating, exhaustion | Long periods on the back, crunches, high impact if symptomatic | Jumping, maximal loads, unstable balance work |
Exercises to keep, modify or avoid
Lower body that works well
Goblet squat, sumo squat, dumbbell Romanian deadlift, step-ups, glute bridges (inclined later on), banded lateral walks, TRX-assisted squats in the third trimester.
Upper body and core that work well
One-arm dumbbell row, incline press instead of flat, face pulls and band pull-aparts, Pallof press, bird dog, farmer’s and suitcase carries, inclined dead bug.
| Exercise or pattern | Why to modify | Alternative |
|---|---|---|
| Crunches and sit-ups | High abdominal pressure, can worsen diastasis | Pallof press, bird dog, inclined dead bug |
| Long periods lying on the back (from the second trimester) | Can cause dizziness or nausea in some women | Incline of 30–45 degrees, side-lying |
| Jumping and plyometrics | Impact on the pelvic floor, fall risk | Low-impact versions without the jump |
| Ballistic barbell lifts | Instability and risk to the abdomen | Controlled kettlebell work early on if well tolerated, then remove |
| Contact sports and activities with a high fall risk | Risk of abdominal trauma | Remove completely |
| Maximal loads with breath holding | High intra-abdominal pressure | Moderate loads with controlled breathing |
The pelvic floor: what every trainer should know
Your role has clear limits
As a personal trainer you don’t diagnose or treat pelvic floor dysfunction; that is the job of a pelvic floor physical therapist. Your role is to protect the pelvic floor in training by avoiding excessive pressure, recognize warning signs and refer, and work with the physical therapist when needed. Our pelvic floor exercises guide covers the basics.
Warning signs that need a referral
- Leaking urine when coughing, sneezing, jumping or lifting: common, but not something to accept as normal; it needs a pelvic floor assessment.
- A feeling of heaviness or dragging in the vagina: possible prolapse; refer promptly.
- Pelvic pain during exercise: not something to push through; modify and refer.
- Doming along the midline of the abdomen during effort: the exercise creates too much pressure; modify or remove it.
How to protect the pelvic floor in training
- Coordinated breathing: exhale during the effort and avoid long breath holds.
- Avoid bulging: if the abdomen pushes outward under load, reduce the load or change the exercise.
- Don’t prescribe Kegels blindly: they don’t suit everyone, and an overactive pelvic floor can get worse; leave specific pelvic floor exercises to the physical therapist.
Working with her healthcare team
- Written clearance: ask her to request a note from her OB-GYN or midwife confirming she can exercise and listing any restrictions.
- Share your plan: a short summary of the types of exercise, intensity and frequency you plan shows professionalism, even if not every provider replies.
- Update after each prenatal visit: any new diagnosis (placenta previa, gestational diabetes, high blood pressure) can change your programming.
Diastasis recti: what you need to know
Diastasis recti is the separation of the rectus abdominis along the linea alba. It is a normal adaptation in pregnancy: one study found it in all women assessed at 35 weeks (Mota et al., 2015). The concern is when it doesn’t recover well after birth or when training makes it worse.
- During pregnancy: minimize exercises that create strong forward pressure on the abdomen, and teach her to roll onto her side to get up from the floor.
- After birth: before returning to traditional ab work, she should be assessed by a pelvic floor or women’s health physical therapist.
- Warning sign: a ridge or dome along the midline during effort means the load is too much; modify straight away.
Returning to training after birth
There is no universal timeline
The “six weeks” often quoted is a simplification. ACOG recommends postpartum contact within three weeks and a comprehensive postpartum visit by twelve weeks, and says exercise can resume gradually when it is medically safe. Before impact or heavy loading, a pelvic floor assessment by a physical therapist is a good standard. A widely used UK guideline suggests waiting at least 12 weeks before returning to running, after an assessment (Goom, Donnelly and Brockwell, 2019).
| Phase | Approximate timing | Content |
|---|---|---|
| Phase 0: early recovery | 0 to about 6 weeks | Walking, diaphragmatic breathing and whatever the physical therapist prescribes; rest, sleep when possible and bonding come first |
| Phase 1: reactivation | About 6–12 weeks, after clearance | Mobility, deep core and glute activation, pelvic stability; short 20–30 minute sessions without impact or heavy loads |
| Phase 2: rebuilding | About 3–6 months | Progressive strength with light to moderate loads, cardiovascular base; expect higher RPE because of broken sleep |
| Phase 3: progressive return | From about 3–6 months onward | Higher intensity and impact if there are no pelvic floor symptoms and core function is good, after assessment |
After a cesarean
Recovery is often slower because there is surgical healing. Follow her obstetric provider’s guidance and be especially conservative with abdominal work and trunk flexion in the first months.
Beyond the physical
Mind your language
Avoid talking about “getting your body back” or “losing the baby weight”. Focus on health, function and how she feels.
Mental health
Perinatal depression and anxiety are common. Exercise can help, but if you notice persistent sadness, loss of interest, intrusive negative thoughts or isolation, encourage her to talk to her doctor or midwife. In a crisis in the United States, she can call or text 988.
Total flexibility
There will be cancellations because she hasn’t slept or the baby is sick. Adapt without judging and celebrate long-term consistency over short-term perfection.
Common mistakes trainers make
Being too conservative
Fear of “doing harm” can reduce training until it gives no benefit. A healthy pregnant client with clearance can lift, sweat and work hard; balancing safety and stimulus is your job.
Not adapting communication
Asking how she feels at the start of every session is essential, not a formality. Make it clear that modifying or cancelling is fine.
Rushing the postpartum period
Returning to intense training too soon can contribute to pelvic floor symptoms. Recovery is a marathon, not a sprint.
Working alone
Pre- and postnatal training is a team effort with the OB-GYN, midwife, pelvic floor physical therapist and sometimes a perinatal mental health professional.
Managing pregnant clients day to day
Flexible programming and documented decisions
Plan week by week or in two- to three-week blocks: in TrainerStudio you can copy a week and adjust it in minutes, set exercise alternatives she can swap in on harder days and prescribe by RPE. Scheduled check-in forms can ask about new symptoms and her latest prenatal visit, the chat lets her send you her clearance letter as a file, and private notes, visible only to you, keep a record of the clearance, restrictions, program changes and referrals.
Conclusion
Training women through pregnancy and the postpartum period is one of the most rewarding things you can do as a coach. You don’t need to be a physical therapist or an obstetrician. You need specific training, the humility to know the limits of your role and the ability to work with other professionals. Do that, and you contribute to a healthier pregnancy and a better recovery for every client you support. Our personal trainer niches guide covers how to position this specialization.
Note
This article is general guidance for personal trainers and does not replace medical advice. Every pregnant client should have her OB-GYN’s or midwife’s approval before starting or continuing an exercise program.
Sources
- American College of Obstetricians and Gynecologists (2020). Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 804.
- Mottola MF et al. (2019). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine.
- World Health Organization (2020). WHO guidelines on physical activity and sedentary behaviour.
- Davenport MH et al. (2018). Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine.
- Mota P et al. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum. Manual Therapy.
- Goom T, Donnelly G, Brockwell E (2019). Returning to running postnatal: guideline for medical, health and fitness professionals managing this population.
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