Exercise in your First Trimester
The first trimester of pregnancy can create a lot of anxiety, excitement, fear, fatigue, sickness, confusion, you name it.
Whether your pregnancy was planned or not, you’re faced with the reality of a new life growing inside of you and allllll of the joys (or discomforts) along with it.
I was really quite lucky in my first trimester. I felt mildly unwell and VERY fatigued, but I was able to continue with my daily work/life activities, albeit with a little less gusto. I modified my exercise big time because of fatigue and because impact movements, such as running, were just not feeling great.
Before I dive into what exercise looked like for me, let’s take a look at the evidence for why exercise is generally safe, and recommended, during pregnancy.
How does pregnancy affect your response to exercise?
Changes in balance (likely to be more affected in 2nd and 3rd trimester)
Increased body temperature
Increased shortness of breath
Increased heart rate
Changes in energy
Increased joint mobility
Potential increased risk for muscle or ligament strain/sprain
What are the benefits of exercise in the first trimester?
May decrease nausea
Less likely to develop musculoskeletal pain during pregnancy
Improved energy
Decreased stress
Improved mood and sense of well-being
Social support (if exercising with others)
Helps to maintain muscular and cardiovascular endurance
Decreased muscle/strength loss
Improved sleep
Feeling of accomplishment
Allows you to maintain or build strength that you will need postpartum
Is exercise is safe in the first trimester?
Likely, this is going to be the first question you asked yourself in regards to exercise. You want to exercise but also want to make sure that, first and foremost, your baby is safe.
Over the years there has been a lot of research done in this area. Here are some of the most updated, evidence-based suggestions from the American College of Obstetricians and Gynecologists (ACOG)
“Physical activity and exercise in pregnancy are associated with minimal risks and have been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements.”
“Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”
“Obstetrician–gynecologists and other obstetric care providers should evaluate women with medical or obstetric complications carefully before making recommendations on physical activity participation during pregnancy. Activity restriction should not be prescribed routinely as a treatment to reduce preterm birth.”
Additionally, ACOG reports that exercise has not been shown to increase risk for miscarriage, low birth weight, or early delivery.
Phew. That alone should bring you some peace in the fact that exercise IS safe, given you have a healthy pregnancy.
Sometimes recommendations taken from research is outdated or may even be overly cautious (this is my opinion). This may lead to too little activity because of fear and not because of an actual risk. Don’t get me wrong, sometimes there is good reason to avoid or decrease exercise (I will get to that shortly). However, knowing that these organizations are likely erring on the side of caution AND saying it has NOT been shown to increase risk of miscarriage, should give you comfort!
When should you avoid or be cautious with exercise in your first trimester?
Pre-existing health conditions (such as certain heart and lung diseases)
Severe anemia
Twins or multiples (this alone does not mean automatically should automatically not exercise, speak with your doctor about your personal risks and likely some movement will actually be beneficial)
Cervical insufficiency
Severe sickness
Your doctor says so!
* Note that these are more specific to the first trimester and this list is not all-inclusive. As your pregnancy progresses, different complications may arise that I will cover in a future post (be on the lookout for Trimester 2!). It is always suggested that you follow the advice of your own medical team.
What types of exercise should be avoided?
Again, this is not personalized advise. Check with your provider if you have specific questions!
Anything that may cause a fall or collision (horseback riding, skiing, etc)
Activities where you may get hit in the stomach (ie boxing)
High risk activities with potential for impact (such as water-skiing, surfing, sky diving)
Scuba diving (due to potential for decompression sickness)
Exercise in extreme altitude
High temperature activities (such as running on a very hot day, hot yoga)
Max exercise (pushing toward heart rate max, complete breathlessness)
High-impact (running, jumping, etc) IF it is causing you symptoms or you have existing pelvic floor dysfunction (such as prolapse, leakage, pain)
Exercise that causes abdominal coning (secondary to diastasis recti)
What exercise should be included? And how do I structure my weeks?
Core exercises
Pelvic floor exercises
Strength training
Cardio (stair climber, stationary bike, running, walking, rower, bodyweight, dance, swimming)
Yoga/Pilates
WHAT YOU ENJOY
The recommended frequency for a healthy pregnancy is at least 150min of moderate intensity exercise weekly.
You are much less likely to comply to a structure that you hate, and what you enjoyed prior to pregnancy may have changed now that you’re pregnant. Explore what you like and vary activity as much as you can.
New to exercise?
Begin with 5-10 minutes of movement you enjoy (such as walking, swimming), and progress by 5-10 minutes each week until you reach 30 minutes. Then you may begin adding in weight, speed, intervals, etc.
When should you stop exercising?
Bleeding
Chest pain
Abnormal heartbeat
Trouble breathing
Dizziness/fainting
Worsening or severe headache
Abnormal muscle weakness
Regular, painful contractions
Pelvic floor symptoms (such as leakage, pelvic heaviness, pain)
What my exercise + movement looked like…
Walking - most days (20-60min)
Yoga - 2-3 days/week (15-20min)
Pilates - 1-2 days/week (15-20min)
Core and pelvic floor stabilization exercises - Daily (5-10min)
Low-Moderate intensity stationary bike - 3-4 days/week (30-45min)
2-3 mile walk/run - every 10 days or so (if I was feeling good!)
House cleaning/chores - weekly
I aimed to move at least 20-30min/day.
Sometimes this looked like cleaning my house slowly for 30 minutes, then taking a nap.
Sometimes this looked like a moderate intensity 45min stationary bike ride.
Sometimes this looked like 10 minutes of yoga.
Sometimes this looked like starting a walk and turning around after 5 minutes because I just felt unwell.
Other areas of health I focused on…
Hydration - my personal goal was/is 100oz per day, more if I have sweat or exercised
Small and frequent “meals” - I aimed to consume a snack every couple of hours to combat nausea and keep my energy up as best I could, even if I wasn’t particularly hungry
Rest - I gave myself full permission to rest while also making movement decisions based on how I would feel afterwards. What I mean is that sometimes walking made me feel better, even though it was hard to get myself going initially. Other times I knew that walking would only make me more tired, so I’d skip it. It’s a learning process, always taking note of how you feel afterwards (are you more tired or more energized?)
Sleep - this one wasn’t hard for me at all. I was sleeping like a baby and often going to bed so early I hit 9-11 hours of sleep. Do you realize how quickly that little fetus is growing in these weeks? Of course sleep should be prioritized! I would even suggest prioritizing this over waking up early to exercise, but again it comes down to how you feel afterwards (more or less energy for the day).
Decreased social media scrolling - This may sound weird since part of my job is running my social media page. BUT, as some of you may have experienced, I had a decent amount of worry/anxiety in those first several weeks in particular. I realized that scrolling social media and seeing pregnancy-related information was overwhelming and further heightened my anxieties. I just decided not to scroll in that time, and am still cautious of this.
As I mentioned throughout, always refer back to your medical team with questions or concerns you may have. Every pregnancy is unique and requires unique care!
I hope that the top 3 things you take from this post are that, for most, exercise is beneficial and safe, it may look/feel different day-to-day, it should feel good!
