Safe Exercises for First Trimester: A Pelvic Floor PT’s Favorites as you Begin Your Pregnancy Journey
Congratulations and welcome to the wild ride that is first trimester. Maybe it’s your first rodeo, or maybe you’re already a mama who is hoping to be more active (gotta build stamina if you are chasing a toddler while pregnant). Wherever you are on your motherhood journey, you deserve to feel confident moving your body with safe exercises for the first trimester.
If you’re hoping to stay (or become) active during your pregnancy, you might be wondering:
What exercises are safe for my baby?
Is lifting weights safe in the first trimester?
Can I run while pregnant?
Can intense exercise in pregnancy cause a miscarriage?
These questions come up a lot among my pelvic floor physical therapy clients. Unfortunately, there is a lot of bad information out there on becoming or remaining active in pregnancy - including coming from your OBGYN office.
The good news is that for most individuals, it is absolutely safe to move your body during all phases of your pregnancy, even the first trimester (I always suggest reaching out to your local healthcare provider for more personalized guidance). In this blog I am sharing my recommendations on safe exercises for first trimester, as a certified pelvic floor physical therapist.
Let’s clear that up those misconceptions!
Can Exercise in the First Trimester Cause Miscarriage?
If you’re googling this because you’ve experienced pregnancy loss, first of all, I want to say I am so so sorry.
As a mama who has had 2 miscarriages, I know what it’s like to feel like any wrong move you make could harm your baby or even have dire consequences.
Or maybe you are just having a lot of anxiety about all the things you should and shouldn’t be doing in pregnancy.
I’m here, and sooooo happy, to tell you that you can relax and exhale: research shows there is NO relationship between exercising (high or low intensity) in the first trimester, and miscarriage.
Benefits of Exercising in the First Trimester
I know it can feel impossible to exercise in the first trimester when you are so fatigued and nauseous. But, did you know exercising throughout your whole pregnancy has SO many benefits for you and for your baby, from pregnancy into birth and postpartum?
First of all, exercise can reduce medical complications for you and baby.
In a study conducted on pregnant women, they found that higher physical activity levels were associated with lower rates of gestational hypertension and preeclampsia.
AND
Babies born from moms with higher physical activity levels are less likely to have complications upon delivery
READ: higher physical activity levels in first trimester are associated with IMPROVED outcomes - not worse.
Exercise in first trimester can be protective against aches and pains often said to be “normal” in pregnancy, things like:
Lower back pain
Hip pain
And as a pelvic floor physical therapist, I’m ALWAYS going to champion strength training in pregnancy to stay pain-free AND to prepare your body for the demands of postpartum and motherhood (baby stuff is heavy!!! Carrying that after giving birth? We need to train for that!)
Understanding What is Happening to Your Body in the First Trimester
While there are SO many benefits to exercising in the first trimester and throughout your entire pregnancy, there are some important things to consider.
In the first trimester, you are already undergoing massive hormonal changes.
While the blast in pregnancy hormones is known to cause nausea and fatigue, your musculoskeletal system (think - your muscles, bones, and joints) is also impacted from day one.
The hormone relaxin does just what it sounds like - it impacts your joints by loosening the ligaments for the purpose of eventually birthing a baby out of your pelvis.
Very cool! Except - when your muscles are not strong enough to stabilize your joints.
Your pelvis and spine, specifically, rely on the abdominal muscles, diaphragm, pelvic floor, glutes, and several other small muscles to stabilize you - and when that balance is thrown off, it can lead to problems like:
Back pain
Hip pain
Pelvic floor tightness
So on the one hand, we want to be mindful that your body is in a more hypermobile state than usual when you are pregnant. On the other hand, strength training and other forms of exercise are exactly what you need to mitigate some of the aches and pains that can arise in pregnancy.
What if I Feel so Sick I Can’t Move?
I know, I know - but I’m nauseous!!!
Look, I am never going to be your high school basketball coach telling you to suck it up. I get it. Pregnancy is hard. It can even be miserable for some!
But I want you to know that exercise can benefit you EVEN in these nauseous stages. Even low to moderate intensity exercise can HELP nausea by promoting better blood flow and circulation
Of course, make sure you are as fueled as possible - an empty stomach is a major trigger for nausea - and you definitely don’t want to work out on an empty stomach.
And make sure you are supplementing with electrolytes, as your blood volume is increasing daily.
Exercise Modifications for First Trimester
Again - exercise is SAFE in pregnancy, but there are some things to consider given that you are growing a whole human.
You may find that lower intensity exercise you did before pregnancy now feel like high intensity. This is why I recommend going by perceived rate of exertion or RPE scale. On a scale of zero to 10, you want a mix of low-moderate exertion with high levels of exertion. In pregnancy, you may need more or longer rest breaks, or to shorten high intensity intervals.
The wild thing about pregnancy is there may be days where you have tons of energy and can go just as hard as you did pre-pregnancy, but other days you’ll feel like an absolute sloth. Pay attention to this, fuel well, hydrate, and know that it’s ok to take steps back as needed (but that you aren’t hurting anything by pushing yourself a little)
“Don’t START anything new in pregnancy?”
You may hear the advice not to start anything new that you haven’t done before in pregnancy.
But what if you weren’t exercising before? What if you weren’t strength training before?
As a doctor of physical therapy, I can confidently say that you CAN start in pregnancy. Should you train for a marathon? Probably not. But you do need to strength train and do some form of cardio like walking or swimming for optimal outcomes.
If you were completely sedentary before, or aren’t familiar with weight lifting techniques, it’s a great idea to work alongside a pelvic floor physical therapist to get a customized plan to reduce risk of injury.
Safe Exercises for First Trimester
Before we dive into my recommended safe exercises for first trimester, I want to reiterate my thoughts about modifications. If you are already working out, there’s really not much you need to change, besides ensuring you are fueled and you are listening to your body.
Stability Training
I recommend focusing on core and pelvic floor coordination exercises. These help hold your pelvis and trunk together to reduce back pain, sciatica, and SPD later on in pregnancy .
Some of my favorites are:
Bear Planks
Fire Hydrant
Side plank clamshell
These exercises are a great place to start to focus on stabilizing and strengthening your core and pelvic floor muscles for decreased back and pelvic pain in pregnancy.
If you have pain or discomfort with these exercises, you should definitely get a 1:1 consultation with a pelvic floor physical therapist to determine the right exercises for you and your body.
Strength Training
Ultimately, you are going to need to build true muscle strength. The above exercises will help your brain “turn on” the right muscles, but you really want to add some of the below strength training exercises to protect your joints and enjoy the benefits of exercising in pregnancy.
Here are some great exercises to get you started - keep in mind that if you have increased back pain, sciatica, leaking, or pelvic heaviness, you should check in with a pelvic floor physical therapist to determine appropriate modifications for you.
Lower body
Goblet squat - great for glute and functional pelvic floor strengthening. Use anything you have in your house if you don’t have a dumbbell or kettlebell.
Reverse lunge - Single leg strengthening is a must! Great for pelvic floor coordination, balancing out muscle imbalances, and overall stability.
Upper body
Overhead press - split stance
This overhead press with a split stance helps to work your core, gluts, and pelvic floor muscles while building strength in your shoulders and upper back - which will be essential as you get ready to lug baby gear around.
Split stance Row
Works your upper back muscles which you’ll need for all things baby wearing, getting the car seat in and out of the car, and picking up your growing baby.
Final Thoughts
Okay mama, I hope that you are feeling energized and CONFIDENT in moving your body during the first trimester! You deserve to feel your best, and exercising is one of the greatest tools for mitigating pesky pregnancy symptoms, and preparing your body for labor.
It’s important to keep in mind that sometimes you may have issues that you shouldn’t have to handle on your own. I encourage you to seek out support during this season so you can address pelvic floor issues like incontinence (leaking urine), tailbone pain, back pain, SPD.
This is where pelvic floor physical therapy comes in. Pelvic floor physical therapists can help you diagnose the problem or problems you’re experiencing, and come up with an individualized exercise plan (that may include some of the above exercises) catered to your specific problems, needs, and lifestyle. Furthermore, seeking help from a pelvic floor therapist can help you feel your best during pregnancy, and confidently prepare for birth and a juicy postpartum recovery.
I’d be happy to support you in this journey mama - please reach out!
Speaking of postpartum recovery, make sure you grab my Free Postpartum Recovery Checklist with all the supplies you need to make a juicy transition into motherhood, care for your pelvic floor in those early postpartum days, and nourish your body for optimal healing. Get it here.
Ready for More Support?
Hi! I’m Dr. Jackie Roelofs
- A doctor of physical therapy specializing in the pelvic floor in pregnancy, postpartum and beyond. My pregnancy and birth prep programs are available in person in New Orleans, and worldwide through virtual coaching.
If you are craving support during one of the biggest transformations of your life, fill out a contact form and I’ll reach out to you within 2 business days.
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