Pregnancy and Postpartum Exercise: It's Time to Move Past “Just Be Careful”
For generations, the message around exercise during pregnancy and after birth has largely been one of caution.
Don’t lift too much.
Don’t do abdominal exercises.
Don’t run or jump.
Be careful.
Wait until six weeks postpartum before you start exercising again.
And to be fair, there was a reason for that: we didn't have much research.
When evidence is limited, healthcare tends to err on the side of caution. But the problem is that many of those cautious recommendations have stuck around even as the research has changed.
And the research has changed.
In Episode 130 of The Pelvic Floor Project, I spoke with Dr. Margie Davenport, a professor at the University of Alberta and one of Canada's leading researchers in pregnancy and postpartum physical activity.
Her message was clear:
Exercise during pregnancy isn't simply something that is “okay” to do. It can be an important part of supporting the health of both mom and baby.
And after birth?
The evidence is challenging another long-standing message: that women should essentially rest for six weeks and then somehow be “cleared” to return to activity.
It's time for a more nuanced conversation.
How did pregnancy become a time to “be careful”?
Dr. Davenport explained that the first real exercise guidance for pregnant women came out in the 1980s.
At the time, recommendations were understandably conservative. There simply wasn't enough evidence to know how different types or intensities of exercise affected pregnancy.
But over the decades, researchers have accumulated considerably more data.
The 2019 Canadian Guideline for Physical Activity Throughout Pregnancy was developed after researchers synthesized the available literature into 12 systematic reviews and meta-analyses.
The resulting recommendation was that, when there are no contraindications, pregnant women should aim for at least 150 minutes of moderate-intensity physical activity each week, spread over at least three days.
And the benefits weren't small.
The research reviewed for the guidelines found that physical activity during pregnancy was associated with a 40% reduction in the odds of major pregnancy complications, including gestational diabetes, gestational hypertension and pre-eclampsia.
It was also associated with a 67% reduction in the risk of prenatal depression.
Importantly, the research did not find an increased risk of miscarriage, having a small baby or having a baby prematurely.
Even doing less than the recommended 150 minutes appears to provide benefits.
In other words:
Some movement is better than none.
Do you need to decrease your exercise as pregnancy progresses?
This is one of the most common assumptions I hear.
Women will come into my clinic and almost apologize for exercising.
They'll tell me:
“Don't worry, I've cut back.”
Or:
“I'm not doing abdominal exercises anymore.”
Or:
“I stopped exercising when I found out I was pregnant.”
There seems to be an underlying belief that as pregnancy progresses, exercise should automatically decrease.
But according to Dr. Davenport, there isn't evidence showing that healthy pregnant women need to progressively reduce their activity simply because their pregnancy is advancing.
In fact, emerging research suggests that substantially reducing training during pregnancy may have consequences for returning to activity postpartum.
This doesn't mean everyone should maintain exactly the same exercise routine.
Some women will want to reduce their activity.
Some will develop symptoms that require modification.
Some will have medical conditions where exercise needs to change.
And sometimes pregnancy simply feels terrible and getting through the day is enough.
But that's very different from telling every pregnant woman:
You should slow down because you're pregnant.
What about lifting weights?
Weightlifting is another area surrounded by fear.
Historically, women have often been encouraged to switch to very light resistance training during pregnancy.
But newer research is challenging that assumption too.
Dr. Davenport discussed research looking at women who were lifting at greater than 80% of their one-repetition maximum before pregnancy. Those who continued lifting during pregnancy had a 51% reduction in the odds of pregnancy complications compared with those who reduced their activity levels.
Many of the women who reduced their activity said they had done so because a healthcare provider or family member told them to.
That doesn't mean every pregnant woman should suddenly start lifting very heavy weights.
It means weightlifting itself isn't automatically something we need to fear.
Instead, we need to consider the individual.
If lifting feels good and you aren't experiencing concerning symptoms, your approach may be very different from someone who develops pelvic pressure, pain or urinary leakage when lifting.
That's where I often use the idea of a threshold with my patients.
Exercise can be beneficial while still requiring modification for your body.
Running, jumping and higher-intensity exercise
The same principle applies to cardiovascular exercise.
Running and jumping have traditionally landed in the “probably shouldn't do that while pregnant” category.
But once again, Dr. Davenport explained that researchers haven't been seeing the harm that was historically assumed.
Research into vigorous activity and higher-intensity exercise during pregnancy is still developing, so there are areas where we simply don't have enough data to make broad population-level recommendations.
That's an important distinction.
“We don't have enough research yet” isn't the same thing as “we know this is dangerous.”
For someone who was running regularly before pregnancy and continues to feel good running, the conversation may look very different from someone who develops pelvic girdle pain, heaviness, leaking or other symptoms.
We don't necessarily need to eliminate the activity.
We may need to figure out how to modify it so that it works for the person doing it.
What about exercising on your back?
Here's another one many pregnant women have heard:
Don't lie on your back.
The Canadian guidelines do not recommend universally avoiding exercise in a supine position.
Dr. Davenport explained that although some older research raised questions about fetal responses during supine exercise, newer research — including studies involving bench pressing — has shown reassuring responses.
The practical recommendation?
Pay attention to how you feel.
If lying on your back makes you dizzy, lightheaded or unwell, change positions.
If you feel completely fine, there isn't evidence suggesting that every pregnant woman needs to avoid the position simply because she is pregnant.
Our bodies are pretty good at giving us information.
But there ARE times exercise needs to change
None of this means exercise recommendations should be universal.
There are medical conditions during pregnancy where moderate-to-vigorous exercise may need to be modified or avoided.
This is where the conversation becomes more individualized.
Interestingly, even our thinking about these contraindications is evolving.
Dr. Davenport explained that researchers are actively revisiting the existing recommendations because newer studies have begun looking at populations that were traditionally excluded from exercise research.
One thing that has become increasingly clear is that complete inactivity or bed rest isn't benign.
Prolonged inactivity can negatively affect muscle mass, bone health and mental health, and research has also raised concerns about effects on pregnancy outcomes.
So even when moderate-to-vigorous exercise isn't appropriate, that doesn't necessarily mean don't move at all.
The appropriate amount and type of movement needs to be determined for that individual.
What about IVF and pregnancy after infertility?
This deserves its own mention because it's a perfect example of why evidence alone doesn't tell us everything.
Someone who has spent years trying to become pregnant, experienced pregnancy losses or gone through fertility treatment may understandably feel very differently about exercise.
Dr. Davenport explained that we still don't have enough research to confidently say whether stopping or continuing exercise during fertility treatment improves outcomes.
So we have to consider the whole person.
For one woman, continuing to exercise may create so much anxiety that it isn't worth it.
For another, exercise may be one of her most important strategies for managing the stress and anxiety associated with fertility treatment.
Mental health matters too.
Sometimes the best decision isn't about finding a perfect exercise prescription.
It's about understanding the evidence we have and making a decision that feels right for the individual.
Then the baby arrives. Now what?
This is where I think our traditional advice becomes particularly strange.
Before specializing in pelvic health, I spent the first several years of my physiotherapy career working in hospitals.
I worked with people immediately after knee replacements, hip replacements and open-heart surgery.
These are significant procedures.
There are incisions.
There are sutures.
Sometimes there are saws involved.
And yet we don't tell these patients:
Don't move anything for six weeks and then you're good to go.
We start rehabilitation.
Slowly.
Appropriately.
Respecting tissue healing.
But we start.
Then I had my first baby and remember thinking:
I'm the physiotherapist. I'm supposed to know what to do here.
And yet there was very little guidance.
Women are still frequently given some version of:
Rest. Be careful. Start physio at six weeks.
Then at six weeks, they're often told they're “cleared.”
Cleared for what?
Running?
Jumping?
Lifting weights?
Carrying a baby in an awkward position while simultaneously hauling a car seat and diaper bag?
Our bodies don't work like that.
The postpartum guidelines are changing this conversation
Until very recently, there was surprisingly little formal guidance around postpartum physical activity.
Dr. Davenport and her colleagues helped develop the 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour and Sleep Throughout the First Year Postpartum.
One of the important shifts is toward early, gradual movement rather than waiting for an arbitrary date.
The research reviewed for the guideline found that physical activity — including moderate-to-vigorous physical activity before 12 weeks postpartum — was associated with important mental health benefits.
Early movement also appears beneficial.
That doesn't mean delivering a baby on Monday and running 10 km on Tuesday.
It means we can stop thinking of the first six weeks as a period where the body should simply be left alone.
Start low. Go slow. Rebuild the foundations.
Exactly how quickly that happens will be different for everyone.
Six weeks isn't a finish line
Imagine two women give birth on the same day.
One exercised throughout an uncomplicated pregnancy, has an uncomplicated delivery and feels quite well afterward.
The other spent several months restricting activity because of pregnancy complications, experiences a difficult delivery and significant tearing, and is exhausted and struggling with sleep.
Why would we expect both women to follow the same postpartum exercise timeline?
We wouldn't do that with two people recovering from knee surgery.
And we shouldn't do it postpartum either.
Some women may be ready to progress activity relatively quickly.
Others may take months.
For some, returning to their previous activities may take closer to a year.
Both can be normal.
The calendar alone doesn't determine readiness.
What about the pelvic floor immediately after birth?
This is another area where I think our language needs to change.
Women with tearing, episiotomies or pelvic floor symptoms are often told to essentially leave the pelvic floor alone until six weeks.
But muscles and tissues need circulation.
Movement helps bring blood, oxygen and nutrients to healing tissues.
That doesn't mean aggressively strengthening a newly injured pelvic floor.
Think of it more like gentle range of motion.
Breathing.
Relaxing.
Connecting with the muscles.
Gentle contractions when appropriate.
Allowing the body to begin moving again within its tolerance.
The goal isn't to push through pain or ignore tissue healing.
It's to move away from the idea that the postpartum body is so fragile that movement itself is dangerous.
Your body has thresholds — not an expiry date
This is perhaps the biggest concept I want women to take away from this conversation.
Instead of asking:
“Am I allowed to do this?”
Sometimes a better question is:
“How does my body respond when I do this?”
Maybe walking for 20 minutes feels fantastic but 40 minutes increases pelvic heaviness.
That's useful information.
Maybe squatting feels fine but adding weight causes leaking.
Useful information.
Maybe running for two minutes feels good but running for ten creates pelvic pain.
Again — information.
Those symptoms don't necessarily mean you're damaged or that you'll never do the activity again.
They can help us identify your current threshold and determine what needs to change so we can gradually move that threshold.
We need to stop making women afraid of their bodies
Pregnancy changes the body.
Birth requires recovery.
A Caesarean section is major abdominal surgery.
A vaginal birth can involve significant changes to muscles and connective tissues.
We shouldn't minimize any of that.
But respecting recovery isn't the same thing as promoting fragility.
The message shouldn't be:
Be careful.
It should be:
Let's help you understand your body.
Let's tell women that movement is beneficial.
Let's teach them how to modify exercise when symptoms appear.
Let's help them understand that recovery is progressive rather than something that magically occurs at six weeks.
And let's make sure the people giving women this advice — physicians, midwives, physiotherapists, exercise professionals and other perinatal providers — actually have access to the current evidence.
Because research only changes healthcare when the information makes its way into the hands of the people who need it.
Pregnant and postpartum women deserve better than fear.
They deserve information, options and confidence in what their bodies can do.
This blog is intended for educational purposes only and does not replace individualized medical advice.
About Dr. Margie Davenport
Dr. Davenport was the Chair of the 2019 Canadian Guideline for Physical Activity throughout Pregnancy, and the 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour and Sleep throughout the First Year Postpartum. This work led to the development of the Get Active Questionnaire for Pregnancy, Get Active Questionnaire for Postpartum and the Canadian Society for Exercise Physiology/American College of Sports Medicine Pre & Postnatal Exercise Specialization. Dr. Davenport leads the Program for Pregnancy and Postpartum Health (www.exerciseandpregnancy.ca), and has published more than 200 manuscripts related to physical activity and sport during preconception, pregnancy and the postpartum period. Over the last decade she has worked with a number of National/International organizations including FIFA, the World Health Organization, International Olympic Committee, Sport Canada, the Canadian Society for Exercise Physiology, and the American College of Sports Medicine to support physical activity during and following pregnancy.
Episode Partners
This episode of The Pelvic Floor Project is supported by Embodia and SRC Health, organizations that help make it possible for me to continue creating evidence-based pelvic health education.
Embodia provides online continuing education and mentorship for pelvic health and rehabilitation professionals, including access to courses and expert-led learning from clinicians around the world.
SRC Health creates medical compression garments designed to provide support during pregnancy, postpartum recovery and for women experiencing pelvic health concerns.
Some partner links may be affiliate links, which means I may receive a small commission if you make a purchase, at no additional cost to you. Sponsorship does not influence the topics, guests or educational content of The Pelvic Floor Project.
