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Adding to all these shifts, pregnancy hormones cause the joints to loosen up due to the stretching of ligaments. These musculo-skeletal changes can lead to strain, injury and discomfort.

Fortunately, daily exercise can help reduce the discomfort of some of these physical changes and offers many health benefits. Stretching and strengthening exercises may help alleviate discomfort and for many people, exercise helps to decrease fatigue, increase muscular and cardiovascular strength and stamina, relieve stress and anxiety, improve mood and energy levels, support better focus and improve sleep. Regular exercise can also help maintain or achieve a healthier weight.

The American College of Obstetricians and Gynecologists recommends a minimum of 30 minutes of exercise a day during pregnancy as long as your healthcare provider gives you the green light to be active. If you have limitations, ask your healthcare provider what you can safely do.

Stop exercising and call your healthcare provider if you have any of these symptoms:

• Vaginal bleeding
• Dizziness or feeling faint
• Increased shortness of breath
• Chest pain
• Headache
• Muscle weakness
• Calf pain or swelling
• Uterine contractions
• Decreased fetal movement
• Fluid leaking from the vagina

What to Do

On your own or in a group, opt for whatever is most engaging for you

Prenatal versions of yoga and Pilates classes modify exercises and positions for pregnant participants. If you enjoy working out in a group setting, these classes may be a great fit. If you prefer to do yoga or Pilates alone, you might consider taking a private class, or renting a DVD or trying an online class and exercising at home. Check out your local library or “on demand” cable for free rentals of these types of videos.

Choose from a variety of exercises that are generally safe for pregnancy

Here are some ways you can get the recommended amount of exercise:

• Walking: If you did not exercise prior to pregnancy, walking is an easy and effective way to be active. Even if you were already exercising regularly or doing other types of exercise, consider setting a goal of walking for at least 30 minutes per day. Build up to this slowly if needed. Perhaps start with walking 10 minutes once per day. When that feels comfortable, aim for walking 10 minutes twice per day. Continue to increase at a pace that works for you.
• Swimming: Swimming works the whole body without stressing joints and ligaments. As an added bonus, the buoyancy of the water is comforting and relaxing.
• Stationary cycling: Road biking requires good balance and is not recommended during pregnancy; however, stationary biking is a safe variation and equally beneficial. You can choose an upright stationary bike, or even a recumbent one on which you sit in a larger seat with a back. The reclining position of a recumbent bike may feel better as your pregnancy progresses.
• Jogging: If you were a runner prior to pregnancy, then you can continue jogging during pregnancy as long as your healthcare provider gives the OK.
• Low-impact aerobics: Aerobic activity is generally safe during pregnancy, but stay away from exercise that involves jarring movement or jumping, because these movements can cause joint strain and discomfort.
• Light weight training: Strength training is generally safe if done with the guidance of an expert. Be sure to use slow and controlled movements, do short sets (less than 10 repetitions), and don’t hold your breath while bearing down.

If you are having back pain, you might want to try these exercises

• Isometric exercises: Engage the pelvic floor, abdominal, lower back and gluteus muscles periodically while sitting, and always when lifting, to help strengthen your core and prevent lower back injury.
• Arm and leg extensions: Start in an all-fours hands and knees position, then extend your right arm out to the front and left leg behind you as you inhale. Return to starting position as you exhale and repeat with your left arm and right leg. Do 6 sets on each side.
• Back press: Stand with your back against the wall and feet about one foot away from the wall. Press your lower back into the wall and hold for 10 seconds. Repeat 10 times.
• Pelvic tilts: Practicing pelvic tilts will help stretch the lower back muscles that may have tightened after performing the above strengthening exercises. To do this, you can either stand straight with your back against the wall (recommended in the second and third trimester), or lie on the floor with your knees bent, feet flat on the floor and hip distance apart. Then draw your belly button towards your spine and gently rock your hips towards your face so that your tailbone lifts slightly – you will feel your lower back press into the floor or wall.
• Child’s pose: Start in an all-fours hands and knees position with hands under shoulders and your knees wider than your hips. Bring your hips back to your heels, arms still extended in front, and hold for 5 seconds. Come back up to your hands and knees. Repeat 5 times.
• Sitting twist: Sit with legs crossed. Turn to your left, placing your left hand on the floor behind you and your right hand on your left knee as you move into a gentle stretch. Hold for a breath. Do the same on the other side. Repeat the set of twists 5 more times.

Make strengthening your pelvic floor part of your daily exercise routine

Practice 30 perineal muscle squeezes per day. Try 10 squeezes three times per day, half of them at a rhythmic pulse and the other half with a longer squeeze and release. In other words, do 5 faster squeezes and 5 slower ones during each session. See Everything I need to know about pelvic floor exercises for more details.

Find creative ways to remind yourself to exercise your pelvic floor muscles – perhaps commit to doing your 10 squeezes with each meal or at certain landmarks during your commute to work and back.

One of the great things about Kegels is that you can do them discreetly, including in public or at work, so if it is easier for you to do 10 of them at spontaneous moments then go for it! Doing these exercises in small increments throughout the day may be more effective than just one long session and, for those who find the process overwhelming initially, more doable. For additional benefit, when you can, perform your pelvic floor exercises in a variety of positions such as on hands and knees, sitting in butterfly pose, standing, or lying on your side.