It’s no secret that physical activity during pregnancy can help you stay strong and comfortable as your body grows. During an uncomplicated pregnancy, most providers will recommend continuing the same forms of exercise you used prior to pregnancy. This strategy might feel just right for the first trimester and even the second, too, with a few tweaks as your body grows and center of gravity shifts. But once you reach the third trimester, you might find that your body just wants to slow down.
So how do we keep up with the benefits of exercise and staying strong for labor when our bodies don’t want to do much? Let’s go through the best exercises to focus on during the third trimester to stay prepared for labor, delivery, and postpartum. Please note that this topic is worth a discussion with your prenatal care provider to be sure these types of movements are safe and beneficial for your health.
The top exercises we’re covering are broken down into three main categories: aerobic, mobility & strength, and mindset. As we move through each of these sections, keep in mind the red flags that indicate it’s time to stop your workout and call your prenatal care provider – such as vaginal bleeding, abdominal pain, regular painful contractions, amniotic fluid leakage, shortness of breath before exertion, dizziness, headache, chest pain, muscle weakness affecting balance, and calf pain or swelling.
Cardiovascular health is important for everyone, and pregnant women are no exception. Though you may not feel up to your usual mileage or speed, continuing to move your body throughout pregnancy with aerobic activity can help you and your baby stay healthy.
Among the benefits of cardiovascular physical activity for pregnant women are reduced risk of hypertensive (high blood pressure) disorders including preeclampsia, lower glucose levels and incidence of gestational diabetes mellitus, and reduced rates of cesarean birth in women who participate in aerobic exercise. The physical challenge of labor increases cardiac output by 30-50%, which means continuing to exercise as much as you (and your provider) are comfortable with can have benefits for your entire cardiovascular system through labor, delivery, and early postpartum.
Aerobic exercise is considered safe for uncomplicated pregnancies, too. According to a systematic review referenced by the American College of Obstetricians and Gynecologists, aerobic exercise at the recommended dose is not associated with an increased risk of preterm birth or gestational age.
So what is the recommended dose? Aim to walk, swim, or ride a stationary bike for 30-60 minutes, at least 4 to 7 days per week. Ideally, you’ll be able to talk throughout your workout, which is a measure of intensity known as “the talk test”. The talk test should correspond to working at moderate intensity, or approximately 4-6 on a 10-point scale of perceived exertion.
The “rate of perceived exertion” method has been demonstrated to be more reliable than measuring heart rate alone. Previously, healthcare providers often recommended that pregnant women keep their heart rate below 140 beats per minute, though this strategy is no longer considered standard for most pregnancies. Additionally, if you were exercising at a high impact/intensity level prior to pregnancy, you may be able to continue challenging your body to a similar degree – though you should always discuss this type of intensity with your healthcare provider.
Those last few months and weeks of pregnancy can bring a number of physical challenges, including pelvic pain, backaches (especially in the lower back), and more. If you’re having pain with walking or stationary cycling, you may feel better with a little support from the water. Try hopping in the pool for some lap swimming, low-impact aerobics, or even walking “laps” to get your regular exercise in.
Mobility & Strength
Both mobility and strength are essential components for staying comfortable during late pregnancy and preparing your body for the challenge of birth.
The key with the movements included below is to move through your available range without holding your breath or straining, as that can place excessive pressure on your pelvic floor and add strain to your abdominal muscles. For instance, a full deep squat may be appropriate for some, while a mini-squat movement will offer similar benefits to others. Start small and stay within a comfortable-for-you range to avoid the risk of injury.
Now let’s go over some of the exercise routines that will help you best prepare for birth.
- Lunges: For a starting position, hold on to something sturdy to the side (like a countertop, a railing, or the back of a solid chair), and stand with both feet together. Bring one leg back into a lunge position, then press through the heel of the front leg and exhale to bring your body back to standing. Repeat ten times on each side. This movement can be used to stretch the front of the hips and lower belly, and also helps to maintain strength in the legs. Adjust the depth of your lunge according to how you’re feeling, and avoid wide, deep lunges if you’re having trouble with pelvic/cervix pain.
- Squats: While holding on to something sturdy in front of you, hinge at your hips and sit back and down, as though you’re going to sit in a chair, then press through your legs and exhale as you return to standing. Repeat 10-20 times. This movement can also be done with an actual chair behind you. Make sure it’s solid and positioned so that it won’t move around (perhaps backed up against the wall). Slowly lower into the chair, then take a deep breath, exhale, and press through your legs to return to standing. Try to do this without using your hands, if possible.
- Hip Stretches: Your pelvic ligaments start to loosen up right away during early pregnancy, and you might really start to feel the effects of that on your hip and gluteal muscles as your baby grows during the third trimester. Adding in a few gentle hip stretches to your daily routine not only helps keep you moving comfortably through those final weeks but also allows your body to have more freedom of movement during labor and delivery.
- To stretch the back of the hip, start by reclining on the couch or bed with knees bent, then bring one foot up to rest on the opposite knee. Pull the elevated knee toward your chest just until you feel a gentle stretch for 20-30 seconds. Small pelvic tilts can also help to deepen the stretch to those tense hip muscles.
- To stretch the front of the hip, start by reclining on the edge of the couch or bed with the outside leg resting on the floor to allow a gentle stretch to the front of the hip. Bring the foot on the ground backward under your body to deepen the stretch. If the reclined position doesn’t feel good late in pregnancy, try mini-lunges with a short pause at the bottom of the movement instead.
- Cat/Tabletop: Take the time to stretch out your spine each day. Start on hands and knees on the floor, or place your hands on the kitchen counter. Round your spine as you exhale, pressing your mid-back up toward the ceiling, then return to a neutral spine position, or “tabletop”, with your spine relaxed and your back flat. Repeat 5-10 times, as often as you feel you need it throughout the day. This stretch is a safe and effective way to give your back muscles a quick break throughout the day. Also, if you choose to use an epidural during labor you will need to sit with your back rounded as the epidural is placed – it certainly doesn’t hurt to be prepared!
Pelvic Floor Preparation: Did you know that there are only two types of events in your life that require the full release of your pelvic floor? The first is bowel movements and the other is, you guessed it, childbirth! In fact, your pelvic floor will stretch up to 300% during vaginal delivery – that’s a whole lot of stretch! Fortunately, there are things you can do to warm up your body for this new sensation and teach your pelvic floor how to relax ahead of time. Diaphragmatic breathing actually gets the pelvic floor moving, whether you realize it or not. As we inhale, the pelvic floor drops down slightly, and as we exhale, it returns to its neutral position.
Try this: Take a deep breath into your ribcage and diaphragm. As you exhale, let your body return to baseline without any effort. Inhale again, this time allowing your lower belly and pelvic floor to release slightly, then exhale and again return to baseline. You can use this inhale-and-release strategy in various positions as a part of your birth preparation, including a wide-kneeling child’s pose, hands & knees, side-lying, and lying on your back. You might find you’re able to let those muscles move in some positions more than others, and that awareness may come in handy when it’s time to push during delivery!
Perineal Stretching: There is also emerging evidence that stretching the perineum (the area right around the vaginal opening) during the final weeks of pregnancy can help reduce the severity of tearing in first-time moms and can reduce lingering postpartum pain in moms of two or more. Perineal stretching can be done from 36 weeks onward, with a partner or by yourself.
To start, insert a thumb or a finger into the vaginal opening, then gently stretch the tissues around the bottom of the opening until you feel the sensation of stretching. If the vaginal opening was a clock face, you would be stretching along the bottom from approximately the 3:00 to 9:00 positions. This might feel like a mild sting or stretch, but it should not be painful. Hold the stretch for up to 10 seconds while taking diaphragmatic breaths (and consciously releasing your pelvic floor), then move on to the next area. A few minutes of perineal stretching each day can help your body prepare for the sensation & mobility that you’ll need during birth.
Getting your body and mind ready for the intensity of labor is the central topic for most childbirth classes. If you’re feeling up for it, you can incorporate some of that mental preparation into your third-trimester workouts. Interval training can simulate the intensity of a contraction, followed by a short but sweet rest break between them.
Try this: build a small circuit with exercises that feel comfortable to your pregnant body. This could include a small step-up, elevated plank burpee, mini-squats, reverse lunges, or upper body dumbbell work. Set up your timer to “work” for 30-90 seconds followed by a “rest” period of 1-2 minutes, for a total of 10-20 minutes. During the “work” periods, stay within a comfortable level of exertion by using the “talk test”. During the “rest”, do all that you can to maximize those minutes – sit down, take deep breaths, slow your body down, and calm your mind.
The real focus here is the rest. It’s all about how quickly and efficiently you can bring your heart rate and breathing down, calm your body & mind, and use visualization strategies to imagine a comfortable birth.
This strategy can be used throughout the third trimester, and it can be modified to suit your body’s needs. Even walking or standing up out of a chair can count as “work”, and when it’s time to labor you’ll be ready to maximize your “rest” time between contractions.
Now It's Time to Get Started
Whether you exercised prior to pregnancy or not, these simple movements & moderate aerobic exercises can help you prepare for the challenge of giving birth. As always, check with your healthcare provider before starting anything new, or reach out to a physical therapist for more individualized support. If you feel pain or discomfort, stop exercising and contact your doctor for medical advice. And lastly, remember – your body was made for this!