Today, we’re unpacking one of the most common questions I get asked: Should I exercise in the first trimester of pregnancy? The short answer is yes — you absolutely should! But it’s a bit more nuanced than simply staying active. As a doctor of physical therapy, with women’s health and pelvic floor certifications, here are some key components I recommend.
This early pregnancy phase is not just about moving your body — it’s about laying the foundation for core and pelvic floor health that will support you throughout pregnancy and postpartum recovery.
Whether you’re newly pregnant, trying to conceive, or supporting a loved one during this season, this overview offers science-backed, whole-body, pelvic-floor aware exercise tips for the first trimester.
EPISODE 14 | HOLISTICALLY WELL PODCAST: HOW A PT RECOMMENDS EXERCISING IN THE FIRST TRIMESTER: CORE, PELVIC FLOOR & WHOLE-BODY SUPPORT
Whether you learn best by listening or watching, we’ve got something for you! You can catch the full conversation on the Holistically Well Podcast—available on all your favorite platforms!
🎧 Holistically Well Podcast on Apple | Episode 14
🎙️ Holistically Well Podcast on Spotify | Episode 14
💻 Holistically Well Podcast on YouTube | Episode 14
Why Does Exercise Look Different in the First Trimester?
Even if you don’t look pregnant yet, your body is already undergoing profound changes starting as early as week four of pregnancy. Hormonal shifts, postural adaptations, and neurological changes are all at play beneath the surface.
💡 Looking for a trimester-specific approach that honors all these early changes?
My Holistically Well Pregnancy Program walks you through safe, science-backed movement strategies for every stage.
The Role of Hormones: Relaxin and Pelvic Stability
The hormone relaxin increases quickly in early pregnancy, and it relaxes ligaments throughout your body — especially around the pelvis. This loosening can cause instability, contributing to common pregnancy aches such as:
- Hip pain
- Glute pain
- Sciatica
- Lower back discomfort
This explains why the way you move needs to adjust early on.
Fatigue and Nausea Impact Exercise
Common first trimester symptoms like fatigue and nausea can disrupt your usual workout routine. I’ve created a free guide addressing how to combat these symptoms to support your exercise!
Your deep core muscles, including the transverse abdominis and pelvic floor, begin to function differently early in pregnancy. Continuing high-intensity workouts without modification can lead to:
- Increased abdominal separation (diastasis recti)
- Pelvic floor dysfunction
- Increased pressure or discomfort in the pelvic region
These changes might not be immediately obvious but can lead to problems if not addressed.
The Risks of High-Intensity Exercise in Early Pregnancy
Exercising at 80% or more of your max effort multiple days a week can stress your nervous system, potentially increasing the risk of pregnancy loss. From a biological perspective, your body is wired to feel safe when carrying new life — excessive physical stress can signal danger.
As an exercise physiologist and doctor of physical therapy, I strongly encourage exercise during pregnancy, but with mindful adjustments to intensity.
In recent years, pregnancy exercise culture has shifted from caution to empowerment. Women are encouraged to stay active, which is wonderful. However, the “how” — the safe, intentional way to exercise — is often missing.
If you were doing moderate exercises like Pilates or walking pre-pregnancy, you can usually continue safely. But high-intensity interval training (HIIT), marathon training, or sprint workouts often need modification to protect your body and baby.
What to Modify or Avoid in the First Trimester
- Avoid high-intensity interval training (HIIT) at >80% max effort
- Avoid breath-holding or Valsalva maneuvers during lifts or core work
- Watch for abdominal “coning” or bulging — reduce intensity if present
- Don’t fear lying on your back for exercises like bridges — just avoid prolonged periods and monitor symptoms
- Avoid exercises causing pain, heaviness, or leakage
- Modify or avoid single-leg moves if you experience pelvic pain
✨ You can stay active without pushing through.
Inside the Holistically Well Pregnancy Program, I guide you step-by-step through movements designed to support your energy, protect your pelvic floor, and keep your nervous system regulated.
Proven Benefits of Prenatal Exercise
Research shows that low to moderate intensity exercise during pregnancy can:
- Reduce the risk of gestational diabetes, preeclampsia, and hypertension
- Improve cardiovascular health and normalize blood pressure
- Enhance blood flow to baby, supporting healthy birth weight
- Shorten the pushing phase during labor
First Trimester Movement Exercises
Your core is a pressure management system — including the front wall (transverse abdominis), the pelvic floor at the bottom, your diaphragm at the top, and the back muscles. Coordinating deep breathing with gentle pelvic core activation protects against:
- Pelvic organ prolapse
- Urinary leakage
- Pain in the pelvic area
Starting this coordination early (even while trying to conceive!) makes a huge difference.
Promote Blood Flow and Lymphatic Circulation
Gentle movement encourages natural detoxification, improves digestion (helpful against pregnancy constipation), and reduces fatigue. Low-impact exercises like walking, mobility circuits, or resistance training are ideal.
Emotional Health support in the First Trimester
Exercise reduces stress and gives a sense of control during a season of change. Modify workouts to maintain emotional benefits without overstressing your body. For example:
- Swap high-intensity runs for conversational-paced jogs
- Choose non-heated yoga or Pilates classes
Physical Therapist Recommended Exercises for the First Trimester
As a holistic doctor of physical therapy with women’s health and pelvic floor certifications, here are some key components I recommend.
Breath Work
Focus on diaphragmatic breathing to engage your deep core and pelvic floor:
- Lie on your back, one hand on chest, one on belly
- Inhale deeply (4–6 seconds), feeling belly rise
- Exhale slowly (8–12 seconds), blowing out like blowing out a candle
- On exhale, gently lift pelvic floor as if lifting a marble
Core Activation
Once breath is established, incorporate gentle core exercises:
- Bird dog
- Dead bug
- Bear crawl
Always engage the deep core and pelvic floor with breath.
Pelvic Floor Awareness Beyond Kegels
Pelvic floor needs coordination — lengthening on inhale, gentle contraction on exhale — not just Kegel-style tightening. Match pelvic floor activation with exercise load:
- Squat with breath: inhale down, exhale lift with pelvic floor engagement
- Bridge with breath: exhale lift hips while activating pelvic floor
- Cat cow for mobility and pelvic floor coordination
Avoid any exercises that cause pelvic pressure, leakage, or discomfort.
The benefits are clear — but knowing how to move is what makes all the difference.
With on-demand videos and expert physical therapy guidance, the Holistically Well Pregnancy Program helps you build strength safely!
Strength and Mobility Exercises for First Trimester
Low to moderate intensity resistance training is great. Pair every movement with breath:
- Inhale during lowering phase (eccentric)
- Exhale during lifting phase (concentric)
Exercises to try for First Trimester:
- Squats and bridges (double leg for pelvic stability)
- Single leg work like lunges, step-ups (if no pelvic pain)
- Rows and bicep curls
Use a mirror to monitor pelvic alignment during single leg moves.
Walking and Gentle Cardio
Walking 20–30 minutes daily is highly recommended for circulation, blood sugar regulation, and baby positioning. Continue activities like swimming, cycling, or elliptical at moderate intensity, adjusting as needed.
My Personal Journey
During my first pregnancy, I pushed myself too hard, ignoring nausea, fatigue, and discomfort. It wasn’t until my third pregnancy that I embraced gentler, breath-focused, pelvic-floor aware exercise — and it made a huge difference in how I felt physically and emotionally.
This is why I created the Holistically Well Pregnancy Program — to guide you through safe, effective exercise from trimester to trimester.
Ready for More Guidance?
If you want a step-by-step pregnancy exercise program with trimester-specific workouts, pelvic floor strategies, and holistic wellness tips, check out my Holistically Well Pregnancy Program. Use code THANKYOU100 for $100 off as a thank you for being part of this community!
Final Note
If this post helped you, please share it with a friend or leave a review to help other expecting women find the support they need. Until next time, be kind to your body and trust its innate wisdom. 💫
