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Exercise During Pregnancy: The Australian Guideline, and What the Latest Research Adds
By Nat Costanzo, Accredited Exercise Physiologist (AEP).
At RH Reproductive Health and Kinetic Club, exercise during pregnancy is one of the questions we get asked about most often, and one of the most misunderstood. So we put together what we know, both from the official Australian guideline, from clinical practice, and from the recent research which adds texture for our patient and client group, in one place.
Because we are such exercise advocates and enthusiasts here's a stat that caught our attention most: 71% of pregnant people don't know that Australia has a national guideline for exercise during pregnancy. Not vague advice, an actual, evidence-based set of recommendations, published by exercise and sports medicine researchers, that most people have simply never been told about during their preconception and prenatal care.
We know that because we support so many people in this space, it is our responsibility to communicate this critical information.
The guideline 📑
The Australian guidelines for physical activity in pregnancy and postpartum (Brown et al., 2022) came out of a five-stage evidence review spanning 27 different health outcomes. There are four core recommendations:
Move like you're not pregnant. Meet the same Australian Physical Activity and Sedentary Behaviour Guidelines for Adults, before, during, and after pregnancy; roughly 150 to 300 minutes of moderate intensity activity a week.
Adapt as you grow. Modify the type and intensity of activity as your body changes. Each trimester comes with different considerations.
Train the pelvic floor. Daily pelvic floor exercises, during pregnancy and after birth- not just once something's gone wrong.
Make the call together. Physical activity decisions should be a shared conversation with your health professional, not something you figure out alone.
In practical terms: roughly 150- minutes a week of moderate activity, or 75 minutes of vigorous activity, two days of strength training and daily pelvic floor work- adjusted for your symptoms and as your body changes through the trimesters.
KEY FINDING: The review found exercise during pregnancy and postpartum to be safe for both the pregnant person and baby, genuinely beneficial- not just an absence of harm- and protective, lowering the risk of complications including excessive gestational weight gain, preeclampsia, depression, and gestational diabetes, among others.
In my experience not all bodies are the same, and guidelines are general by design. If you're navigating a specific health consideration or not sure where and how to start, I recommend an individualised plan from an exercise specialist.
Book in with me (Nat) for a FREE- 10- minute discovery call here to explore your options.
The nuance: depression & timing ⏱️
Here's where recent research adds something the guideline alone doesn't tell you. A 2025 systematic review and meta-analysis (Fuenzalida et al.) looked at nine randomised controlled trials on exercise and perinatal depressive symptoms and found that the mental health benefit of exercise was substantially stronger when it happened during pregnancy than when it happened postpartum, where the effect was minimal and not statistically meaningful.
Practically this means that the timing of exercise matters significantly. Starting movement in the preconception period and continuing through pregnancy is shown to significantly improve mood and depressive symptoms compared to starting exercise for those same reasons after birth. If mental health is part of why you're motivated to move, pregnancy itself, not the postpartum period alone seems to be the more responsive window. And if you're prone to depressive symptoms generally, then we know that your postpartum depression risk is increased.
The same research also found something reassuring. Benefits started showing up at around 100 minutes of activity per week, well below the 150-minute minimum target and that's an important distinction! The guideline number is the target for optimal benefit; it's not the minimum threshold before anything works. If you're not consistently hitting 150 minutes, that doesn't mean you're not getting some life- changing benefits from the movement that you are doing.
What's actually happening in the body? 🧬
A 2026 systematic review (Redondo-Delgado et al.) looked at what structured exercise does biologically during pregnancy, examining maternal serum, umbilical cord blood, breast milk, and placental tissue across 11 randomised controlled trials. The changes were measurable:
↓ Inflammatory markers (TNF-α, interleukin-6) went down- meaningful, since persistently elevated levels are linked to complications like preeclampsia and preterm birth.
↑ Interleukin-10, the body's natural anti-inflammatory signal, went up, better balancing the inflammatory load pregnancy already places on the body.
↓ Lipid profiles improved — lower LDL and triglycerides, supporting healthy blood vessel function for both the pregnant person and baby.
✓ Glucose regulation improved, directly relevant to gestational diabetes risk.
↑ BDNF (brain-derived neurotrophic factor), a protein tied to brain cell growth and mood regulation, increased- offering one plausible biological explanation for the mental health findings above.
✓ Positive changes even showed up in cord blood, breast milk, and placental tissue- meaning the benefits extend to baby, not just the person carrying the pregnancy.
These effects were seen with 12 or more weeks of exercise, two to three times a week, at moderate-to-vigorous intensity. Aerobic and resistance training performed in the same session showed the strongest combined effect.
Practical application:
Frequency = | 2-3x/ week |
Intensity = | Moderate- vigorous |
Time = | 30-60 minutes |
Type = | Combined strength & aerobic training = greatest effect |
Putting it together 🤔
A few things worth taking away:
The target doesn't change because you're pregnant. Roughly 150+ minutes per week of moderate activity, modified trimester to trimester.
Progress beats perfection. Benefits appear before the full target- pregnancy is a particularly responsive window for the payoff.
Consistency is the lever, not intensity. Listen to your body, move when you can, rest when you need to, and focus on the long-term picture rather than any single session.
This is general information, not individual advice. Everybody and every pregnancy is different- talk to your health professional and an exercise specialist about what's right for you specifically.
Where we come in 🌱🏋🏻♀️
At RH Reproductive Health, our naturopaths specialise in pregnancy, IVF support, PMOS, endometriosis, and menopause, and Nat, our exercise physiologist, supports women and AFABs across every life stage, including pregnancy.
If you'd like a plan built around your trimester, ability, likes/ dislikes, your symptoms and what actually motivates you- that's exactly what we're here for!
Get in touch to book in and build a nutrition and exercise plan that's genuinely yours.
Our online resources 💻
4 x 30-minute exercise videos guided by Nat (AEP) and expertly designed to support participants through their preconception and prenatal phases.
One- time payment of $69.
1 x 75- minute practitioner webinar.
Rhiannon Hardingham (naturopath) and Nat Costanzo (exercise physiologist) share their clinical gems, the latest research and guidelines for helping you to support your pregnant patients with safe and effective nutrition and exercise practice during pregnancy.
FREE webinar.
A downloadable PDF which includes:
Exercise recommendations based off the Australian guideline.
Considerations per trimester.
Recommendations for exercise safety.
Free download.
Nat Costanzo (she/her) BExSSc, MClinExPhys, AEP 🩺
With more than 10 years experience, Nat is a highly qualified exercise physiologist, Pilates instructor & personal trainer, with a special interest in supporting women and AFABs to navigate preconception, pregnancy, postpartum, perimenopause and healthy ageing. As an exercise physiologist, she is uniquely qualified in supporting all those wishing to adopt or return to exercise when challenged by confidence, injury or disability.
Nat provides a safe, non judgmental space, whilst facilitating fitness for all levels, ages and genders. Nat's infectious and motivational style is well-appreciated by her clients, who credit her with their success in maintaining and enjoying regular exercise.
Nat is available both online and in-person (in her clinic, Kinetic Club, in Collingwood, Melbourne).
Nat can help you with exercise for:
preconception, including during IVF treatments
pregnancy
postpartum
menstrual cycle issues, including pain, PMS & PMDD
the menopausal transition
return to or entry to exercise
weight loss and maintenance
PMOS and endometriosis
Tell us what interests you....
What do you want to hear from us about next?
Endometriosis & PMOS
PMS & PMDD
Weight loss & maintenance
Reference list 📚
Brown, W. J., Hayman, M., Haakstad, L. A. H., Lamerton, T., Mena, G. P., Green, A., Keating, S. E., Gomes, G. A. O., Coombes, J. S., & Mielke, G. I. (2022). Australian guidelines for physical activity in pregnancy and postpartum. Journal of Science and Medicine in Sport, 25(6), 511–519. https://doi.org/10.1016/j.jsams.2022.03.008
Fuenzalida, P., Droppelmann, G., Mahecha, S., & Feijoo, F. (2025). Impact of exercise dose–response on maternal mental health and perinatal depression prevention: A systematic review and meta-analysis. International Journal of Public Health, 70, Article 1608940. https://doi.org/10.3389/ijph.2025.1608940
Jarbou, N. S., Gabra, M., Baskerville, K., Mawson, T., Newell, K. A., & Nealon, J. R. (2026). A cross-sectional survey of Australian women's perspectives and experiences of exercise during pregnancy, including women that experience mental illness. BMC Pregnancy and Childbirth, 26, Article 306. https://doi.org/10.1186/s12884-026-08697-y
Redondo-Delgado, P., Santos-Lozano, A., & Maroto-Izquierdo, S. (2026). Impact of exercise training during pregnancy on maternal biomarkers: A systematic review. American Journal of Obstetrics and Gynecology, 234(1), 61–77. https://doi.org/10.1016/j.ajog.2025.09.021
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