Pregnancy brings remarkable changes to a woman’s body, affecting posture, muscles, joints, breathing, and emotional health. Antenatal physiotherapy is a safe and effective way to support these changes through guided exercises, posture correction, and education. A trimester-wise physiotherapy plan ensures that exercises are adapted to the mother’s changing needs while keeping both mother and baby safe.
This article provides a trimester-wise antenatal physiotherapy exercise guide, with easy-to-follow illustrated descriptions, to promote comfort, strength, and preparation for childbirth.
Why Antenatal Physiotherapy Is Important
Regular physiotherapy during pregnancy helps to:
- Reduce back, pelvic, and hip pain
- Improve posture and balance
- Strengthen pelvic floor muscles
- Enhance circulation and reduce swelling
- Improve breathing and relaxation
- Prepare the body for labor and delivery
- Support faster postnatal recovery
General Exercise Safety Guidelines During Pregnancy
- Always consult a doctor or physiotherapist before starting exercises
- Exercise at moderate intensity (able to talk while exercising)
- Avoid breath holding
- Maintain proper hydration
- Stop exercises if pain, dizziness, bleeding, or breathlessness occurs
- Avoid prolonged supine (lying on back) positions after the first trimester
First Trimester Physiotherapy (0–12 Weeks)
Focus: Gentle movement, relaxation, and body awareness
Common Changes
- Fatigue and nausea
- Hormonal fluctuations
- Emotional sensitivity
Physiotherapy Goals
- Promote relaxation
- Reduce early muscle tension
- Maintain light activity levels
Illustrated Exercise Descriptions – First Trimester
1. Diaphragmatic Breathing
Position: Sitting or semi-reclined
How to perform:
- Place one hand on the chest and one on the abdomen
- Inhale slowly through the nose, expanding the abdomen
- Exhale gently through the mouth
- Repeat 8–10 times
Benefits: Improves relaxation and oxygen supply
2. Neck and Shoulder Mobility
Position: Sitting upright
How to perform:
- Slowly bend your neck forward, backward, and sideways
- Perform gentle shoulder rolls forward and backward
- Repeat 5–10 times
Benefits: Relieves neck stiffness and stress
3. Pelvic Tilts
Position: Crook lying (knees bent)
How to perform:
- Tighten abdominal muscles gently
- Flatten your lower back against the bed
- Hold for 3–5 seconds, relax
- Repeat 10 times
Benefits: Reduces early low back discomfort
4. Ankle Pumps
Position: Sitting or lying
How to perform:
- Move ankles up and down
- Rotate ankles clockwise and anticlockwise
- Perform 15–20 repetitions
Benefits: Improves circulation and prevents swelling
Second Trimester Physiotherapy (13–28 Weeks)
Focus: Strengthening, posture control, and endurance
Common Changes
- Growing abdomen
- Postural changes
- Improved energy levels
Physiotherapy Goals
- Strengthen core and pelvic muscles
- Prevent back and pelvic pain
- Maintain overall fitness
Illustrated Exercise Descriptions – Second Trimester
1. Pelvic Floor Muscle Exercises (Kegels)
Position: Sitting or side-lying
How to perform:
- Tighten muscles as if stopping urine flow
- Hold for 5 seconds, relax for 5 seconds
- Perform 10–15 repetitions
Benefits: Prevents urinary leakage and supports pelvic organs
2. Quadruped Arm and Leg Raise
Position: Hands and knees
How to perform:
- Keep spine neutral
- Raise one arm or the opposite arm and leg
- Hold for 3–5 seconds
- Alternate sides, repeat 8–10 times
Benefits: Improves core stability and balance
3. Sit-to-Stand Exercise
Position: Sitting on a chair
How to perform:
- Stand up slowly using leg strength
- Sit down with control
- Repeat 10–12 times
Benefits: Strengthens thighs and gluteal muscles
4. Calf Stretch
Position: Standing with support
How to perform:
- Step one leg back
- Keep heel on floor
- Lean forward slightly
- Hold 15–20 seconds, repeat both sides
Benefits: Prevents leg cramps and tightness
Third Trimester Physiotherapy (29–40 Weeks)
Focus: Comfort, breathing, and labor preparation
Common Changes
- Increased body weight
- Reduced balance
- Pelvic pressure
Physiotherapy Goals
- Reduce discomfort
- Improve breathing efficiency
- Prepare pelvic muscles for labor
Illustrated Exercise Descriptions – Third Trimester
1. Lateral Costal Breathing
Position: Sitting or side-lying
How to perform:
- Place hands on rib cage
- Inhale deeply, expanding ribs sideways
- Exhale slowly
- Repeat 6–8 times
Benefits: Improves breathing during labor
2. Pelvic Rocking
Position: Sitting on a chair or a Swiss ball
How to perform:
- Gently tilt the pelvis forward and backward
- Keep movements slow and controlled
- Perform 10–15 repetitions
Benefits: Relieves back pain and improves pelvic mobility
3. Supported Squats
Position: Standing with chair or wall support
How to perform:
- Bend knees and lower hips slightly
- Keep back straight
- Return to standing
- Repeat 6–10 times
Benefits: Strengthens legs and prepares pelvis for delivery
4. Side-Lying Relaxation
Position: Left side-lying with pillow support
How to perform:
- Support the abdomen and between the knees
- Focus on slow breathing
- Practice for 5–10 minutes
Benefits: Improves circulation and reduces pressure
Conditions Where Exercise Should Be Avoided
- Vaginal bleeding
- Severe anemia
- Placenta previa
- Pre-eclampsia
- Uncontrolled gestational diabetes
- History of repeated pregnancy loss
Role of a Physiotherapist in Antenatal Care
A physiotherapist:
- Designs individualized exercise programs
- Manages pregnancy-related pain
- Educates about posture, labor positions, and breathing
- Provides emotional support and confidence
Conclusion
A structured, trimester-wise antenatal physiotherapy program supports a healthier pregnancy by improving strength, comfort, and mental well-being. With proper guidance, pregnancy exercises help women stay active, reduce pain, and prepare physically and emotionally for childbirth.
Healthy movement today leads to a smoother delivery tomorrow.
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