How do you build a workout plan for a pregnant client?

The contraindications to exercise in pregnancy are medical, specific, and not something a personal trainer diagnoses. ACOG lists conditions such as significant heart or restrictive lung disease, an incompetent cervix or cerclage, persistent second or third trimester bleeding, placenta praevia after 26 weeks, premature labour during the current pregnancy, ruptured membranes, preeclampsia or pregnancy-induced hypertension, and severe anaemia.

Your job is to ask for clearance from the treating physician or midwife and to record that you have it. It is not to work out whether any of that list applies. A pregnancy with complications belongs in a plan written with the clinician rather than around them.

Teach the client the stop signals as well: vaginal bleeding, regular painful contractions, fluid leaking, shortness of breath before exertion, dizziness, headache, chest pain, calf pain or swelling, or muscle weakness that affects balance. Any of those ends the session and goes back to the clinician.

ACOG's baseline is at least 150 minutes of moderate-intensity aerobic activity per week for a pregnancy without complications, spread across the week rather than stacked into one day. A client who trained before pregnancy can generally continue what she was doing, adjusted as the pregnancy progresses.

Heart rate is a poor dial in pregnancy, because resting heart rate and blood volume both change. Use the rating of perceived exertion instead, around 13 to 14 on the 6 to 20 Borg scale, or the talk test: if she cannot hold a conversation, the intensity is above moderate.

Resistance training twice a week at 2 to 3 sets of 10 to 15 reps with continuous breathing sits comfortably alongside that aerobic volume. Pelvic floor muscle training is worth including too, and it is one of the better-supported additions here for reducing the risk of urinary incontinence around birth.

Fall risk is the clearest exclusion, and it grows as the centre of gravity shifts. Contact sport, activities where a fall is likely, and unsupported single-leg work all drop out; lunges, split squats, jump squats and high knees come out of a general plan for exactly this reason.

Heavy maximal lifting comes out because of the breathing that goes with it. A barbell squat or deadlift taken near failure invites a Valsalva manoeuvre, which spikes intra-abdominal pressure and blood pressure. Moderate loads with continuous breathing do not, so the change is the intensity rather than the movement.

From around the second trimester, positions that need prolonged flat lying on the back or on the front become impractical. The bench press, floor press, dead bug, plank and supine glute bridge all have a seated or standing equivalent. The stated concern with prolonged motionless supine lying is compression of the vena cava, and it is worth being honest that the evidence for harm during exercise is weak; comfort and the occasional bout of light-headedness are the practical reasons to switch.

A few exclusions sit outside the gym entirely: scuba diving, hot yoga or hot pilates, and vigorous activity at high altitude for someone who is not acclimatised are all advised against during pregnancy.

• Contact sport and anything with a realistic fall risk
• Jumping, impact and fast changes of direction
• Unsupported single-leg work such as lunges and split squats
• Heavy lifts taken near failure, because of the breath-holding
• From the second trimester, exercises that need lying flat on the back or the front
• Scuba diving, hot yoga, and unacclimatised exertion at high altitude

Most of it survives. Squats to a comfortable depth with support if needed, supported step work, hip hinges with a light load, seated and standing pressing and rowing, cable and machine work, band work, and low-impact cardio on a bike or a cross trainer are all normally fine.

Trunk work moves rather than disappears. Side-lying work, standing anti-rotation work, bird dog variations and pelvic floor work replace the supine and prone core exercises that get dropped, so the client still has a core block on the worksheet.

Loaded trunk flexion such as a weighted crunch or a cable crunch is usually left out later in pregnancy. The evidence for harm is thin here too; the practical reasons are comfort and the coning along the midline that some clients get.

After delivery, activity can usually be resumed gradually as soon as it is medically safe, and the timeline depends on the birth. A caesarean or a complicated delivery changes it, so the return date is the clinician's call rather than a fixed number of weeks you apply to everyone.

Build back with volume before intensity, and treat pelvic floor and trunk work as the entry point rather than the finishing touch. Urinary leakage, a feeling of heaviness or bulging, and pain during intercourse are all reasons to send the client back to a clinician rather than to progress the plan.

In RungGym, ticking pregnancy for a client removes the exercises the database flags for it from the entire plan: the supine and prone exercises, the jumping and balance-risk work, and the heavily loaded barbell lifts with a Valsalva risk.

Where an exercise only needs an adjustment, the note comes through on the worksheet. The bodyweight squat carries the instruction to limit depth in the third trimester and use support for balance if needed, and a split squat done against a bench carries the note to use support, keep the depth limited and set the bench lower.