New research published in Medicine & Science in Sports & Exercise (the flagship journal of the American College of Sports Medicine) is challenging long-held assumptions about high-intensity and high-load resistance training in early pregnancy.
This study examined women in their first trimester who were already engaged in high-load resistance training prior to pregnancy. Importantly, it explored an area often missing from pregnancy exercise research: pelvic floor health.
Key findings included:
- Pelvic floor symptoms (including stress urinary incontinence) did not worsen in the first trimester and, in many cases, improved
- Many women safely maintained high training loads (>80% of pre-pregnancy 1RM)
- Miscarriage rates were consistent with population norms, with no increased risk associated with high-load training
- Pre-conception pelvic floor symptoms were common — highlighting the importance of pelvic health assessment before and during pregnancy
- Fatigue and nausea, rather than safety concerns, were the main barriers to exercise in early pregnancy
This research reinforces the importance of individualised, evidence-informed guidance rather than blanket restrictions — particularly for active and athletic women. It also highlights a critical gap in care following miscarriage, where many women receive little or no guidance on returning to exercise.
(Prevett & Davenport, 2026)
