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Walking in Pregnancy: How Much, at What Pace, Until When

Team Ri-Hub15 min lettura

Revisione clinica: Daniele Carretto, Fisioterapista (Albo 2019) · Pubblicato il 18 agosto 2026

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There is a question almost everyone asks around the fifth or sixth month, usually while already walking: am I doing too much, or too little? And the annoying thing is that there are no clear signals. Nothing specific hurts, you are just more tired than before, and you do not know whether that tiredness is a limit or an excuse.

Here are the three numbers that matter straight away:

  • 150 minutes a week of moderate-intensity activity: it is the total the guidelines ask for, and walking covers almost all of it;
  • in short bouts: nobody asks for half an hour in one go;
  • at a pace where you can talk but not sing: it is the most reliable yardstick you have.

Everything else (steps, distance, "until when") is background, and that is where most people go wrong.

The total: 150 minutes, and what that really means

The 2019 Canadian guideline, which remains the most solid reference on this subject, asks for at least 150 minutes a week of moderate-intensity aerobic activity, spread over at least three days and preferably all of them. The World Health Organization's 2020 recommendations give the same figure, throughout pregnancy and also after birth.

The American College of Obstetricians and Gynecologists' 2020 document contains a sentence worth reading twice: in the absence of obstetric or medical complications, physical activity in pregnancy is safe and desirable. Among the benefits observed it lists less gestational diabetes, fewer caesarean sections and fewer operative vaginal births, and shorter recovery times after birth.

So you are not asking for permission: you are following a recommendation.

Translated into an ordinary day, 150 minutes means 20 to 30 minutes a day, and they can be split however you like: ten after breakfast, ten on the shopping run, ten in the evening.

Split up or all at once? The data is more honest than you might expect

A randomised trial tested both versions, and the result is counterintuitive. Forty women with gestational diabetes were randomised between weeks 28 and 30: one group carried on with standard care (a continuous 30-minute walk almost every day), the other did three 10-minute walks after the main meals. Twenty-six completed it, with continuous glucose monitoring.

The result: spreading the activity into ten-minute blocks after meals did not improve blood glucose after the meal compared with continuous walking. In fact, that group spent about 57 minutes a day more sitting and about 11 minutes less moving. Adherence to the 30 daily minutes, however, was high in both cases.

So splitting it up is not a magic trick, but nor is it a stopgap. The real risk is something else: treating the walk as the task that entitles you to sit for the rest of the day.

In a randomised trial of 124 sedentary women, comparing walking and stretching on risk factors for pre-eclampsia, those assigned to walking exercised less than those assigned to stretching, and less and less as pregnancy progressed. The correct reading is not "stretching beats walking": it is that the best activity is the one you can actually keep up.

Momento tranquillo di una madre e del suo neonato che si rilassano a casa.

The steps: useful numbers, not rules

"Ten thousand steps" is not a recommendation for pregnancy, and an official step threshold does not exist. There are, however, useful observations to use as an order of magnitude.

In a Japanese longitudinal study of 70 women in the third trimester, wearing a hip accelerometer for four weeks, those who averaged 7,195 steps a day (with an overall activity level of 7.2 MET-hours a day) did better on several indicators of sleep quality, and a reduction in steps predicted poorer sleep. It is observational and on a small sample: it tells you the two travel together, not that walking more will make you sleep.

In the TOP randomised trial, of 425 pregnant women with obesity, the target proposed was 11,000 steps a day measured with a pedometer, and the physical activity intervention reduced weight gain in pregnancy by 1.38 kg on average.

In the 2026 AWARE study, of women with a short cervix, which means at high risk of preterm birth and not an ordinary pregnancy, those with a median below 3,500 steps a day gave birth at an earlier gestational age (34.9 weeks against 37.7) and were more often below 34 weeks (47.3% against 17.7%).

This needs to be read honestly: it is an association, in a selected and small population, and the direction could be reversed, since a pregnancy already going wrong makes people less active. But in the same study the prescribed restriction of activity did not prolong the pregnancy (hazard ratio 0.95, 95% CI 0.88 to 1.03). Generic "stay at rest" is not a treatment.

The pace: why the talk test beats the heart rate monitor

The old rule of 140 beats per minute is no longer in the guidelines. The reference today is moderate intensity, and the practical way to recognise it is the talk test: at that pace you can hold a conversation, but not sing.

There is a physiological reason. In a study of 51 women, tested on a treadmill at 20 and 32 weeks and at 12 weeks after birth, the rating of perceived exertion did not change across those points, neither at moderate nor at vigorous intensity. What did change was the relationship with energy cost: at 32 weeks, for the same oxygen consumption, the activity was more demanding. The authors' conclusion is the sentence to keep: pregnant women probably compensate by reducing their walking speed.

Your body is already doing the right thing on its own: slowing down is not giving in, it is the correct adjustment.

How walking changes, trimester by trimester

In a study that followed 30 women with the same kinematic analysis across all three trimesters, the spatio-temporal parameters of walking, such as speed and step length, did not change significantly. Something more subtle did: the time spent on one foot alone increased, and above all the base of support widened, and in the final part of pregnancy the tilt of the pelvis increased. The authors read the widening of the base as a safety strategy, not as a fault.

A study of 35 women adds the missing piece: during walking, lateral tilt of the trunk is the main strategy you use to keep your centre of mass within the base of support, and the changes depended more on the relative increase in weight than on absolute weight. What matters is not how much you weigh: it is how much you have changed compared with yourself.

If you feel clumsy and notice you walk with a wider stance, that is not a deterioration: it is an adaptation.

When walking sets off pubic or pelvic pain

It needs saying plainly: pelvic girdle pain is not caused by walking, but walking is one of the things that makes it impossible to ignore.

In a study of 324 women in pregnancy with pelvic girdle pain, 29.6% had a mild limitation of daily activities, 57.1% a moderate limitation and 13.3% a broad limitation. For seven women in ten it is something that changes the day.

And walking is where it shows. In a comparison of 12 women with pelvic pain and 12 without, walking speed was lower in those with pain, and it correlated negatively with fear of movement: you slow down to protect yourself, and slowing down becomes part of the problem. The sample is very small, it must be said. On balance, a study of 63 women between weeks 12 and 38 measured greater sway in those with pelvic pain, especially in the third trimester.

What to do in practice if walking sets off your pubis:

  • shorten the single stretch, not the total: four laps of seven minutes hurt less than one of half an hour, because pelvic pain has a distance threshold;
  • avoid asymmetries: sloping pavements, uneven paths, always climbing a step with the same leg, carrying the bag always on the same side;
  • stairs slowly, with both feet on the same step at the worst moments;
  • no long strides: lengthening the stride asks the pubic symphysis for exactly the movement that hurts.

Do not expect a pelvic belt to fix your walking. In a study of 46 pregnant women with pelvic pain, 58 without pain and 23 non-pregnant women, the differences in centre of plantar pressure during walking were minimal, and wearing the belt reduced walking speed. It is a support, not a correction.

If the pain is concentrated on the pubic bone, the full picture is in Pubic pain in pregnancy: what to do about pubic bone pain. If it wraps round to the back, the buttocks or the sacroiliac joints, it is pelvic girdle pain.

Is walking enough for back pain?

No, and this is one of the most honest things we can tell you.

The reference systematic review gathered 32 studies and 52,297 women. From 13 randomised trials it emerges that exercise in pregnancy does not reduce the likelihood of having back pain, pelvic girdle pain or lumbopelvic pain. From 15 randomised trials, however, it emerges that it reduces how much they hurt (standardised mean difference −1.03, 95% CI −1.58 to −0.48). The quality of the evidence ranges from "very low" to "moderate": the authors say so themselves.

And when the pain is already there, walking on its own rarely suffices. In a randomised trial of 45 women, the programme that worked, with better pain and disability scores at 36 weeks, was a combination: aerobic and strength exercises twice a week plus at least 30 minutes of brisk walking every day. It is the package that produced the result, not walking in isolation.

One note that still needs confirming: a randomised trial of 44 women with mild-to-moderate pain compared Nordic walking (three 45-minute sessions a week for 12 weeks) with standard care plus 30 minutes of moderate walking three times a week, and the group with poles improved on walking, pain and quality of life. It is a single small study: we would not build a recommendation on it.

The full picture of what is safe and what is not is in Exercise in pregnancy: recommended, not just allowed.

Shoes and terrain: the part nobody tells you

The foot really does change in pregnancy, and does not fully return to how it was.

In a longitudinal study of 49 women measured in the first trimester and again 19 weeks after birth, the height of the plantar arch and its stiffness had decreased significantly, while foot length and arch lowering had increased, and it was the first pregnancy that explained most of the change. It is not swelling that goes away: it is structure. Consistent with this, in a study of foot health in pregnancy, difficulties with footwear got worse trimester after trimester, peaking in the third.

What you need, concretely:

  • measure your foot now, do not trust last year's size: you may need half a size more;
  • a wide, stable sole, an upper that keeps the foot still, and an adjustable fastening for the swelling that changes through the day;
  • no slip-on shoes for long outings: very easy to put on, very bad to walk in;
  • a low heel but not completely flat: a couple of centimetres of difference unloads the calf;
  • if the swelling is significant, the issue is broader than shoes: we cover it in Swollen legs in pregnancy: what really helps.

Falls: how much happens, and where

In a study of 2,847 working women who had been pregnant, 26.6% had fallen during pregnancy and 6.3% at the workplace. In 66.3% of the falls at work, the woman was walking on a slippery floor, was in a hurry, or was carrying an object.

Stairs are the most involved setting. An analysis of United States emergency departments between 2008 and 2017 recorded 1,466 cases of pregnant women who fell on stairs, which, estimated across the country, corresponds to about 57,512 visits over ten years. A 2026 review of 33 studies confirms that the consequences range from mild to serious, with obstetric injuries that simply do not exist in other people.

But one finding reverses the instinct. In a small study of women followed in the second and third trimesters, 52% had fallen during pregnancy, and sedentary women were more likely to fall than those who did regular physical activity.

The answer to falls is not to walk less: it is to walk better. Even ground, good light, no rushing, hands free, a handrail on stairs, and avoiding wet or icy surfaces when you can.

The signs to stop

These need to be known by heart. If one of these appears during or after a walk, you stop and call whoever is following your pregnancy:

  1. excessive shortness of breath that does not go away with rest;
  2. strong chest pain;
  3. regular and painful uterine contractions;
  4. vaginal bleeding;
  5. persistent leaking of fluid from the vagina;
  6. dizziness or fainting that does not pass with rest.

There are two more that are closely connected with walking, and they are easy to mistake for normal:

  1. pain or swelling in one calf only, perhaps warm or red: in pregnancy blood clots more easily, and a calf that hurts on one side only is not tiredness. It needs checking the same day, not at the next appointment;
  2. a severe headache that does not pass, visual disturbances (flashes, spots, blurred vision), sudden swelling of the face and hands or pain under the right ribs: these are the signs of pre-eclampsia, and they require calling straight away.

Normal breathlessness, heavy legs in the evening on both sides, the need to sit down halfway are not on this list. They are pregnancy.

There is also a different category, which is not an emergency but is a signal not to ignore: if the pain you feel while walking increases from week to week, if the distance you can manage keeps getting shorter, if you wake at night to turn over in bed, or if you have started avoiding going out. In those cases the problem does not get solved by resting more.

What a physiotherapist can do (and what not)

If walking has become the worst part of your day, it is almost never necessary to stop. What is needed is for someone to look at how you walk, which side the pain appears on, how far you can go before it flares, and what you do in the twenty-three hours when you are not walking.

This can be done well over a video call too, because the real work is yours: the stretches you shorten, the stairs you do in a different way, the exercises you add twice a week. With Ri-Hub you start with a free twenty-minute introductory consultation with a physiotherapist: you tell us about a typical day, we look at how you move, and you leave with two or three things to change straight away. Follow-up sessions cost 29,90 €.

What we do not do, and we tell you first: we do not replace whoever is following your pregnancy. Bleeding, leaking fluid, contractions, high blood pressure or doubts about the baby's movements go through your gynaecologist or midwife, and we will tell you straight away to call them.

What really changes, according to 117 randomised trials: moving during and after pregnancy.

Sources

Sources last checked: September 2026.

Domande frequenti

How much should I walk in pregnancy?

The reference is not a distance, it is a weekly total: the guidelines ask for at least 150 minutes a week of moderate-intensity aerobic activity, spread over several days. Walking covers almost all of it. In practice that is 20 to 30 minutes a day, and they do not have to be consecutive: three 10-minute walks count the same as one of 30. If you have not been moving for months, the number to start from is not 150: it is what you can manage this week, plus a little more.

How many steps a day are right?

There is no official threshold in steps, and be wary of anyone who presents one as if it were a rule. What exists are observations: in a Japanese study of 70 women in the third trimester, those who averaged 7,195 steps a day, together with a high overall level of activity, slept better on several indicators, and a drop in steps was a factor predicting poorer sleep. In a study of 425 women with obesity, the target proposed was 11,000 steps a day, and the intervention reduced weight gain in pregnancy by 1.38 kg on average. These figures come from populations different from yours: use them as an order of magnitude, not as a task.

What pace should I walk at?

At a pace where you can talk but not sing. It is the most reliable test you have, because the perception of effort in pregnancy remains surprisingly stable: in a study of 51 women measured at 20 and 32 weeks and after birth, the rating of perceived exertion did not change across those points at the same intensity. What changes is the speed you choose spontaneously to feel at that level, and that is fine, because at 32 weeks the same perceived effort corresponds to a different energy cost. Slow down without feeling guilty: you are doing the right thing.

Does walking cause pubic pain or make it worse?

It does not cause it, but it is one of the activities that make it obvious, and walking more slowly is precisely one of the measured signs: in a comparison of 12 women with pelvic girdle pain and 12 without, walking speed was lower in those with pain, and it correlated with fear of moving. Pelvic pain really does limit daily life: among 324 women with this pain, 57.1% had a moderate limitation of activities and 13.3% a broad one. But the answer is not to stop altogether: it is to shorten the stretches, avoid asymmetries and be guided on what to train.

Until which week can I walk?

Until the end, if the pregnancy is proceeding without complications and you have none of the stop signs. There is no week when walking becomes forbidden. What changes in the third trimester is stability: the base of support widens, the tilt of the pelvis increases, and in a study of 63 women postural sway was greater in the third trimester regardless of pain. So you carry on, but on more predictable ground and with less hurry.

What shoes do I need?

A stable sole, a wide base, a fastening that keeps the foot still, and above all a size bought now, not last year. The foot really does change in pregnancy: in a longitudinal study of 49 women, arch height and stiffness had decreased and foot length had increased, and these changes were still present 19 weeks after birth, with a first pregnancy having more effect than later ones. And discomfort in footwear is one of the aspects that worsens most as pregnancy advances. It is not vanity: it is the shoe that no longer fits.

When should I stop and call someone?

Six signs need to be known by heart: excessive shortness of breath that does not go away with rest; strong chest pain; regular and painful uterine contractions; vaginal bleeding; persistent leaking of fluid from the vagina; dizziness or fainting that does not pass with rest. Add two that are easy to mistake for normal while walking: pain or swelling in one calf only, which needs checking the same day, and a severe headache with visual disturbances or sudden swelling of the face and hands, which are signs of pre-eclampsia. If one of these appears, the walk ends there and you call whoever is following your pregnancy. Breathlessness, heavy legs on both sides and the need to sit down for a moment are not on this list.

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