Aug 19, 2025
Version 1
Structured Antenatal exercise protocol for 3rd trimester pregnancy V.1
- Razowana Tasnim1,
- Dr. Md. Feroz Kabir2
- 1Jashore University of Science and Technology;
- 2Jashore University of Science & Technology
Protocol Citation: Razowana Tasnim, Dr. Md. Feroz Kabir 2025. Structured Antenatal exercise protocol for 3rd trimester pregnancy. protocols.io https://dx.doi.org/10.17504/protocols.io.bp2l6zx7zgqe/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: August 18, 2025
Last Modified: August 19, 2025
Protocol Integer ID: 224896
Keywords: Pregnancy, Antenatal Exercise, Antenatal Care, Labor, Birth outcomes, structured antenatal exercise protocol for 3rd trimester pregnancy, trimester antenatal exercise protocol, antenatal exercise protocol, regular physical activity during pregnancy, structured antenatal exercise program, structured antenatal exercise protocol, activity in the third trimester, third trimester on maternal labor characteristic, overall maternal fitness, integrative strategies in obstetric care, neonatal birth outcomes in uncomplicated pregnancy, birth outcomes in uncomplicated pregnancy, third trimester, 3rd trimester pregnancy, refining maternal healthcare guideline, maternal labor characteristic, maternal healthcare guideline, uncomplicated pregnancy, safe exercise practice, obstetric care, promoting safe exercise practice, neonatal birth outcome, trimester, regular physical activity, optimal birth outcome, birth outcome, pregnancy, prolonged labor, neonatal well, affecting labor progress, labor progress, delivery outcome, lower
Abstract
Regular physical activity during pregnancy can enhance maternal well-being and support optimal birth outcomes. However, many women reduce activity in the third trimester due to discomfort and concerns, potentially affecting labor progress and delivery outcomes. Structured antenatal exercise protocol may improve overall maternal fitness, reduce prolonged labor, lower rates of operative delivery, and improve neonatal well-being. This study aims to evaluate the effectiveness of a structured antenatal exercise program in the third trimester on maternal labor characteristics and neonatal birth outcomes in uncomplicated pregnancies. This study will generate essential evidence on the effectiveness of a structured third-trimester antenatal exercise protocol in optimizing labor processes and birth outcomes in uncomplicated pregnancies. The findings will contribute to refining maternal healthcare guidelines, promoting safe exercise practices, and supporting integrative strategies in obstetric care.
Attachments
Protocol Summary.pdf
639KB
Guidelines
CONSORT
Troubleshooting
Intervention
Experimental Group: Structured Antenatal Exercise + Routine Antenatal Care
Structured Antenatal Exercise:
Warm-up:
• Frequency: Before every session
• Intensity: Low, comfortable pace
• Time: 5 minutes
• Type:
▪ Slow side stepping
▪ Shoulder rolls
▪ Arm circles
▪ Ankle circles
First 2 weeks:
• Frequency: 5 days/week
• Intensity: Moderate (perceived exertion: able to talk comfortably)
• Time: 30 minutes per session
• Type:
o Aerobic:
▪ Walking
▪ Stair climbing
o Stretching:
▪ Hip flexor stretch
▪ Ankle-to-knee stretch
▪ Calf stretch
▪ Butterfly stretch
▪ Seated saddle stretch
o Pelvic Floor:
▪ Kegel exercise
▪ Pelvic floor relaxation exercise
From 3rd week until labor
• Frequency: 5 days/week
• Intensity: Moderate (progress as tolerated, avoiding fatigue)
• Time: 30 minutes per session
• Type: Continue Aerobic, Stretching, and Pelvic Floor exercises +
o Add Strengthening:
▪ Bodyweight squats
▪ Lunges
▪ Leg raises
▪ Pelvic tilts
Cool-down
• Frequency: After every session
• Intensity: Relaxed, slow breathing
• Time: 5 minutes
• Type:
▪ Diaphragmatic breathing
▪ Relaxation exercise
Control Group: Routine Antenatal Care only without antenatal exercise
Protocol references
•Artal, R. and O’Toole, M. (2003) ‘Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period’, British Journal of Sports Medicine, 37(1), pp. 6–12. Available at: https://doi.org/10.1136/bjsm.37.1.6.
•Chauhan, A. et al. (2024) ‘Does antenatal exercise shape labor and delivery outcomes?’, Archives of
Gynecology and Obstetrics, 310(6), pp. 2957–2961. Available at https://doi.org/10.1007/s00404-024-07801-x.
•Chen, C. et al. (2024) ‘Effects of different physical exercise types on health outcomes of individuals with hypertensive disorders of pregnancy: a prospective randomized controlled clinical study’, The Journal of Maternal-Fetal & Neonatal Medicine, 37(1), p. 2421278. Available at: https://doi.org/10.1080/14767058.2024.2421278.
•Claiborne, A., Wisseman, B., Kern, K., Steen, D., Jevtovic, F., McDonald, S., et al. (2024) ‘Exercise during pregnancy dose: Influence on preterm birth outcomes’, European Journal of Obstetrics & Gynecology and Reproductive Biology, 300, pp. 190–195.
Available at https://doi.org/10.1016/j.ejogrb.2024.07.017.
•Claiborne, A., Wisseman, B., Kern, K., Steen, D., Jevtovic, F., McDonald, S., et al. (2024) ‘Exercise FITT‐V during pregnancy: Association with birth outcomes’, Birth Defects Research, 116(4), p. e2340.
Available at: https://doi.org/10.1002/bdr2.2340.
•Gascoigne, E.L. et al. (2023) ‘Physical activity and pregnancy outcomes: an expert review’, American
Journal of Obstetrics & Gynecology MFM, 5(1), p. 100758. Available at: https://doi.org/10.1016/j.ajogmf.2022.100758.
•Masoud, A.T. et al. (2020) ‘The effect of antenatal exercise on delivery outcomes: A systematic review and meta-analysis of randomized controlled trials’, Journal of Gynecology Obstetrics and Human Reproduction, 49(6), p. 101736. Available at: https://doi.org/10.1016/j.jogoh.2020.101736.
•Mrayan, L. et al. (2024) ‘Evaluate the effectiveness of using non-pharmacological intervention during childbirth: an improvement project in Jordanian maternity hospitals’, BMC Women’s Health, 24(1), p. 605. Available at https://doi.org/10.1186/s12905-024-03414-3.
•The effects of vigorous intensity exercise in the third trimester of pregnancy: a systematic review and
meta-analysis | BMC Pregnancy and Childbirth (no date). Available at: https://link.spr, 24(1), p. 605. Available at https://doi.org/10.1186/s12905-024-03414-3.5-024-03414-3.
• Yuksel, H. et al. (2017) ‘Effectiveness of breathing exercises during the second stage of labor on labor
pain and duration: a randomized controlled trial’, Journal of Integrative Medicine, 15(6), pp. 456–461. Available at: https://doi.org/10.1016/S2095-4964(17)60368-6.
Acknowledgements
This study will be partially funded by the Department of Physiotherapy and Rehabilitation, JUST, and Dhaka College of Physiotherapy.