From Conception to Court: A Guide to Exercise and Pickleball During Pregnancy
In my last article, I playfully explored how the pickleball craze seemed to bring a wave of pregnancies among active women. While we can’t say the sport itself causes conception, there is real science behind the idea: regular physical activity improves hormonal balance, metabolic health, and overall well‑being, all of which can boost fertility. Women who stay active often have more regular cycles, and maintaining a healthy weight makes it easier for the body to conceive. So in a roundabout way, getting more women moving—whether on a pickleball court, a walking trail, or a swimming pool—may very well be helping more families grow.
But now, the question every obstetrician hears the moment a patient sees that positive pregnancy test: “Doc, I got pregnant playing pickleball… can I keep playing?” The short answer is not a simple yes or no. It depends on your trimester, your experience level, and how you play. Let me walk you through what you need to know.
First, the good news: for women with healthy, uncomplicated pregnancies, regular exercise is not only safe—it is strongly encouraged. Major medical organizations recommend at least one hundred fifty minutes of moderate‑intensity aerobic activity each week. That breaks down to about twenty to thirty minutes on most days. Moderate intensity means you can still carry on a conversation while you are moving—think brisk walking, swimming, stationary cycling, or prenatal yoga. The benefits are impressive: women who exercise regularly have up to thirty‑eight percent lower risk of developing gestational diabetes, and up to forty‑one percent lower risk of pre‑eclampsia. They gain less excess weight, have lower blood pressure, and often experience shorter labours with fewer caesarean deliveries. Beyond that, exercise eases back pain, reduces leg swelling, and lifts the mood, helping to ward off both antenatal and postpartum depression.
Of course, exercise is not for everyone. There are certain conditions where you should not exercise at all. These include severe heart or lung disease, severe pre‑eclampsia, uncontrolled diabetes or high blood pressure, cervical insufficiency, unexplained vaginal bleeding, preterm labour, placenta praevia after twenty‑eight weeks, severe anaemia, and triplet or higher‑order pregnancies. There are also conditions where exercise may be allowed but only after a thorough discussion with your doctor—these include a history of recurrent miscarriage, extreme obesity, severe underweight, twin pregnancies, or poorly controlled seizures. Always check with your obstetrician before starting or continuing any exercise routine during pregnancy.
Now, let us talk specifically about pickleball. Unlike walking or swimming, pickleball comes with unique risks that require extra caution. The first is the risk of falling. As your belly grows, your centre of gravity shifts forward, making sudden stops, quick pivots, and lateral movements much more challenging. A fall on the court can cause abdominal trauma or even placental abruption. The second risk involves your joints. The hormone relaxin, which surges during pregnancy, loosens your ligaments to prepare for childbirth—but that also makes your ankles and knees more prone to sprains. Third, the Philippine heat adds another layer of concern. Overheating, especially in the first trimester when your baby’s neural tube is developing, can be harmful. That is why hydration and temperature control are critical.
So, what does the trimester‑by‑trimester advice look like? In the first trimester, you may be able to continue playing, but only if you are an experienced player. You should limit yourself to social doubles matches—never competitive singles—and stop the moment you feel nauseous, dizzy, or unusually tired. Hydrate before, during, and after every game. If you have never played pickleball before, pregnancy is not the time to start.
By the second trimester, things change significantly. After twenty weeks, your balance is noticeably altered, and competitive play should stop entirely. Even social doubles become riskier. If you truly insist on playing, restrict yourself to indoor courts with good traction, take frequent rest breaks, and never play more than fifteen to twenty minutes at a time. But honestly, this is the time to start transitioning to safer alternatives like walking or swimming.
By the third trimester, the recommendation is clear: hang up your paddle. The fall risk is simply too high, and your balance is significantly impaired. No game is worth endangering you or your baby. Instead, keep moving with gentle, low‑impact activities that keep you fit without the risks of quick directional changes.
No matter what stage of pregnancy you are in, you must know the warning signs that require you to stop any exercise immediately and call your doctor. These include vaginal bleeding or leakage of fluid, regular and painful contractions, dizziness, headaches, chest pain, shortness of breath that comes on before exertion, calf pain or swelling that could signal a blood clot, and a noticeable decrease in your baby’s movements. If any of these occur, do not wait—seek medical attention right away.
Let us also talk about our tropical climate here in the Philippines. To stay safe while staying active, plan your exercise during the cooler hours—early morning or early evening—and choose air‑conditioned indoor courts whenever you can. Drink water regularly throughout the day, not just when you feel thirsty, because dehydration can sneak up on you quickly in our heat. I also want to address a common belief many Filipino women hold—that bed rest is always best during pregnancy. While there are specific medical conditions that truly require it, for most healthy pregnancies, too much bed rest does more harm than good. It can weaken your muscles and even raise your risk of blood clots. More importantly, it does not prevent preterm birth in most cases. Unless your doctor specifically tells you to rest, remember that movement is medicine. Staying active—safely—is one of the best gifts you can give yourself and your baby.
So, here is my final take‑home message for every expecting mother who loves her pickleball: pickleball may have helped you conceive, but a healthy pregnancy demands smart choices. Keep your body moving—that is non‑negotiable—but choose your activities wisely. When in doubt, slow down or switch sports. Your paddle will still be waiting for you after you deliver. Your health and your baby’s health are always worth more than any game.
Medical Insider – Dr. Apple Cepedoza
