Table 1. Goals for Prenatal and Postnatal Performance.^5,31,34.

Stage	Goals	Example Criterion
First Trimester	Discuss musculoskeletal changes Discuss physiological changes associated with pregnancy Introduce transverse abdominis control in association with proper diaphragmatic breathing Instruction in Rate of Perceived Exertion (RPE) Establish guidelines and develop exercise prescription Discuss warning signs and contraindications for exercise during pregnancy	Medical clearance for exercise Independence in RPE ratings Ability to appropriately contract and relax transverse abdominis without breath holding
Second Trimester	Encourage safe exercise and mobility Develop postural strength and endurance Review warning signs and contraindications for exercise during pregnancy	Medical clearance for exercise Awareness and independence of appropriate standing and sitting postures
Third Trimester	Improve coordination in relaxation of the pelvic floor musculature to allow for delivery while maintaining adequate facilitation for continence Continue focus on postural strength and endurance Education regarding potential birth positions as desired	Medical clearance for exercise Ability to contract and relax pelvic floor musculature without breath holding Awareness of options regarding birthing positions both with and without epidural intervention
Postpartum Weeks 0-2	Encourage safe and appropriate movement to facilitate healing Limit subjective pain levels associated with the expected decrease in activity after delivery Instruct and incorporate proper body mechanics for handling of newborn	Anterior/posterior pelvic tilting to assist with postural restoration Appropriate performance of diaphragmatic breath Light standing open kinematic chain (OKC) movements to mimic walking
Postpartum Weeks 3-4	Slowly improve coordination with pelvic floor and transverse abdominis musculature in association with proper diaphragmatic breathing Initiate a short duration (<15 minutes) walking program with frequency increasing as desired with increasing frequency and duration as tolerated	Transversus abdominis sets – 20x5s holds in supine, side-lying, and quadruped Bridges – double leg 30x5s 10 minutes of asymptomatic walking Pelvic floor contract/relax – short holds (<5s)
Postpartum Weeks 5-6	Increase walking program duration (<30 minutes) so long as symptoms are not noted during or after performance Incorporate functional movements required of the athlete for activities of daily living	Muscular endurance tasks i.e. repetitions of 15-30 with weights <10 lbs (baby can often be used as “weight” for functional performance) Pelvic floor contract/relax – long holds (10s) Clamshells, reverse clamshells, standing march/hip abduction/hip extension, quadruped fire hydrants/donkey kicks, sit to stand, double leg calf raises, 4-way straight leg raise
Postpartum Weeks 7-⁠12	Discuss medical clearance and differences in medical and musculoskeletal clearance for exercise Integrate strength, endurance, and power training to prepare for high impact exercise Potentially include impact exercise (8-10 week mark)	Muscular strength tasks i.e. repetitions of 8-12 with weights as tolerated Squats, single leg sit to stand, mountain climbers (to table), single leg calf raise, step ups 30 minutes asymptomatic walking
Postpartum Weeks 13+	Return to full activity including running/sport Running-specific medical interview to assist with prescription of individualized running plan35	Exercises completed with a metronome consistent with desired athlete cadence 60s of symptom free performance - single leg calf raise, single leg hop down from step, single leg hopping, jump in place, wall sit, plank hold