This article reviews the key considerations for strength and conditioning practitioners working with female athletes during pregnancy. As more athletes continue their sporting careers through pregnancy and motherhood, coaches need to understand the anatomical and physiological changes that occur across the three trimesters and how these may influence training. The article discusses cardiovascular, respiratory, hormonal and postural adaptations, alongside nutritional requirements and weight management during the antenatal period. 

Practical guidance is provided for adapting exercise throughout pregnancy, with emphasis on an individualised approach that prioritises maternal and foetal health. Considerations include modifying training volume and intensity, monitoring exercise using heart rate and the talk test, and adapting resistance training as pregnancy progresses. The article also identifies activities that may present increased risk, including contact sports, activities with a risk of falling and exercises involving high impact or excessive strain. 

Pelvic floor function and diastasis recti are also addressed, with practical recommendations for exercise prescription and referral where appropriate. The article highlights absolute and relative contraindications to exercise and the importance of ongoing communication between the athlete, coach and medical professionals. It concludes that physical activity can be safely undertaken during pregnancy when programmes are appropriately monitored and adapted, with health rather than performance placed at the centre of sporting decisions.