Expect unveils GLP-1-era pregnancy fitness and coaching model built around metabolic health
"Postpartum care begins in pregnancy"
Pregnancy and postnatal fitness platform Expect has launched a new model combining physician-approved exercise with virtual doula coaching, specifically designed to help women improve metabolic health before, during and after pregnancy.
The company says the programme aims to reduce the risk of gestational diabetes, later-life diabetes and other complications — as the use of GLP-1 drugs such as Ozempic and Wegovy continues to rise among women of reproductive age.
Expect, available globally on iOS and Android, offers medically reviewed workouts for pregnancy and postpartum. Every session is approved by a panel of 17 practising physicians from major US medical centres including the University of Chicago and NYU Langone, with the aim of making prenatal exercise as safe and effective as possible.
“Postpartum care begins in pregnancy,” says CEO and co-founder Dara Cook. “We’re building resilience before, during, and after delivery — so women aren’t just surviving motherhood, they’re thriving through it.”
GLP-1s and the maternal health gap
GLP-1 agonists such as Ozempic and Wegovy are not approved for use in pregnancy, but their popularity in the wider metabolic health market has prompted fresh discussion about how best to support women at key reproductive stages. Even high-profile figures have entered the conversation — Serena Williams recently revealed she used a GLP-1 medication through the telehealth company Ro following the birth of her second child.
Gestational diabetes affects roughly one in ten pregnancies, and half of those women go on to develop type 2 diabetes later in life. Expect’s new initiative focuses on reducing these risks through movement — supporting women to build metabolic resilience before, during and after pregnancy.
As Cook continues: “Working out in pregnancy and postpartum is the only time you work out for two—yourself and your baby. Fitness needs to join the pantheon of healthy eating and sleeping as a hallmark of a healthy pregnancy.”
Virtual doula coaching for everyday support
The company’s new Expect Doula Coach pairs users with certified doulas who provide light-touch, ongoing support between medical visits. Coaches check in weekly by text, hold two brief video sessions each month, and are trained to flag concerns that may require escalation to a user’s obstetric team.
Unlike most fitness apps, Expect’s platform blends movement with emotional and practical care. Each user gets trimester-specific exercise plans drawn from Expect’s OB/GYN-approved movement library, along with clear “when to pause and call” guidance for safety.
The aim is to improve adherence and reduce preventable complications such as unnecessary triage visits or delayed postpartum recovery. Expect also sees potential for the model to support overstretched hospitals and insurers seeking scalable, between-visit support. For doulas, it offers flexible, paid virtual roles with clear training and clinical protocols.
Building resilience before and after birth
The company’s medical advisor, Dr I-Min Lee of Harvard Medical School, co-authored research showing that exercising in the year before pregnancy can cut the risk of gestational diabetes by more than 75%. Expect’s approach, Cook says, is to “move prevention upstream”.
Cook founded Expect after watching her sister, who had her first child at 35, experience a smooth pregnancy and a 20-minute active labour. Her obstetrician credited one key factor: consistent exercise. That realisation — and the lack of medically vetted fitness guidance for pregnancy — led Cook and co-founder Joseph Pacheco to build Expect around a medical review process that treats pregnancy fitness as a clinical as well as consumer issue.
Doula coaching costs $249, or the app on its own costs $19.99 a month (or $199 a year) and is FSA/HSA eligible. Expect also partners with organisations including Penn Medicine, the Boston Public Health Commission, and Harvard Pilgrim Health Plans. Pelvic floor physical therapists now prescribe Expect to patients directly and its flagship programme, Pelvic Floor Rescue, was designed by a board-certified therapist and reviewed by a urogynecologist — tackling an issue that affects more than 90% of women during or after pregnancy.
“Pregnancy has a similar impact on the body as running an ultra-marathon,” says Cook. “Expect trains you for it better than anyone else.”