Although a healthy lifestyle approach is intuitive for obese pregnant women, no guidelines currently exist to manage these women throughout pregnancy. Women who are medically prescreened for contraindications can engage in a walking program three to four times per week, starting at 25 min per session and adding 2 min per week until reaching 40 min, with sessions continuing until delivery. A target heart rate of 102–124 beats per minute should be promoted for women 20–29 years of age and a rate of 101–120 beats per minute for women 30–39 years of age. A pedometer step count of 10,000 steps per day is suggested as a goal, as this level of activity provides important health benefits. Combining healthy eating with a walking plan prevents excessive weight gain during pregnancy and promotes a healthy fetal environment.