While studies have long shown the beneficial health effects of physical activity during pregnancy, such recommendations have been rarely analyzed in terms of how practitioners adapt such health messages to patients’ social profiles. The present study sought to apprehend the logics underlying practitioner (non)recommendations of physical activity and exercise during pregnancy, and how these were associated with social distinctions made between patients. Semi-directive interviews were conducted with 20 midwives and 17 gynaecologists and obstetricians in south-eastern France. Based on thematic analyses, the results show how recommendations draw from both medical and social knowledge, mobilizing social representations regarding physical activity, (non)normative bodies and othered social categories of class, ethnicity or obesity. The othering processes reiterate gendered social hierarchies as well as moral orders surrounding normative bodies and health-enhancing behaviours. The findings demonstrate how social hierarchies and beliefs intertwine with public health discourses about the body and health-enhancing practices, suggesting directions for reducing their impact in contexts of medicine and health.