What are the exercise guidelines for pregnancy?

From the Guidelines

Pregnant women should aim for at least 150 minutes of moderate-intensity physical activity per week, accumulated over a minimum of 3 days, and incorporate a variety of aerobic and resistance training activities to achieve greater benefits. This recommendation is based on the strongest and most recent evidence from the 2019 Canadian Guideline for Physical Activity throughout Pregnancy 1 and the World Health Organization 2020 guidelines on physical activity and sedentary behaviour 1.

Key Recommendations

• All women without contraindication should be physically active throughout pregnancy, with a strong recommendation and moderate-quality evidence 1
• Pregnant women should accumulate at least 150 min of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications, with a strong recommendation and moderate-quality evidence 1
• Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged, with a strong recommendation and moderate-quality evidence 1
• Incorporating a variety of aerobic and resistance training activities, as well as adding yoga and/or gentle stretching, may be beneficial, with a strong recommendation and high-quality evidence 1

Important Considerations

• Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position, with a weak recommendation and very-low quality evidence 1
• Pelvic floor muscle training (PFMT) may be performed on a daily basis to reduce the risk of urinary incontinence, with a weak recommendation and low-quality evidence 1
• Pregnant women should limit the amount of time spent being sedentary and replace sedentary time with physical activity of any intensity, as recommended by the World Health Organization 2020 guidelines 1

Benefits of Exercise During Pregnancy

• Regular exercise during pregnancy can help manage weight, reduce pregnancy discomfort, improve sleep, increase energy, boost mood, prepare for childbirth, and may reduce the risk of gestational diabetes and cesarean delivery
• Exercise during pregnancy confers benefits for maternal and fetal health outcomes, including reduced risk of pre-eclampsia, gestational hypertension, gestational diabetes, excessive gestational weight gain, delivery complications, and postpartum depression, as recommended by the World Health Organization 2020 guidelines 1

From the Research

Exercise Guidelines for Pregnancy

• Physical activity is essential for maternal and infant health, and healthcare professionals should inform pregnant women about the benefits of physical activity to prevent possible health issues 2
• Moderate intensity activities are recommended during the whole time of pregnancy, and benefits have been reported for aerobic exercise, lumbar stabilization and stretching exercise, water exercise, nerve and tendon-slip exercise, resistance training, and strength training 2
• Yoga has been shown to benefit women who suffer from anxiety, depression, stress, low back pain, and sleep disturbances during pregnancy, and its safety has been demonstrated for first-time practitioners and fetal tolerance 3
• Pilates exercise may reduce pregnancy-related low-back pain more than usual prenatal or no exercise, with moderate-quality evidence supporting its effectiveness 4

Types of Exercise

• Yoga interventions have been found to reduce anxiety, depression, and perceived stress, and to reduce duration of labor and increase odds of normal vaginal birth 5
• Pilates has been shown to be effective in improving sleep quality, pain, depression, and other maternal health outcomes during pregnancy, with variations in method, frequency, and practitioners highlighting the need for standardized protocols 6
• Aerobic exercise, lumbar stabilization and stretching exercise, water exercise, nerve and tendon-slip exercise, resistance training, and strength training are also recommended during pregnancy 2

Frequency and Duration

• Twelve or more yoga sessions delivered weekly/bi-weekly have been found to have a statistically significant impact on mode of birth, while 12 or more yoga sessions of long duration (> 60 min) have been found to have a statistically significant impact on perceived stress 5
• Pilates exercise duration has been found to range from 4 to 16 weeks, with twice-weekly sessions being the most common 6