Canadian Guidelines for Exercise during Pregnancy
Regularly participating in physical activity throughout one’s life is linked to many health advantages including increased physical fitness and mental health, alongside a reduction in chronic diseases and mortality.
Pregnancy is a unique time in a person’s life where lifestyle choices, including exercise, can have a significant impact on a person’s own health and the health of their growing baby. Nevertheless, a small percentage of women are participating in regular physical activity itself, nevermind the 150min per week that is typically mentioned. This may be because not enough information is provided at prenatal visits about safe pregnancy activities or the amount of exercised needed per week. Furthermore, many people may worry that physical acitivity may increase miscarriage risk.
Participating in physical activity is also associated with reduced adverse pregnancy outcomes and adverse fetal outcomes. Notable adverse pregnancy outcomes include gestational diabetes, gestational hypertension, preeclampsia, depression and more.
Exercise Recommendations in Pregnancy
Canadian guidelines state that:
All women should be physically active during pregnancy
at least 150 min of moderate-intensity physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications
In people less than 29 years old, moderate intensity is 125-146 beats per minute (bpm)
In people older than 30, moderate intensity is 121-141 bpm
Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged
A variety of aerobic and resistance training activities should be incorporated to achieve greater benefits. This also includes yoga and/or gentle stretching
When to start exercising in pregnancy
For people who have been inactive in the past, they are encouraged to engage in physical activity in pregnancy, but may need to start gradually and at a lower intensity. As their pregnancy progresses, they can increase the duration and intensity of exercise.
Safety Precautions for Exercise
Not all types of physical activity is safe in pregnancy. The guidelines list safety precautions to be mindful of:
Avoid physical activity in excessive heat, especially with high humidity (ex. hot yoga)
Avoid activities which involve physical contact (ex. hockey) or danger of falling (ex. non-stationary cycling)
Avoid scuba diving
People living below 2500m should avoid physical activity at high altitude (>2500m)
Safe & Beneficial Exercise in Pregnancy
Walking
Stationary cycling
Aerobic exercises
Dancing
Resistance exercises (ex. using weights, elastic bands)
Stretching exercises
Hydrotherapy, water aerobics
When to stop physical exercise immediately
Continuous shortness of breath, which doesn’t resolve with rest
Severe chest pain
Regular and painful uterine contractions
Vaginal bleeding
Continuous fluid loss from the vagina, suggesting membrane rupture
Continuous dizziness or faintness, which doesn’t resolve with rest
Contraindications to Exercise
There are two types of contraindications to be aware of: relative and absolute.
Relative Contraindications
Exercise should be discussed with your primary or obstetrical care provider to discuss the advantages and disadvantages of moderate-to-vigorous intensity activity before beginning.
The following are relative contraindications, pulled directly from the guidelines:
Recurrent pregnancy loss
Gestational hypertension
A history of spontaneous preterm birth
Mild/moderate cardiovascular or respiratory disease
Symptomatic anaemia
Malnutrition
Eating disorder
Twin pregnancy after the 28th week
Other significant medical conditions
Absolute Contraindications
Pregnant people with absolute contraindications should not participate in moderate-to-vigorous intensity activity.
The following are absolute contraindications, pulled directly from the guidelines:
Ruptured membranes
Premature labour
Unexplained persistent vaginal bleeding
Placenta previa after 28 weeks gestation
Preeclampsia
Incompetent cervix
Intrauterine growth restriction
High-order multiple pregnancy (ex. triplets)
Uncontrolled type I diabetes
Uncontrolled hypertension
Uncontrolled thyroid disease
Other serious cardiovascular, respiratory or systemic disorder
Next Steps
As you can see, exercise in pregnancy is beneficial as it helps to reduce adverse outcomes. To determine if it’s safe for you to begin or continue exercise speak to your family doctor or obstetrical care provider.
Naturopathic Doctors can also guide your exercise journey in pregnancy, and ensure that you’re nourishing yourself in the best manner possible. If interested, contact me for more information.