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 their lifestyle choices, including exercise, can have a significant impact on their health, and the health of their growing baby. Nevertheless, a small percentage of women are participating in regular physical activity itself, never mind the 150 minutes 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 exercise needed per week. Furthermore, many people worry that physical activity 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 are 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
Exercise during pregnancy can offer meaningful benefits and may help reduce the risk of certain adverse outcomes. As always, it’s important to check in with your midwife or obstetrical care provider to ensure it’s appropriate for you.
Some people also choose to work with a naturopathic doctor for additional guidance - supporting safe movement in pregnancy while ensuring nutrition keeps pace with changing needs.
If you’d like ongoing, low-pressure education around pregnancy care, exercise, and nourishment, I share this kind of information in my newsletter. You’re welcome to sign up if it feels supportive.