The specific recommendations in the 2019 Canadian Guideline for Physical Activity throughout Pregnancy are provided below with corresponding statements indicating the quality of the evidence informing the recommendations and the strength of the recommendations (explanations follow).

1. All women without contraindication should be physically active throughout pregnancy. Strong recommendation, moderate-quality evidence.

Specific subgroups were examined:

  • Women who were previously inactive. Strong recommendation, moderate-quality evidence.
  • Women diagnosed with gestational diabetes mellitus. Weak recommendation, low-quality evidence.
  • Women categorised as overweight or obese (prepregnancy body mass index ≥25 kg/m2). Strong recommendation ii , low-quality evidence.

2. Pregnant women should accumulate at least 150 min of moderate-intensityiii physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications. Strong recommendation, moderate-quality evidence.

3. Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged. Strong recommendation, moderate-quality evidence.

4. Pregnant women should incorporate a variety of aerobic and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial. Strong recommendation, high-quality evidence.

5. Pelvic floor muscle training (PFMT) (eg, Kegel exercises) may be performed on a daily basis to reduce the risk of urinary incontinence. Instruction on the proper technique is recommended to obtain optimal benefits. Weak recommendation iv , low-quality evidence.

6. 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. Weak recommendation v , very-low quality evidence.


All pregnant women can participate in physical activity throughout pregnancy with the exception of those who have contraindications (listed below). Women with absolute contraindications may continue their usual activities of daily living but should not participate in more strenuous activities. Women with relative contraindications should discuss the advantages and disadvantages of moderate-to-vigorous intensity physical activity with their obstetric care provider prior to participation.

The following are absolute contraindications to exercise:

  • Ruptured membranes.
  • Premature labour.
  • Unexplained persistent vaginal bleeding.
  • Placenta praevia after 28 weeks’ gestation.
  • Pre-eclampsia.
  • Incompetent cervix.
  • Intrauterine growth restriction.
  • High-order multiple pregnancy (eg, triplets).
  • Uncontrolled type I diabetes.
  • Uncontrolled hypertension.
  • Uncontrolled thyroid disease.
  • Other serious cardiovascular, respiratory or systemic disorder.

The following are relative contraindications to exercise:

  • 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.