Guidelines and Recommendation for Exercise in Pregnant Women – SERIES 3


The specific recommendations in this 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).

  • 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,a low quality evidence).
  • Women categorized as overweight or obese (pre-pregnancy body mass index ≥25 kg/m2) (strong recommendation,b low quality evidence).
  • 2Pregnant women should accumulate at least 150 minutes of moderate-intensityc physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications (strong recommendation, moderate quality evidence).
  • 3Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged (strong recommendation, moderate quality evidence).
  • 4Pregnant women should incorporate a variety of aerobic exercise and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial (strong recommendation, high quality evidence).
  • 5Pelvic floor muscle training (e.g., Kegel exercises) may be performed on a daily basis to reduce the risk of urinary incontinence. Instruction in proper technique is recommended to obtain optimal benefits (weak recommendation,d low quality evidence).
  • 6Pregnant women who experience light-headedness, experience nausea, or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position (weak recommendation,every low quality evidence).





The objective is to provide guidance for pregnant women, and obstetric care and exercise professionals, on prenatal physical activity.


The outcomes evaluated were maternal, fetal, or neonatal morbidity or fetal mortality during and following pregnancy.


Literature was retrieved through searches of Medline, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full-text, Child Development & Adolescent Studies, ERIC, Sport Discus,, and the Trip Database from database inception up to January 6, 2017. Primary studies of any design were eligible, except case studies. Results were limited to English, Spanish, or French language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal, or neonatal morbidity or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.


The Guidelines Consensus Panel solicited feedback from end-users (obstetric care providers, exercise professionals, researchers, policy organizations, and pregnant and postpartum women). The development of this guideline followed the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument.

Benefits, harms, and costs

The benefits of prenatal physical activity are moderate, and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end-users indicated that following these recommendations would be feasible, acceptable, and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.