Pregnancy

Appendix C: American College of Obstetricians and Gynecologists’ Opinion on Exercise during Pregnancy*

Absolute contraindications to aerobic exercise during pregnancy:

• Hemodynamically significant heart disease
• Restrictive lung disease
• Incompetent cervix/cerclage
• Multiple gestation at risk for premature labor
• Persistent second or third trimester bleeding
• Placenta praevia after 26 weeks gestation
• Premature labor during the current pregnancy
• Ruptured membranes
• Preeclampsia/pregnancy-induced hypertension

Relative contraindications to aerobic exercise during pregnancy:

• Severe anemia
• Unevaluated maternal cardiac arrhythmia
• Chronic bronchitis
• Poorly controlled type I diabetes
• Extreme morbid obesity
• Extreme underweight (body mass index <12)
• History of extremely sedentary lifestyle
• Intrauterine growth restriction in current pregnancy
• Poorly controlled hypertension
• Orthopedic limitations
• Poorly controlled seizure disorder
• Poorly controlled hyperthyroidism
• Heavy smoker

Warning signs to terminate exercise while pregnant:

• Vaginal bleeding
• Dyspnea prior to exertion
• Dizziness
• Headache
• Chest pain
• Muscle weakness
• Calf pain or swelling (need to rule out thrombophlebitis)
• Preterm labor
• Decreased fetal movement
• Amniotic fluid leakage

*Reproduced with permission from the American College of Obstetricians and Gynecologists from “Exercise during pregnancy and the postpartum period.” ACOG Committee. Opinion No. 267. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2002;99:171-3.