Review underscores health benefits of physical activity during pregnancy

August 13, 2019

Previous studies have shown that – at best – only one in three pregnant women is exercising enough, despite the known health benefits and guidelines set forth by several leading health organizations.

Dr. Kelly Evenson

Dr. Kelly Evenson

“Exercise carries a host of health benefits for both mom and baby, but we are clearly falling short in encouraging pregnant women to stay physically active or in helping them address barriers to doing so,” says Kelly Evenson, PhD, professor in the Department of Epidemiology at the UNC Gillings School of Global Public Health.

To encourage greater education about physical activity recommendations as part of routine clinical care for pregnant women, Evenson and her team conducted a careful review and comparison of three national guidelines and one international guideline on physical activity during pregnancy. The paper, “Review of Recent Physical Activity Guidelines During Pregnancy to Facilitate Advice by Health Care Providers,” for which she is lead author, was published in the August issue of Obstetrical and Gynecological Survey.

Physical activity has been linked with a lower risk of pregnancy complications such as high blood pressure, new onset diabetes during pregnancy, cesarean section, excessive weight gain and preterm birth, as well as a shorter length of labor. During the postpartum period, it also is associated with shorter recovery time and reduced symptoms of depression.

“Each of the four guidelines, which are informed by the latest evidence, align in their recommendation that apparently healthy pregnant women, under the guidance of their health care provider, should take part in regular light and moderate intensity aerobic and muscle conditioning activities,” Evenson says.

The team examined national guidelines from the American College of Obstetrics and Gynecology (ACOG), the Society of Obstetricians and Gynecologists of Canada, and the United States’ Physical Activity Guidelines for Americans (second edition). In addition, they reviewed the International Olympic Committee expert panel recommendations released between 2016-2018.

ACOG recommends women get at least 20 to 30 minutes of physical activity a day; similarly, the Canadian and other expert guidelines suggest at least 150 minutes of physical activity spread throughout the week. The types of activities recommended include walking, swimming, stationary cycling and low-impact aerobics, modified yoga or pilates. Women should be able to talk while exercising to gauge whether they are over-exerting themselves. Women who were inactive prior to pregnancy are advised to start exercise more gradually, at a lower intensity or duration.

The review also identifies key challenges clinicians face when talking with women about physical activity and other health habits that need to be addressed, such as nutrition and weight. Potential barriers, according to researchers, include a belief that intervening might cause negative consequences to the pregnancy or baby, an unsupportive environment, and a lack of knowledge, time and resources. Evenson and her team share tools and resources to assist health care providers tin having these discussions.

“Clinicians are busy, and many may not be aware of the updated guidelines for physical activity during and following pregnancy, or the tools that are available to help them,” Evenson says. “We are hopeful that this review will provide clarity about the latest recommendations and increase their use by clinicians and, in turn, increase the level of participation in physical activity among healthy pregnant women.”

This review was conducted in collaboration with researchers at the University of Western Ontario in Canada and Saint Louis University in Missouri.

Contact the Gillings School of Global Public Health communications team at

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