Women’s Health — all lessons

Contraindications and precautions of prenatal exercise

Absolute and relative contraindications to exercise in pregnancy, warning signs to stop, and activities to avoid, based on current guidelines.

Advanced Evidence: Strong evidence 3 min read Reviewed 2026-10-31 Status: draft

Learning objectives

  • List absolute and relative contraindications
  • Identify warning signs to stop exercise
  • Identify activities to avoid in pregnancy
  • Apply screening tools

Before this lesson

Why this matters

Most pregnant women can exercise safely, but some conditions make it unsafe.

Absolute contraindications (examples) [mottola2018]

  • Ruptured membranes
  • Premature labour
  • Unexplained persistent vaginal bleeding
  • Placenta praevia after 28 weeks
  • Pre-eclampsia
  • Incompetent cervix
  • Intrauterine growth restriction
  • High-order multiple pregnancy (e.g., triplets)
  • Uncontrolled type 1 diabetes, hypertension or thyroid disease
  • Other serious cardiovascular, respiratory or systemic disorders

Relative contraindications (examples)

Recurrent pregnancy loss, gestational hypertension, history of spontaneous preterm birth, mild/moderate cardiovascular or respiratory disease, symptomatic anaemia, malnutrition, eating disorder, twin pregnancy after 28 weeks.

Activities to avoid [acog2020]

Contact sports, activities with high fall risk, scuba diving, hot yoga or exercise in excessive heat, and exertion at high altitude without acclimatisation.

Screening

Use a pregnancy-specific screening tool (e.g., the CSEP Get Active Questionnaire for Pregnancy) and the obstetric provider’s advice.

Common mistakes and misconceptions

Case study

A client at 30 weeks reports a diagnosis of placenta praevia. The trainer pauses the programme and contacts her with a request to follow her obstetrician’s guidance.

Further learning: video lessons

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Knowledge check

Knowledge check · 0/5

1. An absolute contraindication is…

Answer B. Mottola et al. (2018).

2. A warning sign to stop exercise is…

Answer B. Seek care.

3. An activity to avoid in pregnancy is…

Answer B. Decompression risk.

4. A relative contraindication requires…

Answer B. Individual decision.

5. Placenta praevia after 28 weeks is…

Answer B. Canadian guideline.

Short-answer & application questions

  1. Create a prenatal screening checklist.
  2. Write a stop-exercise card for clients.
  3. List safe alternatives to contact sports.

Key takeaways

  • Absolute contraindications include ruptured membranes, preterm labour, persistent unexplained bleeding, placenta praevia after 28 weeks, pre-eclampsia and uncontrolled serious conditions.
  • Relative contraindications require discussion with the obstetric provider.
  • Stop and seek care for warning signs such as bleeding, contractions, fluid leakage, chest pain or dizziness.
  • Avoid contact sports, activities with high fall risk, scuba diving and exercise in excessive heat.

Connected topics

References

  1. Mottola MF, Davenport MH, Ruchat SM, et al. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52(21):1339–1346. doi:10.1136/bjsports-2018-100056 Guideline check pending
  2. American College of Obstetricians and Gynecologists (2020). Physical activity and exercise during pregnancy and the postpartum period: ACOG Committee Opinion No. 804. Obstetrics & Gynecology, 135(4):e178–e188. Guideline check pending

Educational content only — not medical advice. Consult a qualified clinician for diagnosis or treatment.