REF-567 · American College of Obstetricians and Gynecologists (ACOG), 2020 · Obstetrics & Gynecology, 2020 Apr;135 · Paper · PubMed
Physical Activity and Exercise During Pregnancy and the Postpartum Period (ACOG Committee Opinion No. 804)
Key Findings
When there are no obstetric or medical complications or contraindications, physical activity during pregnancy is safe and desirable; pregnant women should get encouragement to continue or begin safe physical activity.
Women who regularly did vigorous-intensity aerobic activity, or were physically active, before pregnancy can continue it through pregnancy and the postpartum period.
Observational studies show benefits: decreased gestational diabetes mellitus, cesarean birth and operative vaginal delivery, and shorter postpartum recovery time; physical activity can be an essential factor in preventing postpartum depressive disorders.
Risks are minimal; some modification of routines may be needed because of normal anatomic and physiologic changes and fetal requirements.
The document lists absolute and relative contraindications and warning signs to stop exercise (full text; not checked against the abstract): e.g. hemodynamically significant heart disease, restrictive lung disease, cervical insufficiency/cerclage, multiple gestation at risk of preterm labor, persistent 2nd/3rd-trimester bleeding, placenta previa after 26 weeks, ruptured membranes, preterm labor, preeclampsia, severe anemia; stop for vaginal bleeding, dyspnea before exertion, dizziness, headache, chest pain, calf pain/swelling, regular painful contractions, amniotic-fluid leakage.
Practical Application
ACOG Committee Opinion 804 (2020): without obstetric or medical contraindications, exercise in pregnancy is safe and desirable; women who did vigorous aerobic activity before pregnancy can continue it during pregnancy and postpartum; observational evidence links exercise to less gestational diabetes, fewer cesarean and operative deliveries, faster postpartum recovery and prevention of postpartum depression.
Require OB clearance and rule out the CO 804 contraindication list before programming; a "yes to any" = stop and refer — the screening is clinical, not a coaching call.
A previously vigorous exerciser generally does NOT need to detrain on principle — maintain, then modify for anatomic/physiologic changes and symptoms.
Teach the warning-signs list (full text) as hard session-stop rules; frame postpartum activity as protective against depression, not just fitness.
Dosing (minutes/week, days/week) is not given in this abstract — the base takes it from the 2019 Canadian Guideline (REF-568).
Limitations
Committee opinion on largely observational evidence, not a meta-analysis; contraindication screening is a clinical (referral) trigger, not a coaching decision.
The contraindication and warning-sign lists are quoted from the full document, not from the abstract.
How this entry was checked and changed
Why this level
regraded 2026-09-27 from B: major governing-body position statement (rubric: consensus / position statement = A); underlying evidence is largely observational, which the entry states
Content correction 2026-09-27
Contraindication list (incl. "placenta previa after 26 weeks") and warning signs labelled as full text, not abstract.
Level B -> A per rubric (major governing-body position statement); Sport line set to "general" (pregnancy/postpartum are populations, not disciplines).