Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period

New guidelines for exercise in pregnancy and postpartum have been published by the American College of Obstetricians and Gynecologists In January 2002 the American College of Obstetricians and Gynecologists (ACOG) published new recommendations and guidelines for exercise during pregnancy and the postpartum period.1 Regular exercise is promoted for its overall health benefits. Pregnancy is recognised as a unique time for behaviour modification and is no longer considered a condition for confinement. It is currently recognised that habits adopted during pregnancy could affect a woman's health for the rest of her life. For the first time the recommendation suggests a possible role for exercise in the prevention and management of gestational diabetes. The recommendations also promote exercise for sedentary women and those with medical or obstetric complications, but only after medical evaluation and clearance. Box 1 lists the absolute contraindications to aerobic exercise during pregnancy, and box 2 the relative contraindications. As with any form of exercise prescription, these recommendations also include the warning signs to terminate exercise while pregnant (box 3). The recommendations also offer guidelines for sports and recreational activities. It cautions against participation in contact sports and recommends avoidance of scuba diving. As for postpartum resumption of activities, the recommendations note that rapid resumption has no adverse effects, but gradual return to former activities is advised. This review includes background and comments to the above recommendations. The health benefits of physical activity are well recognised, and conversely sedentary habits and low levels of cardiorespiratory fitness are leading risk factors for subsequent development of cardiovascular disease.2,3 The Centers for Disease Control and Prevention and the American College of Sports Medicine (CDC-ACSM) have recommended the accumulation of 30 minutes or more of moderate intensity physical activity on most, and preferably all, days of the week.4 Moderate …