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Are 12 systematic reviews on exercise in pregnancy too many? Not for 125 million women who are pregnant every year: Kudos Society of Obstetricians and Gynaecologists of Canada (SOGC) and Canadian Society for Exercise Physiology (CSEP)
  1. Karim M Khan
  1. Correspondence to Dr Karim M Khan, Department of Family Practice, The University of British Columbia, Vancouver BC V6T 1Z4, Canada; karim.khan{at}

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There are about 125 million pregnancies a year. Exercise may be one of the most important health-promoting behaviours a woman can undertake before and during pregnancy, yet there are many questions around exercise and pregnancy. Can exercise early in a pregnancy lead to miscarriage? Does exercise lead to a tight pelvic floor and thus obstruct the baby’s passage in vaginal delivery? When can I return to being physically active? Is it normal to be incontinent after childbirth and do I need to take steps to address it or will I regain normal micturition without help? When can I have sex?

Figure 1

The IOC summarised the evidence relating to exercise and pregnancy in recreational and elite athletes in a five-part series that began in issue 10 of BJSM in 2016.

The past: 2002–2018

The BJSM published a key consensus statement in 2002, and this had over one million views. There was then a very long gestation period before the IOC convened an expert group to address the issues of exercise in pregnancy with a particular focus on elite athletes. I don’t just want to go for a run during pregnancy but I want to train for an Olympic campaign that will begin as soon as I possibly can after my baby is born. That IOC meeting concluded that data were sparse about exercise in general and that published data were largely absent for elite athletes. You can find the five-part IOC exercise in pregnancy expert consensus papers spread across three volumes of BJSM (2016–2018) (figure 1).1–5

The present: 2019 Canadian guideline for physical activity throughout pregnancy

BJSM is delighted to publish the very comprehensive and quality 2019 Canadian Guideline for physical activity throughout pregnancy.6 It was conceived by the Society of Obstetricians and Gynaecologists of Canada in partnership with the Canadian Society for Exercise Physiology. The clinical Guideline was copublished with the Journal of the Obstetricians and Gynaecologists of Canada; you can find the 12 systematic reviews that underpin this guideline in a double-issue of BJSM (1–6 in BJSM Volume 52, Issue 21 (figure 2) and 7–12 in BJSM Volume 53: Issue 2, this issue, figure 3). Before saying any more about that work, I commend lead author Associate Professor Dr Margie Davenport from the University of Alberta (Edmonton, Canada) and her team.

Figure 2

This first of two issues of BJSM in 2018/2019 includes the Canadian Guideline for physical activity throughout pregnancy and relevant systematic reviews 1–6.

Figure 3

This second of two issues of BJSM in 2018/2019 includes systematic reviews 7–12 and a feature editorial by Professors Raul Artal and Gregory Davies.

Every field has a ‘name’ synonymous with it. Anatomy—Henry Gray, Physiology—McCardle Katch and Katch. The name in obstetrics is Dr Raul Artal, and we are delighted to publish his editorial, alongside his Canadian peer—Dr Gregory Davies. Read their take on what the latest Guideline adds here (see page 81). Their take home message though? Exercise is both safe and beneficial for the fetus.



  • Patient consent for publication Not required.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.