Experts reveal new exercise guidelines for postpartum health benefits

Experts reveal new exercise guidelines for postpartum health benefits | Image Credit: © djoronimo - © djoronimo - stock.adobe.com.

Physical activity benefits for new mothers

The health and well-being of new mothers are improved by at least 2 hours of moderate to vigorous intensity physical activity (MVPA) per week in the first 3 months after birth, according to a recent study published in the British Journal of Sports Medicine.¹

Alongside this activity, investigators recommended daily pelvic floor muscle training to decrease urinary incontinence risk. Additionally, new mothers are recommended to utilize methods that improve sleep quality and duration.

“Further, time spent in sedentary behavior is now understood to be a significant health concern, and poor sleep adversely impacts physical and physiological health,” wrote investigators.²

Development of the guidelines

To provide evidence-based guidelines about physical activity to patients in the first year postpartum, investigators developed the 2025 Canadian Guideline for Physical Activity, Sedentary Behavior and Sleep Throughout the First Year Post Partum. Representatives of professional groups formed the Guideline Consensus Panel to create the guidelines.

Prior to the panel meeting, an online survey was distributed to obtain data about the perceived benefits and harms of physical activity and important postpartum outcomes. The first consensus meeting occurred in April 2022.

During the first meeting, panel members unanimously selected outcomes related to maternal and infant health, critical maternal health outcomes, important maternal health outcomes, and important infant health outcomes. The relationship between postpartum physical activity, sedentary behavior, and sleep and health outcomes was discussed as the key health question.

Systematic reviews and health outcome assessments

Subgroup analyses included the time postpartum when entering the study, mode of delivery, and type of physical activity. The impacts of physical activity, sedentary behavior, and sleep on health outcomes were assessed in 7 systematic reviews.

Studies evaluating outcomes in the first year postpartum were identified through searches of the EMBASE, MEDLINE, CINHAL, Scopus, Evidence-Based Medicine Reviews, SPORTDiscus, Web of Science, and ClinicalTrials.gov databases. Outcomes were assessed using Grading of Recommendations Assessment, Development and Evaluation.

The balance between benefits and harm, overall evidence quality, outcome importance, impact on health equity, feasibility, and acceptability were assessed to determine whether recommendations were strong or weak. Strong recommendations indicated the best outcomes would occur from following the suggestion actions.

Recommendations were drafted during the second consensus meeting in June 2023, with unanimous support given to the draft at this time. Knowledge users and postpartum women then provided feedback to these recommendations that were used for revision. An agreement was unanimously reached for the final refinement.

Core recommendations for postpartum health

There were 9 core recommendations included in the guidelines. The first was for all postpartum patients without contraindications to remain physically active. This was a strong recommendation with moderately certain evidence, meant to prevent and reduce depression symptoms.

For postpartum patients with contraindications to physical activity, investigators recommended receiving medical guidance from a health care provider. This may allow physical activity to occur, though modifications may be necessary.

Examples of MVPA included brisk walking and cycling. According to investigators, these activities should be performed for at least 120 minutes spread across 4 or more days of the week. Investigators strongly recommended incorporating a variety of aerobic and resistance training, with moderately certain evidence.

The fourth recommendation was for pelvic floor muscle training to be performed daily. Alongside reducing the risk of urinary incontinence, this activity can rehabilitate pelvic floor muscles impacted by pregnancy. To achieve optimal outcomes, investigators suggested patients receive instructions from a pelvic floor physiotherapist.

Initiation or continuation of MVPA was also strongly recommended in the first 12 weeks postpartum. Investigators also suggested early mobilization with light-intensity physical activity such as gentle walking, allowing for progression into MVPA after healing. This was a conditional recommendation, alongside a suggestion to follow an individualized progression toward the MVPA.

Sleep recommendations were also provided, including a healthy sleep hygiene routine. Finally, investigators recommended limiting sedentary time to 8 hours or less and no more than 3 hours of recreational screen time. These 9 cores highlighted a new approach that can benefit maternal and infant health during the first year postpartum.

“These clinically meaningful benefits strongly support incorporating consultation and guidance on movement behaviors into clinical practice for the postpartum period,” concluded investigators. “Support for these individuals throughout the first year following childbirth is essential.”

References

1. New mums advised to do two hours of moderate to vigorous exercise a week. BMJ Group. March 25, 2025. Accessed March 27, 2025. https://www.eurekalert.org/news-releases/1077759
2. Davenport MH, Ruchat S, Jaramillo Garcia A, et al. 2025 Canadian guideline for physical activity, sedentary behaviour and sleep throughout the first year post partum. British Journal of Sports Medicine. 2025. doi:10.1136/bjsports-2025-109785