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Summary of International Guidelines for Physical Activity After Pregnancy

Evenson, Kelly R. PhD, MS, FACSM*; Mottola, Michelle F. PhD, FACSM; Owe, Katrine M. PhD; Rousham, Emily K. PhD§; Brown, Wendy J. PhD, MSc, FACSM

Obstetrical & Gynecological Survey: July 2014 - Volume 69 - Issue 7 - p 407–414
doi: 10.1097/OGX.0000000000000077
CME Articles

Postpartum physical activity can improve mood, maintain cardiorespiratory fitness, improve weight control, promote weight loss, and reduce depression and anxiety. This review summarizes current guidelines for postpartum physical activity worldwide. PubMed (MEDLINE) was searched for country-specific government and clinical guidelines on physical activity after pregnancy through the year 2013. Only the most recent guideline was included in the review. An abstraction form facilitated extraction of key details and helped to summarize results. Six guidelines were identified from 5 countries (Australia, Canada, Norway, United Kingdom, and United States). All guidelines were embedded within pregnancy-related physical activity recommendations. All provided physical activity advice related to breastfeeding and 3 remarked about physical activity after cesarean delivery. Recommended physical activities mentioned in the guidelines included aerobic (3/6), pelvic floor exercise (3/6), strengthening (2/6), stretching (2/6), and walking (2/6). None of the guidelines discussed sedentary behavior. The guidelines that were identified lacked specificity for physical activity. Greater clarity in guidelines would be more useful to both practitioners and the women they serve. Postpartum physical activity guidelines have the potential to assist women to initiate or resume physical activity after childbirth so that they can transition to meeting recommended levels of physical activity. Health care providers have a critical role in encouraging women to be active at this time, and the availability of more explicit guidelines may assist them to routinely include physical activity advice in their postpartum care.

Target Audience Obstetricians and gynecologists, family physicians

Learning Objectives After completing this CME activity, physicians should be better able to describe the benefits of physical activity identified in postpartum physical activity guidelines, discuss the impacts of physical activity on breastfeeding as described in postpartum physical activity guidelines, and assess the limitations of the current postpartum physical activity guidelines.

*Research Professor, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; †Professor, R. Samuel McLaughlin Foundation-Exercise & Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine, Children’s Health Research Institute, University of Western Ontario, London, Ontario, Canada; ‡Scientist, Norwegian Resource Centre for Women’s Health, Oslo University Hospital, Rikshospitalet and Department of Psychosomatics and Health Behaviour, National Institute of Public Health, Oslo, Norway; §Lecturer, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom; and ¶Professor, School of Human Movement Studies, University of Queensland, St Lucia, Queensland, Australia

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (NIH, No. UL1TR000083) (Dr Evenson); the University Research Council at the University of North Carolina at Chapel Hill (Dr Evenson); and the Canadian Institutes of Health Research and endorsed by Health Canada and the Canadian Society of Exercise Physiologists (Dr Mottola).

The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Correspondence requests to: Kelly R. Evenson, PhD, MS, FACSM, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 East Franklin St, Suite 306, Chapel Hill, NC 27514. E-mail:

© 2014 by Lippincott Williams & Wilkins.