A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

Kelly R Evenson; Wendy J Brown; Alison K Brinson; Emily Budzynski-Seymour; Melanie Hayman

doi:10.1016/j.jshs.2023.12.004

A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

J Sport Health Sci. 2023 Dec 28:S2095-2546(23)00130-8. doi: 10.1016/j.jshs.2023.12.004. Online ahead of print.

Authors

Kelly R Evenson¹, Wendy J Brown², Alison K Brinson³, Emily Budzynski-Seymour⁴, Melanie Hayman⁵

Affiliations

¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA. Electronic address: kelly_evenson@unc.edu.
² Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia.
³ Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA.
⁴ Faculty of Sport, Health and Social Sciences, Solent University, Southampton, SO14 0YN, UK.
⁵ Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia.

PMID: 38158180
DOI: 10.1016/j.jshs.2023.12.004

Abstract

Background: The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide.

Methods: To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country.

Results: We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA.

Conclusion: Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.

Keywords: Breastfeeding; Caesarean section; Guidelines; Postnatal; Recommendations.

Publication types

Review

Grants and funding

T32 HD091058/HD/NICHD NIH HHS/United States