2025 Canadian Guideline for Physical Activity, Sedentary Behaviour and Sleep throughout the First Year Postpartum
New evidence-based guideline outlines the right amount of physical activity, sedentary behaviour and sleep women should get during the postpartum period to support maternal and infant health and wellbeing.
After childbirth, those without medical restrictions (contraindications) are recommended to follow a gradual, individualized progression towards 120 minutes per week of moderate to vigorous intensity physical activity. It is recommended to do a mix of aerobic exercises and strength training on at least 4 days per week, along with daily pelvic floor muscle exercises to support recovery, sleep and healing. Higher levels of physical activity also supported better quality sleep and reduced risk of depression. Given the challenges faced by postpartum women and people (disrupted sleep, poorer mental health, infant care and feeding) meeting the recommendations within the Guideline may not always be possible. The Guideline highlights that even small steps towards the recommendations can have significant health benefits, and emphasizes that achieving the goals within the guideline cannot occur without robust support from their partner, family and society
New Screening Tool: Get Active Questionnaire for Postpartum
The Guideline Consensus Panel developed the world’s first physical activity pre-screening tool for postpartum individuals to ensure that postpartum activity is started safely. The Get Active Questionnaire for Postpartum is designed for self-completion and helps identify the few people who should consult a healthcare provider before beginning or resuming postpartum physical activity. The tool is available now!
Preamble:
This Guideline provides evidence-based recommendations regarding physical activity, sedentary behaviour and sleep throughout the first year postpartum in the promotion of maternal, and infant health. Physical activity following childbirth was associated with a reduction in the odds of depression (45%), urinary incontinence (37%) and type 2 diabetes (28%), as well as improvements in the symptom severity of depression, anxiety, lumbopelvic pain, change in weight, body mass index and triglycerides. Importantly, the systematic reviews did not identify an increased risk of harm, including injury, adverse events, fear of movement, or decreased breast milk quality or quantity, and exercise was shown to reduce levels of fatigue. Our systematic reviews also found that sleep interventions (e.g., education about infant sleep patterns and strategies) were associated with a reduction in severity of depressive symptoms, and physical activity interventions were associated with improvements in sleep quality and a reduction in daytime fatigue.
The postpartum period is an important transitional life event that presents unique barriers that may make following this Guideline challenging. Robust social and emotional support from partners, family, and society to help postpartum women and people overcome the challenges and barriers associated with the transition from pregnancy to postpartum is essential to effectively progress towards these recommendations. For postpartum women and people experiencing difficulties meeting the targets in this Guideline, any progress, even if small, in meeting physical activity targets increases maternal physical and mental health, while any reductions in sedentary behaviour may also improve cardiometabolic health.
For pregnant women not currently meeting these Guidelines, a progressive adjustment toward them is recommended. Previously active women may continue physical activity throughout pregnancy. Women may need to modify physical activity as pregnancy progresses. There may be periods when following the guidelines are not possible due to fatigue and/or discomforts of pregnancy; women are encouraged to do what they can and to return to following the recommendations when they are able.
These Guidelines were informed by an extensive systematic review of the literature, expert opinion, end-user consultation and considerations of feasibility, acceptability, costs and equity.
Recommendations
The specific recommendations in the 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour and Sleep throughout the First Year Postpartum are provided below:
We recommend all postpartum women and people without contraindications be physically active to obtain clinically meaningful benefits (e.g., prevent and reduce depressive symptoms).
We suggest women and people with potential contraindications to physical activity (see below) obtain medical clearance from a primary healthcare provider (e.g., family physician) about beginning or continuing moderate- to-vigorous physical activity (MVPA) following childbirth. In most cases, MVPA may proceed but modifications may be required until the medical problem has resolved.
We recommend accumulating at least 120 minutes of MVPA (e.g., brisk walking, cycling) spread over four or more days of the week that incorporates a variety of aerobic and resistance training activities.
We recommend performing pelvic floor muscle training (PFMT) daily to reduce the risk of urinary incontinence and rehabilitate pelvic floor muscles impacted by pregnancy, labour, and/or delivery.
Instruction on proper technique from a pelvic floor physiotherapist
is recommended to obtain optimal benefits.
We recommend beginning or returning to MVPA in the first 12 weeks
postpartum to support mental health.
We suggest initiating early mobilization with light-intensity physical activity (e.g., gentle walking, pelvic floor muscle training) and progressing to MVPA once surgical incisions or perineal tears have sufficiently healed and vaginal bleeding (lochia) does not increase with MVPA.
We suggest following an individualized, gradual, and symptom-based progression toward at least 120 minutes/ week of MVPA.
We recommend adopting a healthy sleep hygiene routine (e.g., avoid screen time and maintain a dark, quiet environment
before bed) to support maternal mental health.
We suggest limiting sedentary time to
8 hours or less, including no more than 3 hours of recreational screen time, and breaking up long periods of sitting when possible.
All postpartum women and people can participate in physical activity after childbirth with the exception of those who have medical conditions where it may not be recommended (contraindications; listed below). Those with relative contraindications should discuss the advantages and disadvantages of moderate-to-vigorous intensity physical activity with their primary healthcare provider prior to participation. However, they may continue their usual activities of daily living.
The newly developed Get Active Questionnaire for Postpartum was designed to empower postpartum women to identify if they require medical guidance before beginning or returning to moderate-to vigorous intensity physical activity postpartum, and to reduce barriers to physical activity participation.
Relative contraindications to moderate-to-vigorous intensity physical activity in the first year after childbirth.
Relative Contraindications
While the following are not contraindications to physical activity, additional screening, support and treatment for potential barriers to MVPA by a healthcare provider or qualified exercise professional may be recommended:
Summary
The 2025 Canadian Guideline was developed following a rigorous nearly three year process reviewing more than 19,000 titles and abstracts, and included 574 unique studies which were distilled into seven systematic reviews and meta-analyses covering 21 maternal and infant health outcomes (BJSM). This new guideline is evidence-based and addresses key topics identified by postpartum women. This new Guideline emphasizes that one size does not fit all, rather progression towards the recommended 120 minutes of moderate to vigorous intensity physical activity should be individualized, gradual and symptom based. It is evidence-based but it was driven by what postpartum women actually wanted to know.
Development & Contributors
With financial support from the Christenson Professorship in Active Healthy Living, the Guideline was developed by a pan-Canadian team of researchers, methodologists, and representatives from leading organizations. The development was led by Dr. Margie Davenport (University of Alberta; Chair), and Dr. Stephanie-May Ruchat (Université du Québec à Trois-Rivières; Vice-Chair) with support from:
- Alejandra Jaramillo Garcia (Public Health Agency of Canada)
- Mohammad Usman Ali (McMaster University)
- Milena Forte (College of Family Physicians of Canada)
- Nicole Beamish (Canadian Physiotherapy Association)
- Karen Fleming (Canadian Academy of Sport and Exercise Medicine)
- Kristi B. Adamo (Canadian Society for Exercise Physiology)
- Émilie Brunet-Pagé (Canadian Association of Midwives)
- Radha Chari (Society for Obstetricians and Gynaecologists of Canada)
- Kirstin N. Lane (Canadian Society for Exercise Physiology)
- Michelle F. Mottola (Western University)
- Sarah Neil-Sztramko (McMaster University)
The Guideline was supported by the Christenson Professor in Active Healthy Living, and has been endorsed by the Canadian Association of Midwives, the Canadian Physiotherapy Association, the Chartered Association of Sport and Exercise Sciences (formerly known as the British Association of Sport and Exercise Sciences), the Exercise and Sports Science Australia, and ParticipACTION.
