Canadian Guidelines for Physical Activity, Sedentary Behaviour & Sleep in the First Year After Birth

Canadian Guidelines for Physical Activity, Sedentary Behaviour & Sleep in the First Year After Birth.

(Davenport et al., 2025)

These national guidelines, developed by a panel of interdisciplinary experts, offer evidence-based recommendations to support postpartum women and people in safely engaging in physical activity, improving sleep, and reducing sedentary behaviour during the first year after childbirth.

Key Recommendations

1. Be Physically Active
   All postpartum women and people without contraindications should engage in physical activity for clinically meaningful benefits such as improved mood and reduced depressive symptoms.
   → Strong recommendation | Moderate certainty evidence
2. Medical Guidance if Needed
   Those with potential contraindications (see below) should consult a primary healthcare provider before starting or continuing moderate-to-vigorous physical activity (MVPA).
   → Conditional recommendation | Low certainty evidence
3. MVPA Goal
   Aim to accumulate at least 120 minutes of MVPA weekly, spread over 4+ days, including aerobic and resistance training.
   → Strong recommendation | Moderate certainty evidence
4. Pelvic Floor Muscle Training (PFMT)
   Practice daily PFMT to support pelvic recovery and reduce urinary incontinence. Seek instruction from a pelvic floor physiotherapist for best results.
   → Strong recommendation | High certainty evidence
5. Early Return to Activity
   Returning to MVPA within the first 12 weeks postpartum supports mental health.
   → Strong recommendation | Moderate certainty evidence
6. Light Activity Before MVPA
   Start with light-intensity movement (e.g. gentle walking, PFMT) and gradually increase to MVPA once healing allows and lochia (vaginal bleeding) does not worsen.
   → Conditional recommendation | Low certainty evidence
7. Individualised Progression
   Follow a symptom-based, gradual progression toward 120+ minutes/week of MVPA.
   → Conditional recommendation | Low certainty evidence
8. Sleep Hygiene
   Adopt healthy sleep habits (e.g. limit screens, keep the bedroom dark and quiet) to improve maternal mental health and recovery.
   → Strong recommendation | Moderate certainty evidence
9. Reduce Sedentary Time
   Limit sedentary time to <8 hours/day, with ≤3 hours of recreational screen time, and break up long sitting periods.
   → Conditional recommendation | Very low certainty evidence

Relative Contraindications to MVPA Postpartum

Medical advice is recommended if any of the following are present:

• Severe abdominal or incision pain
• Heavy or unexplained vaginal bleeding
• Postpartum cardiomyopathy
• High blood pressure (>140/90 mmHg)
• Malnutrition or eating disorders
• Deep vein thrombosis symptoms
• Neurological symptoms (e.g. muscle weakness, ataxia)
• Chest pain, shortness of breath, or heart-related symptoms
• Acute infection with fever
• Musculoskeletal injuries or fractures
• Excessive fatigue or signs of low energy availability
• Kidney disease
• Other serious or unstable medical conditions

Helpful Tool: Get Active Questionnaire for Postpartum

Created by the Canadian Society for Exercise Physiology (CSEP), this self-screening tool helps identify whether medical advice is needed before beginning MVPA postpartum.

Get Active Questionnaire for Postpartum 

Safety Tips for MVPA in the First Year Postpartum

• Avoid rapid return to MVPA if experiencing pain, bleeding, or mental health challenges.
• Ensure adequate nutrition, hydration, and rest, especially while lactating.
• Prioritise quality sleep to support physical and emotional recovery.
• Seek and maintain social, family, and emotional support.