Exercise in the Postpartum Period

Abstract

Pregnancy, birth, and the postpartum period are important events in the reproductive lives of women. Exercise guidelines exist for pregnancy, but recommendations for exercise during the postpartum period are virtually nonexistent. It is important to examine the theoretic concerns and potential benefits of exercise during this period, especially with respect to weight retention following pregnancy, lactation performance, and infant growth. It is recommended to increase the definition of the postpartum period to 1 year, because many physiologic changes due to pregnancy remain up to 1 year after delivery. Evidence-based guidelines are presented for postpartum exercise and lactation. Future research should address the impact of exercise and lactation on bone mineral density, nutrition status and weight loss, cardiovascular health, and how to optimize health promotion during the postpartum period.

A systematic review of changes in women’s physical activity before and during pregnancy and the postnatal period

“…Further benefits include improved cardiovascular fitness, weight loss, improved mood and reduced anxiety and depression (Mottola, 2002) without compromising breastfeeding or infant growth (Carey & Quinn, 2001). Women need to return to pre pregnancy exercise levels gradually, not resuming high impact activity too soon.…”

“…This has been endorsed by the Royal College of Obstetrics and Gynaecology (RCOG, 2006). Although well recognized as beneficial, little attention has been paid to the changes in lifestyle behaviours which occur in women during the pre pregnancy to pregnancy and post natal phases (Gaston and Cramp, 2011), with women continuing to reduce their physical activities during pregnancy (Mottola, 2002;Brown and Trost, 2003;Poudevigne and O'Connor, 2006). The extent to which perinatal health behaviours are influenced by habits prior to conception, or the degree to which improved lifestyle habits can be introduced following birth, are still relatively understudied (Abbasi et al, 2014).…”

Exercise and Pregnancy Knowledge Among Healthcare Providers

“…During pregnancy, changes in heart rate (an increase in resting and decrease in maximal heart rate) render heart rate as a less precise way to monitor exercise intensity. 8 To address this issue, Canadian guidelines (PARmed-X for Pregnancy) advise using target heart rate zones representing 60%-80% of age-specific aerobic capacity along with Borg's Rating of Perceived Exertion scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) to monitor exercise intensity. 9 It is important to note that current ACOG and U.S. government recommendations for exercise during pregnancy advocate for at least moderate intensity activity and do not set an upper limit for intensity.…”

“…3 Current evidence shows that PA performed by women undergoing a normal pregnancy is associated with very little risk may decrease a woman's risk for complications during pregnancy (hypertension, gestational diabetes), and may enhance weight loss postpartum. 12 Thus, women are encouraged to perform the minimum amount of PA suggested for all Americans, that is, 150 minutes of moderate to vigorous physical activity per week. 3 The authors of the new Physical Activity Guidelines for Americans stress that healthcare providers and other PA experts should share the latest information about exercise behavior with everyone, including pregnant women.…”

Efficacy of yoga for depressed postpartum women: A randomized controlled trial

“…Thus, the role of maternal exercise for PPD has been examined in several studies. The health benefits of postpartum exercise are well-documented in the exercise literature, including improved cardiovascular fitness, energy (Sampselle, Seng, Yeo, Killion, & Oakley, 1999), and psychosocial functioning (Mottola, 2002). Several studies have investigated the role of exercise in reducing symptoms of postpartum depression, including both randomized controlled trials and observational studies (Daley, MacArthur, & Winter, 2007).…”