Canadian Postpartum Exercise Guidelines

In 2025, a new set of guidelines was released in the British Journal of Sports Medicine about postpartum physical activity, sedentary behaviour and sleep.

The postpartum is a critical time - not only is someone raising a new human being, they’re caring for a new version of themselves all while experiencing common issues like sleep deprivation. Nevertheless, its an opportune time to identify those at elevated risk for future chronic diseases and introduce early interventions to enhance long-term health outcomes.

Postpartum individuals are at heightened risk for conditions like:

• Depression

• Weight retention

• Type 2 diabetes

• Cardiovascular disease

Conditions like type 2 diabetes and cardiovascular disease more likely to occur in people who experienced gestational diabetes and/or gestational hypertension or preeclampsia in pregnancy.

Postpartum Exercise Guidelines

After Birth

Light-intensity physical activity after childbirth is encouraged (ex. gentle walking, deep breathing). When I had a cesarean birth, I was encouraged to start walking as soon as I could (obviously being mindful of my stitches). It was a bit easier after a vaginal birth - where I didn’t have the same hesitation (or same feeling that I might have popped a stitch).

Once the surgical incisions or perinal tears have healed, and vaginal bleeding (known as lochia) is not increasing, you can likely progress to moderate-intensity to vigorous-intensity physical activity. PRO-TIP: Seeing a pelvic floor physiotherapist would be helpful to determine if you’re ready to resume this intensity of physical activity. More on that below.

After Healing

In the first 12 weeks postpartum, it’s encouraged to accumulate at least 120min/week of moderate-to-vigorous intensity physical activity, accumulated over a period of 4 days.

Ideally, this should include aerobic and resistance-training activities. No specific preference was noted in the guidelines.

Contraindications to moderate-to-vigourous intensity physical activity

Certain health conditions can prevent someone from participating in moderate-to-vigourous physical activity. The type of contraindications are absolute or relative.

Absolute Contraindication

A condition where physical activity should be avoided until the condition is resolved because of increased risk of adverse events. However, activities of daily living are often encouraged

Relative Contraindication

Participating in activity will warrant a discussion with a person's healthcare provider to assess the risks and benefits of participating in said activity.

This list of relative contraindications is pulled directly from the guidelines. If you have any concerns about a particular condition or contraindication, speak to your healthcare provider.

• Severe abdominal pain

• Vaginal bleeding not associated with menses

• Postpartum cardiomyopathy

• Caesarean section with symptoms that worsen with activity (ex. surgical incision pain)

• Unstable high blood pressure (>140/90 mmHg)

• Eating disorder

• Malnutrition

• Excessive fatigue suggestive of anaemia or low energy availability (ex. relative energy deficiency in sport)

• Fractures or other significant musculoskeletal injuries

• Calf pain or swelling suggestive of deep vein thrombosis

• Hemodynamic instability

• Acute systemic infection accompanied by fever, body aches or swollen lymph glands

• Breathing difficulties such as shortness of breath at rest, not relieved with medications

• New onset of chest pain, discomfort and other angina-like symptoms with exertion

• Dizziness or light-headedness during activity

• Loss of consciousness for any reason

• Neurological symptoms such as ataxia or muscle weakness affecting balance

• Kidney disease

• New symptoms of heart disease or stroke

• Other medical or physical conditions that may affect the ability to be physically active

Sedentary Behaviour

There is a strong dose–response relationship between sedentary behaviour in adults and cardiovascular disease and mortality, type 2 diabetes, cancer and cancer mortality.

Guidelines recommend to limit sedentary time to 8 hours or less, which includes no more than 3 hours of recreational screen time. When possible, try to break up long periods of sitting.

Pelvic Floor Physiotherapy in the Postpartum

Pelvic floor muscle training is recommended to reduce the risk of urinary incontinence, and rehab pelvic floor muscles impacted by pregnancy, and birth.

To get the best benefits, book an appointment with a pelvic floor physiotherapist as early as 6 weeks postpartum to determine the proper technique for pelvic floor exercises. Not everyone should start with kegels!

Remember…

The postpartum can be a difficult period, and it may be tough meeting these recommendations. That said, any progress - even small, can help improve maternal physical and mental health.

For postpartum women and people experiencing difficulties meeting the targets in the guidelines, any progress - even if small, can improve maternal physical and mental health, and any reductions in sedentary behaviour may improve cardiometabolic health.