REF-1394 · Davenport et al., 2025 · British Journal of Sports Medicine · Paper · PubMed

Is there an official guide for exercise in the year after birth?

Yes: Canada's 2025 guideline (GRADE, 7 reviews) finds following it likely brings large benefits, no adverse events (moderate certainty). Its doses are not in the abstract.

Main caveat: Read from the abstract only. The recommendations, their GRADE strength and certainty, the contraindication list and the funding statement could not be read.
strong evidenceMeasured on non-athletes and recreational people

Davenport and colleagues set out guidance for postpartum women and people, healthcare providers and exercise professionals on physical activity, sedentary behaviour and sleep throughout the first year after childbirth.

The guideline followed GRADE and the AGREE II instrument; the Guideline Consensus Panel included representatives of key professional groups, researchers and methodological experts.

Searches of 12 online databases looked for studies of maternal physical activity, sedentary behaviour or sleep in the first year after childbirth that reported any of 21 maternal or infant health outcomes, chosen with the preferences and values of postpartum individuals in mind; all languages and all designs except case studies were eligible, and certainty was rated with GRADE.

The evidence review produced seven systematic reviews. A separate Delphi identified relative contraindications to moderate-to-vigorous postpartum activity and fed the Get Active Questionnaire for Postpartum.

Evidence-to-decision tables were drawn up and end users (providers, exercise professionals, researchers, policy organisations, postpartum women and people) commented on the recommendations.

The authors conclude that adhering to the recommendations "is likely to result in large improvements in psychological well-being, as well as pelvic, musculoskeletal and cardiometabolic health, and reduced fatigue, while not experiencing adverse events (moderate certainty evidence)", and most end users found them feasible, acceptable, equitable and low in cost.

Our reading: the base's postpartum guidance rested on a Delphi (REF-569) and an unsourced composite (REF-339); this is the guideline layer above them. The abstract gives the method and the verdict, not the recommendations, so the entry holds a place for them until the full text is read.

Protocol

Design: clinical practice guideline (consensus statement) using GRADE and AGREE II; PROSPERO CRD42022359282 for the evidence review.
Panel: Guideline Consensus Panel of representatives from key professional groups, researchers and methodological experts (the groups are not named in the abstract; REF-1398's full text, one of the seven reviews, names the Canadian Society for Exercise Physiology guideline and lists the outcome-setting panel's societies).
Evidence: 12 online databases; maternal physical activity, sedentary behaviour or sleep in the first year after childbirth; 21 maternal or infant health outcomes prioritised with postpartum individuals' preferences and values; no language restriction; all designs except case studies; certainty by GRADE; seven systematic reviews.
Contraindications: a Delphi process on relative contraindications to moderate-to-vigorous physical activity after birth, which informed the Get Active Questionnaire for Postpartum (the items are not in this abstract).
Decision and review: evidence-to-decision tables; feedback from end users (healthcare providers, exercise professionals, researchers, policy organisations, postpartum women and people).
Funding and interests (as available): PubMed prints "Competing interests: None declared." Crossref lists as funders the Christenson Professor in Active Healthy Living and the Université du Québec à Trois-Rivières; one author's affiliation is the Public Health Agency of Canada (Centre for Surveillance and Applied Research). No device maker, federation or data platform is named. The full funding statement is in the full text, not read.

Key Results

Overall verdict (moderate certainty, as rated by the authors): following the recommendations is likely to bring large improvements in psychological well-being, pelvic, musculoskeletal and cardiometabolic health, and reduced fatigue, without adverse events.
End users: most indicated the recommendations would be feasible, acceptable and equitable and need minimal resources from individual and health-system perspectives.
Evidence base: seven systematic reviews covering 21 maternal or infant outcomes; one of them is REF-1398 (pelvic-floor disorders and diastasis, same PROSPERO number).
Not in the abstract: the recommendations themselves — any weekly minutes, intensity, type of activity, pelvic-floor training advice, limits on sedentary time, sleep guidance, when to start — their individual GRADE strength and certainty, and the list of relative contraindications. None of these is carried by this entry.

Mechanisms

Not addressed in the abstract. A guideline states recommendations and the certainty of the evidence behind them; the abstract names no mechanism.
Inference: the outcomes named in the verdict (psychological well-being, pelvic, musculoskeletal and cardiometabolic health, fatigue) match the reviews' outcome list; which reviews carry the "large" improvements, and with what effect sizes, is in the full text.

Practical Application

Is there an official guide for exercise in the year after birth? Yes: Canada's 2025 guideline (GRADE, 7 reviews) finds following it likely brings large benefits, no adverse events (moderate certainty). Its doses are not in the abstract.
What the assistant can say now (A, from the abstract): a national guideline built on seven systematic reviews concludes that being active in the first year after birth, as it recommends, is likely to improve psychological well-being, pelvic, musculoskeletal and cardiometabolic health and fatigue, without harm. Do not quote minutes, intensities, a start date or sleep advice from it: they are not in the abstract.
Screen before moderate-to-vigorous activity: the guideline built a Get Active Questionnaire for Postpartum from a Delphi on relative contraindications; the items are not in this abstract. Not from this paper; the base's own practice: pelvic-floor symptoms (leaking, heaviness, pressure) trigger regression and a pelvic-health referral (SYNTH-36 postpartum line).Inference (transfer from pregnancy): the stop signs in REF-567 (vaginal bleeding, dizziness, chest pain, calf pain or swelling; from that entry's full-text list) are a sensible reason to stop and see a clinician after birth too.
For a runner or athlete: the guideline is a floor for the general population; the return to running is screened (REF-1397: not before 3 weeks, then an individual timeline) and planned (REF-569: relative rest, walk-run, strength, gradual progression); elite athletes come back earlier and carry an injury signal (REF-1402).
What it does not show (from the abstract): any dose, timeline or sleep rule; outcomes in athletes; which contraindications are absolute.

Limitations

Read from the abstract only. The recommendations, their GRADE strength and certainty, the contraindication list and the funding statement could not be read; Europe PMC holds no full text, OpenAlex lists no open copy, and the journal site is behind a bot check that was not tried. The full text has been requested from the authors.
General population. Built for postpartum women and people in general; athletes are not a stated group, so any training number would be a transfer.
Certainty. The overall verdict is moderate certainty by the authors' own rating; "large" improvements are not quantified in the abstract.
Overlap of authors and reviews. The same group wrote the reviews and the guideline (REF-1398 shares four authors), which is usual for a guideline but means the reviews are not independent of the panel.
Funding and interests: competing interests "None declared" (PubMed); Crossref funders are a named professorship and a university; a federal public-health agency is among the affiliations.
How this entry was checked and changed
Why this level

(from the abstract) — a GRADE guideline built on systematic reviews by a national panel is the rubric's A+ design, but this entry is held at A, the grade REF-568 (the 2019 Canadian pregnancy guideline, same group and method) carries, because what an abstract-only entry can carry is the method and one overall statement that the authors themselves rate as moderate certainty; no single recommendation, dose or its GRADE strength is visible. The full text (requested from the authors) is needed before any recommendation, number or A+ grade is carried