Iris A. Lesser, PhD. CSEP-CEP, Pre and Postnatal Exercise Specialist
Recently Davenport et al. released postpartum physical activity guidelines recommending that women engage in at least 120 minutes of moderate to vigorous physical activity per week. While the notion of returning to physical activity postpartum (previous recommendation of 150 minutes of moderate to vigorous physical activity; is not new, the additional support for early return to movement and specific guidance is novel. Of additional benefit is the newly created Get Active Questionnaire Postpartum that can identify any potential medical conditions which may require further healthcare support and guidance prior to engaging in physical activity. This focus on the importance of early mobilization or light intensity physical activity and screening provides much needed support for return to movement given that participants in our study cite lack of education and fear of movement after giving birth as barriers to physical activity engagement.
However, despite the wealth of knowledge these guidelines bring to new mothers around physical activity engagement, there is fear amongst parenting groups that these guidelines put further pressure on new mothers. Specifically, the recommendation that physical activity should begin within the first 12 weeks postpartum to support maternal mental health was deemed controversial. As reported in the Guardian, the social network Mumsnet responded to the guidelines as being “wildly optimistic about what looking after a newborn entails.” This is later discussed as “many of them are already stretched to their limits, and advice like this isn’t always helpful if you don’t have the practical means to follow it.” This is a fair response in a world where there always seems to be judgment on new mothers. However, physical activity postpartum is highly beneficial to new mothers and provides an opportunity to focus on oneself rather than just the demands of a new baby. So how can we better support women to engage in physical activity after the birth of a child in a beneficial and self-compassionate manner? Given the many denoted barriers to engagement in physical activity at this phase such as lack of time, energy, motivation, social support and fatigue women require physical activity recommendations that are tailored to their mental and physical well-being. In our early work offering physical activity interventions we found benefits to group-based physical activity on mental well-being but also that women found it challenging to individualize programming and not compare to others. We have found objective monitoring, such as with heart rate variability and assessment of daily stress and sleep, to be one way in which physical activity can be tailored to the daily challenges of postpartum women without being a one size fits all approach.
Furthermore, as postpartum women attempt to navigate beginning or returning to physical activity after the birth of a child they may be negatively affected by social comparison. After the birth of a child, women are faced with (often) rapidly changing body weight, shape, size, and function, which can further negatively affect physical activity. Within Western cultures, the “bounce-back” narrative – expectation that postpartum weight will be lost quickly, and the body will return to its pre-pregnancy state – dominates and is associated with greater body dissatisfaction. This issue may be further compounded by comparison – particularly via social media. Postpartum women have reported using social media to access health information, including physical activity guidance, postpartum. As a first step to better support postpartum women, we created “realistic” physical activity content that sought to move beyond the dominant Western ideal and images commonly portrayed (e.g., White, slim, and fit women). We are currently in the process of analyzing feedback from postpartum women regarding imagery and have broadly found postpartum women to embrace the need for diverse and representative imagery.
Overall, the announcement of postpartum physical activity guidelines is a large step forward in supporting mothers in taking care of their own health after the birth of a child. However, it’s important to recognize the need for self-compassionate physical activity during a phase of life where one may face multiple barriers to engagement. Societal norms and the “bounce back narrative” often make mothers feel pressured to engage in physical activity, particularly more structured and intensive physical activity. Of particular concern is the notion of intensive mothering as a toxic perspective of motherhood that requires self-sacrifice instead of self-compassion. As noted by a participant; “being a mom to an infant and toddler can be exhausting. I prioritize the health and well-being of my children and husband before I even remember to think about myself. It’s hard to focus on the self and find adequate resources that allow you the space to do so.” These changes in societal norms may support postpartum women’s physical activity engagement while also providing a more realistic understanding of the postpartum experience. As we note in our guidebook “Mothers Moving Forward: a postpartum guide to being physical activity,” physical activity can look different for everyone. For some women, getting through the tasks of infant care can be physically demanding on its own. For other women, especially those who were physically active throughout pregnancy and had an uncomplicated delivery, physical activity may be a return to structured exercise. We must also recognize that postpartum women must have equitable access to quality physical activity and input is needed across all levels of society to make this happen.