New moms need better support easing back into exercise after birth

Getting enough exercise is crucial to the health of new moms, yet most programs designed to increase postnatal physical activity are only somewhat effective. Sarah Liva, a recent PhD nursing graduate at UBC, interviewed new moms to find out why. In this Q&A, she explains her findings and suggests ways to support physical activity.

Why is postnatal physical activity so important?

Motherhood is a significant time of transition around physical activity patterns, with evidence suggesting nearly half of new mothers who were meeting recommended levels of physical activity pre-pregnancy—around 150 minutes of moderate to vigorous activity per week—reduced their activity to below recommended levels within the year following childbirth. Canadian data suggests that women with infant children have some of the lowest rates of physical activity and that patterns of reduced activity persist beyond that first year.

All this is concerning because physical inactivity increases the risk of long-term obesity and related diseases. Globally, physical inactivity is the main cause of about a quarter of breast and colon cancers and diabetes, and a third of heart disease.

Most programs designed to promote physical activity, like counselling or exercise classes, have had mixed or short-term success. As a practicing nurse, it was clear to me that we health-care providers need more knowledge about how women make decisions about physical activity if we are to design effective interventions.

What were your key findings?

I interviewed 30 women from the Lower Mainland who had given birth in the last 12 months and asked them to complete three-day diaries detailing their physical activities to develop a theory about their physical activity decision-making. I found that their perspectives about how important physical activity is for meeting their needs influenced how they made decisions about postpartum physical activity.

One group of women, who considered physical activity important but had previous negative experiences, generally prioritized baby-focused activities over exercise. A second group liked physical activity and engaged in physical activity with their babies but didn’t consider pursuing physical activity without their baby as essential to their feelings of competence as a mother. Because of their experiences with motherhood, the environment, and emotional and physical recovery from birth, this group put their exercise plans on hold in order to prioritize activities that met their baby’s needs. And a third group were women for whom physical activity was a must and something that helped them function. This was the group most likely to pursue activities, including those that didn’t involve their baby, because they felt that this was important not only for their well-being but also their infant’s.

Why does this information matter?

Accurate information about women’s motivations can help health-care providers design more effective and tailored interventions. Women get plenty of guidance about infant care, breastfeeding and similar topics but get very limited or no professional advice about exercise and recovery from birth. Many of the women told me they were uncertain about what types of exercise were good for them. They didn’t know what their “new” bodies were capable of. They would go for a run and get injured or overwhelmed.

Most women were surprised at how “unfit” they felt as they returned to physical activity, which affected their perceptions of physical activity competence. Several reduced their activity, particularly when they had negative experiences or got injured or felt that they couldn’t handle all the physical work involved in caring for their infants.