Mental Health and post natal physical activity
There is low-to moderate quality evidence to suggest physical activity during the antenatal and post natal period may reduce depressive symptoms. There is no clear evidence on type, duration, intensity or frequency but the majority of trials aimed towards the U.K. Chief Medical Officer’s recommendations of 150 mins a week, across 5 days a week of moderate intensity. There are recent systematic reviews and meta-analyses of many randomised and quasi randomised controlled trials with moderate sample sizes, examining the effects of exercise on postnatal depression. [1, 8, 12, 13, 16, 17]. Overall, they show a small-to-moderate reduction in postpartum depressive symptoms among women who were physically active during their pregnancy including women in the general population and those at increased risk of postpartum depression and those diagnosed with mild-to-moderate depression. There is also show a similar effect of physical activity on postpartum depression (prevention and treatment). [8, 12, 16, 22]
These trials studied the effects of physical activity in women with mild-to-moderate depression, so these recommendations should not be generalised to women experiencing severe depressive symptoms. That being said, there have been no negative consequences to being physically active in this group.
No evidence was available for review on the effects of physical activity on the features of other mental health disorders postnatal women can experience.
Quality of evidence
Strength of recommendation
NICE recommends exercise as a treatment for non-postpartum adults with mild-to-moderate depression. There is moderate quality evidence to suggest that exercise is moderately effective in reducing depressive symptoms in postpartum women and at improving psychological wellbeing, such that there should be a strong recommendation for women to be physically active throughout the postpartum period. Physical activity should also be considered an effective adjunct to conventional treatment options in postpartum women diagnosed with postnatal depressive symptoms.
- Demissie Z, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Associations Between Physical Activity and Postpartum Depressive Symptoms. J Women’s Heal. 2011;20(7):1025–34.
- Pritchett RV, Daley AJ, Jolly K. Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis. Br J Gen Pract. 2017;67(663):e684–91.
- McCurdy AP, Boulé NG, Sivak A, Davenport MH. Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period: A Meta-analysis. Obstet Gynecol. 2017;129(6):1087–97.
- Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Cavero-Redondo I, Martínez-Vizcaíno V. Effects of exercise-based interventions on postpartum depression: A meta-analysis of randomized controlled trials. Birth. 2017;44(3):200–8
- Nakamura A, van der Waerden J, Melchior M, Bolze C, El-Khoury F, Pryor L. Physical activity during pregnancy and postpartum depression: Systematic review and meta-analysis. J Affect Disord [Internet]. 2019;246(August 2018):29–41
- Teychenne M, York R. Physical activity, sedentary behavior, and postnatal depressive symptoms: A review. Am J Prev Med [Internet]. 2013;45(2):217–27
- Daley A, Jolly K, MacArthur C. The effectiveness of exercise in the management of post-natal depression: Systematic review and meta-analysis. Fam Pract. 2009;26(2):154–62.