Implementing and upscaling pregnancy and postpartum physical activity: a workgroup report from the international society of behavioral nutrition and physical activity — from individual-level barriers to multilevel implementation and scale-up

Abstract

Abstract Background Physical activity during pregnancy and the postpartum period is important for maternal health, yet participation remains suboptimal, and the implementation and scale-up of physical activity initiatives across diverse cultural and health-system contexts remain challenging. This workgroup report aimed to synthesize perspectives on barriers and facilitators to physical activity during pregnancy and the postpartum period, consider their implications for implementation and scale-up across diverse cultural and health-system contexts, and provide practical implications for research, practice, and policy. Methods Eight researchers with expertise in physical activity research from six countries attended the session “Implementing and Upscaling Pregnancy and Postpartum Physical Activity” as part of the Dare2Share sessions at the ISBNPA annual conference held in June 2025 (Auckland, New Zealand). All eight session participants contributed to developing the manuscript and approved the final version. This workgroup report draws on the professional expertise of the workgroup members. Shared perspectives were developed through facilitated group discussion during the face-to-face session, followed by iterative synthesis and refinement via email-based feedback. Relevant existing literature was used to contextualize and support the perspectives presented. This report reflects a synthesis of shared workgroup perspectives rather than findings from primary empirical data collection. Results This workgroup synthesis identified multilevel barriers and facilitators to physical activity during pregnancy and the postpartum period and developed a multilevel conceptual framework highlighting actionable leverage points across healthcare, community, and family settings. Informed by the Capability–Opportunity–Motivation–Behavior (COM-B) model, the framework links barriers and facilitators to multilevel implementation levers. The framework is intended to support implementation planning and scale-up across the perinatal period. Conclusions The insights emphasize the importance of system-level approaches, supported by cross-sector coordination, to integrate evidence into clinical practice, policy, and community programs.