Active Mom Podcast: Pregnancy, Postpartum, Perimenopause, Menopause & Beyond

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Labor Day is in the rearview, the temps are finally doing what they're supposed to do, and this is the last rewind of the summer. Quite honestly, this is the one I wanted to close out on.
When Margie came on for this one, she spent a good chunk of the hour telling me she couldn't tell me things. I'd ask, she'd dodge. I'd ask sideways, she'd dodge nicer. At one point I told her she was like a mystery novel and I just wanted to know what happened on the next page. She said she'd love to tell me, but she can't.
She wasn't being precious about it. The Canadian postpartum guidelines were still in peer review, and she walked me through exactly why researchers go quiet. Until a paper has been through that process, she is not going to stand up and tell you something is safe. She also told me the first draft went out to postpartum women for feedback and came back with a note that it was going to cause a lot of mom guilt. So they went back and reworked the messaging. As a mom herself, that was not a message she was willing to send.
Listening back now, with the guideline published and Margie already back on the show this past summer to walk us through it, this one plays completely differently. This is the hour right before.
🔹 Why the assumption that elite athletes have the best of everything is mostly wrong, and what happens to the ones who get told they're done at the first trimester
 🔹 The athletes nobody has studied: the ones who wanted to come back and couldn't. Margie's team put out the invitation and got almost nothing back.
 🔹 The one thing Margie says she'd go back and do more of, in pregnancy, in postpartum, and now heading into perimenopause
 🔹 Postpartum and perimenopause showing up in the same body at the same time, and how little we currently have to offer either one
 🔹 In Canada, 7% of all grant funding goes to women's health. The postpartum guideline got none of it. It got built by volunteers and undergrads.
 🔹 The PhD student she says to watch, and why sleep may turn out to matter as much as exercise in this window
Margie is one of my favorite people to just throw questions at, and this is her at her most honest about what we still don't know.
Margie first came on the show back in Ep 38 in 2022, and she was back this summer on Ep 252 to walk through the guideline once it published. If this one leaves you wanting the answers, that's the episode with them.
Find her on Instagram at @drmargiedavenport.
One thing this whole hour keeps circling: screening before somebody hands you a program. Nobody can tell you what your body is ready for without looking at it first. If you're in the Arlington area, come see me in the clinic. If you're anywhere else, telehealth and virtual consults are open. 
This is education, not individualized medical advice. If you're having symptoms, get eyes on it.
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.
Questions or topic requests? DM me 💌

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Somewhere between 2019 and now, "wait 12 weeks" turned into a rule. It is not a rule. It never was.
I have been in pelvic health for 26 plus years, and right now I am watching that number get handed around in Facebook groups, on social, and quite honestly by a lot of professionals who are leaning really hard on it. I don't know that the foundation exists to do that. So this is a solo episode where I walk you back through how we got here.
🔹 Why the six week visit was a medical checkpoint, not a green light to run
🔹 What the 2019 UK document really is, and what it isn't
🔹 The 2024 international Delphi: 95 professionals, 12 countries, seven professions, and what they actually agreed on
🔹 Why "returning before 12 weeks is possible" is the line that keeps getting missed
🔹 The one in a hundred outlier, and why I will not shut her down
🔹 Gatekeeping. My own profession has been doing it, and I was a product of it
🔹 The 2025 Canadian postpartum guidelines, including why sleep got named a movement behavior
🔹 The four variables nobody puts on a timeline: sleep, fueling, support, mental health
🔹 What you control and what you absolutely do not
🔹 The line a kindergarten teacher gave me that I now use with patients
If you are a mom trying to figure out when, this one gives you better questions than a date on the calendar. If you are a pro who has been leaning hard on 12 weeks, this one is an invitation to step back.
And if what you really want to know is where YOU are right now, that is what the free Return to Run Readiness Screen is for. Balance, strength, impact. https://course.carriepagliano.com/R2Rreadyscreen
IN THIS EPISODE
(00:00) Why we are talking about 12 weeks right now
(02:44) Where the six week mark came from
(03:55) The 2019 UK document that was never a guideline
(05:22) ACOG moved off six weeks in 2018
(08:50) The 2024 Delphi: what 95 professionals agreed on
(11:16) The one in a hundred outlier
(14:07) Gatekeeping movement in pregnancy and postpartum
(16:08) The 2025 Canadian postpartum guidelines
(18:06) Phase based instead of date based
(20:26) All roads end up in the same place
(22:03) Sleep
(22:50) Fueling and energy availability
(25:13) Support, childcare and logistics
(28:32) Mental health, and what is going on physically
(31:51) What you control and what you do not
(39:28) Episodes to listen to next
STUDIES MENTIONED
Christopher SM, et al. Br J Sports Med. 2024;58(6):299-312.
Deering RE, et al. Br J Sports Med. 2024;58(4):183-195.
Davenport MH, et al. Br J Sports Med. 2025;59:515-526.
Schulz JM, Thornton JS. Br J Sports Med. 2024;58:511-512.
Christopher SM, Cook CE, Snodgrass SJ. PLoS One. 2021;16(8):e0255383.
ACOG Committee Opinion No. 736. Obstet Gynecol. 2018;131(5):e140-e150.
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.
Questions or topic requests? DM me 💌

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Shefali got hate mail.
Not a snarky comment on a post. Emails. From other people who work with postpartum runners, coming at her over a single number in a consensus paper.
The number was three. As in, after a minimum three week period of rest and recovery, some people might be ready to start doing some things. Drills. Not a 5K. Not a race. Some things.
And she wasn't even giving her opinion. She surveyed clinicians and exercise professionals, coded what they said, and reported it back. That is the entire job of a Delphi.
I'm bringing this one back for the Summer Rewind because there are so many new moms getting back to running right now, and the six week clearance conversation has not moved an inch. It is still the default. It is still a date instead of a plan. And I promise you it is still costing women the strength they walked in with.
🔹 What a Delphi study actually is, and why it exists when the research is thin
🔹 Where the six week rule came from and what it never accounted for
🔹 The consensus on what "postpartum" means, and on who gets to call herself a runner (you'll like this one)
🔹 Why detraining is a real cost and not a theoretical one
🔹 The bias every one of us carries: the moms who were doing great were never in your caseload
🔹 Shefali on her own two pregnancies, and what changed between them
If you have ever been handed a date instead of a plan, press play. And if you're the one handing out the dates, I especially want you in this one.
Which date were you given, and did anybody explain it?
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.
Questions or topic requests? DM me 💌

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This one is going to ruffle some feathers.
Hypopressives. Low pressure fitness. Whatever your algorithm is calling them this week. The theory has been the same since 1984: you do the breath, you hold the posture, your intra-abdominal pressure drops, and your pelvic floor switches on because of that pressure drop.
Nobody had measured the pressure.
Silvia Saraiva did. She trained 36 women who had never done a hypopressive in their lives, gave them two weeks to practice, then brought them into the Motor Function Measurement lab at the University of Ottawa with an intra-abdominal pressure sensor, EMG inside and out, and ultrasound running. Supine and standing. With the hypopressive posture and without it.
The pressure didn't drop. 
The pelvic floor did turn on. Just not through the mechanism we have all been teaching.
Here's what makes this conversation worth your time: Silvia is hypopressives-trained. She still teaches them. She has patients who seek her out specifically to learn them. She is not here to tell you to stop. She is here to tell you the explanation doesn't hold up.
🔹 What a hypopressive actually is, broken all the way down
 🔹 The theory, and where it came from
 🔹 Why the measurement tools matter more than most of us want to admit
 🔹 What happened to intra-abdominal pressure lying down versus standing
 🔹 How hard the pelvic floor actually worked, compared to a max contraction
 🔹 Whether nailing the posture changed anything
 🔹 If the pressure didn't drop, what IS causing the contraction
 🔹 What Silvia tells the patients who ask her to teach them
 🔹 Where hypopressives fit if strength is the goal
Silvia Saraiva, BScPT, MScHK, is a pelvic health physiotherapist and researcher who completed her Master of Science in Human Kinetics at the University of Ottawa under Dr. Linda McLean. Her paper is out now in Physiotherapy, and there is a second one coming.
When you learned hypopressives, or taught them, was the pressure drop the whole point? I want to know what you were told and what you think after listening to the pod!
Saraiva S, McLean L. Intra-abdominal pressure and pelvic floor muscle activation observed during hypopressive exercises performed in supine and standing: An observational cohort study. Physiotherapy. 2026 Sep;132:102316.

Silvia on Instagram: @thepelvicgirl
The lab: @mfm_lab
 00:00 Intro
 01:00 Why we have never covered hypopressives
 01:45 Meet Silvia Saraiva
 02:25 Ottawa to northern Ontario
 05:45 How far the nearest pelvic floor physio really is
 06:55 Why hypopressives are big in Brazil, Spain and France
 07:35 What a hypopressive actually is, step by step
 09:00 The theory: pressure drops, pelvic floor turns on
 10:00 Why how you measure it matters
 10:50 The tools: pressure sensor, EMG, ultrasound, dynamometry
 14:40 Crosstalk, motion artifact, and the problem with earlier studies
 16:15 What clinicians miss when we skim to the conclusion
 18:45 Who was in the study
 21:05 Training beginners, and the expert who flew in
 23:45 Are hypopressives easy? No.
 28:15 The findings
 30:00 Did position or posture matter?
 31:30 If the pressure didn't drop, what is causing the contraction?
 32:40 "You're just not doing it right"
 33:30 What Silvia tells patients now
 35:35 What about a high tone pelvic floor?
 37:40 Prolapse and first line care
 38:20 What she would study next
 42:30 When the explanation is wrong but the results are real
 43:40 Where to find Silvia 
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.
Questions or topic requests? DM me 💌

Send us Fan Mail
Okay, so this one is a Summer Rewind, and I'll be honest with you, I went back and forth on which episodes to bring back. This one wasn't a hard call.
The original aired in September 2022. I re-listened before we re-ran it and quite honestly? I'm still hearing every single one of these myths in clinic. Every one. A couple of years later.
Rich Willy has spent 20+ years treating injured runners and publishing the research the rest of us end up citing. And the thing I love about him is that he opens by admitting he used to believe most of these myths himself. That's the whole reason it holds up.
So I asked him to name the running myths he most wishes would just disappear. Stretch more. Strengthen your glutes. Land softer. You're running wrong.
Here's what we get into:
🔹 Why stretching isn't the thing standing between you and an injury, and what to do with that warm-up time instead
 🔹 The calf, not the glute. Running is a plantar flexor sport, and Rich tells you exactly where to spend your strength minutes if you only have a few
 🔹 The bone force number that flips "just land soft" completely on its head (this one genuinely changed how I talk to runners)
 🔹 Why your single biggest injury risk factor is the injury you already had, back in your 20s, in high school, in a body you don't have anymore
 🔹 REDs, energy availability, and why a normal body weight tells you almost nothing
 🔹 Return to participation, return to sport, return to performance. The three-stage model most of us skip right past
 🔹 What actually happens when you tell a runner to change the way she runs
And I promise you, this is a pelvic health episode. If the calf and the quad and the hip aren't holding up their end of the bargain, the pelvic floor is left holding the ball. You can hyperfocus on the pelvic floor and still completely miss the boat.
So if you're a mom who's five or ten years out and still hasn't gotten back to running, this is for you. And if you're a clinician who's been quietly wondering whether the thing you've taught for a decade is actually still true... this one's for you too. No judgment. I've been there.
Come find Rich on Instagram: @montanarunninglab
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
Follow so you don't miss an episode. Rate & review ⭐⭐⭐⭐⭐ — it's how the next mom searching for these answers actually finds them. Share it with the friend who needs it.
Questions or topic requests? DM me 💌