From static guidelines to dynamic adaptation: a scoping review of maternal physical activity health services worldwide

While the benefits of physical activity (PA) during pregnancy are well-established, PA levels remain low. Many countries have introduced maternal PA guidelines. This review synthesizes key recommendations, identifies gaps, and explores best practices for improving public health services and bridging the gap between evidence-based guidelines and real-world implementation. Following the Arksey and O’Malley scoping review framework and adhering to the PRISMA-ScR guidelines, we systematically searched official sources and academic databases covering all 194 WHO-recognized countries from January 2024 to February 2025. National-level maternal PA guidelines and related implementation studies were identified and screened. Data extraction focused on guideline content, policy support models, implementation strategies, and service accessibility. Analytical frameworks included the Chief Medical Officers’ communication framework and the WHO health system assessment model to evaluate the translation of guidelines into practice. We registered a protocol in the Open Science Framework (OSF) ( https://doi.org/10.17605/OSF.IO/Z5SEY ). A total of 26 countries with eligible national maternal PA guidelines and 37 implementation studies published within the past decade were included. Core guideline recommendations were consistent across countries, emphasizing 150–300 min of moderate-intensity aerobic activity per week, muscle strengthening, and sedentary behavior reduction. However, stage-specific and postpartum recovery guidance remain limited. Implementation models varied, including human-driven, digital, and hybrid approaches, with resource availability significantly influencing service delivery. Key barriers included insufficient cross-sector collaboration, delayed professional training, inadequate community mobilization, and limited use of digital health technologies, particularly affecting low- and middle-income countries’ ability to translate guidelines into effective health services. Global maternal PA guidelines present coherent core principles but require enhancement with stage-specific and personalized recommendations and clearer delineation of professional roles. Dynamic adaptation between policies and practice through strengthened multisectoral collaboration, community engagement, and digital innovation is essential to bridge the implementation gap. Such multifaceted approaches will support sustainable, equitable promotion of maternal physical activity, advancing global health and gender equality goals.