Many women are really keen to return to exercise after pregnancy. Unfortunately, the media often gives unrealistic images and expectations of how quickly women should lose their “baby weight” after pregnancy, and of the type and intensity of exercise that is appropriate to perform.
This is a general guide on suitable exercising in the postpartum year. However, you should consider your individual circumstances and symptoms, as you may be able to do more or less than this.
Why should I exercise after I have had my baby?
There are many benefits in returning to, or starting, exercise after you have had your baby. These include:
- Improving or restoring your general fitness, strength and flexibility
- Helping your body recover from pregnancy and birth
- Helping you return to your pre-baby weight
- Improving overall well-being, and reducing the incidence of postpartum depression and anxiety
- The chance to meet other new mothers if exercising in postpartum group classes
- It can be a great incentive to get out of the house with a young baby!
What type of exercise is appropriate in the postpartum year?
This will vary depending on how long ago you had your baby, the type of delivery you had and whether you had any complications. As a general guide:
Pelvic floor muscle exercises should be done by all women
One in 3 women who have a baby develop urinary incontinence and up to 50% get pelvic organ prolapse. Start pelvic floor exercises regularly and early to help prevent these problems. 3 sets of 8-12 daily is ideal, but you may need to start with fewer repetitions more often at first. See a Women’s Health Physiotherapist if you have any symptoms, or if things just don’t feel “right” down there.
In the first 6 weeks after delivery
Start gently – remember your body is still recovering from pregnancy and birth, and you are still getting used to life with a new baby, and you’re probably sleep deprived too! Gentle, low impact exercise is best.
Walking is a great way to start – slow and short walks initially, gradually increasing speed, distance and incline as your body allows. And you can take your baby with you; the crying doesn’t seem so loud when you’re out of the house, and it might even put them to sleep!
Gentle swimming or walking in a pool is OK once your wounds have healed and your lochia has stopped.
From 6 weeks – 3 months
You can start doing a bit more at this stage, but progress slowly, especially if you have not exercised for some time.
Pilates or yoga are gentle to moderate forms of exercise focusing on posture, core control and stretching. Many places offer postnatal classes too.
Gentle cycling is OK once you can comfortably sit. Start on flat terrain and build up slowly.
Swimming and walking can be continued. You may be ready to increase the intensity or distance by now.
From 3 months onwards
It is possible to return to any form of exercise at this stage, but use your common sense. If it’s been a while since you did certain forms of exercise (weights, high impact) then start back gradually and at a lower level than you were doing previously.
Listen to your body – if you get aches and pains, pelvic floor symptoms or notice abdominal muscle separation, then that type of exercise may not be appropriate. Stop and seek advice.
Signs of trouble
Any type of pelvic floor dysfunction including incontinence and urgency (urinary or faecal), a heaviness, lump or bulge in the vagina (signs of prolapse), pain or difficulty with emptying your bladder and bowels or with intercourse (can be signs of pelvic floor muscle over-activity). Some women will not get symptoms until they start exercising. Certain types of exercise, including high impact exercises (eg, skipping, jumping, running) and heavy weights can be particularly problematic, and may need to be avoided if you have symptoms.
Doming or separation of the abdominal muscles. Most women get some widening of the abdominal muscles (diastasis rectus abdominis muscles, DRAM) during pregnancy, and this may persist postpartum. You may notice it when you do things like getting out of bed or with lifting. If the separation is more than a few centimetres and persists for more than 8 weeks, you should see a Physiotherapist for advice. Strongly loaded abdominal exercises (sit-ups, planks etc) performed incorrectly may make a DRAM worse.
Tender breasts – whilst you are breast feeding, your breasts can be a lot larger and more tender, making some forms of exercise uncomfortable. A supportive sports bra can be very helpful, and you may find feeding before exercise helps too. Your milk supply won’t be adversely affected by exercise, so long as you adjust your fluid and calorie intake up a little to account for exercise demands.
Ongoing pain. Most women find pregnancy-related low back or pelvic pain usually resolves soon after having their baby, but for some it can continue. Neck, back, shoulder and wrist pains are also not uncommon in the early postpartum period. Looking after a young baby can be quite physically demanding! Always get persistent pain checked. Commonly small modifications at home, some exercises and stretches can make a big difference.
A sudden increase, or return, of your lochia. It is normal for this vaginal discharge to continue for some weeks after delivery, and you should avoid swimming in public pools until this stops, due to the risk of infection. Sudden increases in the lochia may indicate a problem, so check in with your GP if this occurs.
What type of exercise should I avoid?
Certainly avoid any form of exercise that brings on any of the trouble signs mentioned above. Again, the advice here is general, and your individual circumstances may be different, so seek personal advice if you are not sure.
In the first 6 weeks remember your body needs time to recover from pregnancy and delivery, no matter what type of delivery you had. You may need plenty of rest to help establish breast feeding, and to allow any scars (Caesarean, perineal) to heal, so go easy on exercise during this time.
Don’t return too quickly to high impact or high intensity exercise and heavy weights, or very strong ‘core’ exercises. You may have lost some fitness and strength over your pregnancy. Start gradually, and build up slowly.
Anything which causes symptoms of pelvic floor dysfunction, including incontinence, prolapse symptoms or pelvic pain. This should always be investigated.
Care with using your baby as an exercise prop. There are many classes around which offer the ability to exercise using your baby as a weight, or pushing the pram for resistance. These can work well in some cases, and provide the chance to exercise, even when child minding is not available. However, many women can end up hurting themselves, as their baby may be too heavy or uncooperative – so if it doesn’t feel right for you, don’t do it.
Care with ‘boot camp’ style postnatal classes. Some trainers and gyms offer intensive classes aiming to improve your fitness and strength “fast” postnatally. They can be great if done well. However, beware of lifting heavy weights, especially if you are not accustomed to this, and of suddenly increasing your exercise intensity in a short period of time – this is a perfect recipe for injury. You are better off gradually increasing exercise intensity and weights over time in a sensible and graded way, and much less likely to end up with an injury, which might set you back for weeks or months.
Your GP, Midwife, Obstetrician or Physiotherapist can help you determine what exercise is appropriate for you, and what type of exercise should be safe for you to undertake. Please remember, this information is general and may not be right for you.