With so much cultural emphasis on “body after baby,” it’s no wonder that many new moms want to know when it’s safe to return to exercise after delivering and which exercises are best. Unfortunately, there’s little in the way of hard-and-fast rules when it comes to postpartum fitness because each body and each delivery is unique.
“Technically you’ll be cleared to return to exercises by your OB-GYN or midwife six to eight weeks postpartum,” says Laura Ward, a physical therapist specializing in pelvic health and women’s health rehabilitation at the Ohio State University Wexner Medical Center in Columbus.
However, she adds that “depending on your delivery and previous fitness levels it may be better to wait until around 12 weeks when your tissue is 100% healed to return to working out. There are safe exercises that can be performed before 12 weeks, but they may not be at the same level as your normal workout.”
She notes that it takes 12 weeks for soft tissue to fully heal “and can take four to eight weeks to gain strength.”
Recovering from Delivery
However, Dr. Sarah Isquick, an OB-GYN with Santa Clara Valley Medical Center in San Jose, California, notes that depending on how you’re classifying “exercise,” some women can get back to it almost immediately after delivery. “If you had an uncomplicated vaginal birth, you can typically start exercising as soon as you feel ready. For some, this can be as early as a day or two after your birth. If you had a cesarean birth, we recommend waiting until six weeks after birth to resume resistance training or more vigorous aerobic exercise.”
Sarah Bowmar, a certified nutrition specialist, personal trainer and prenatal and postpartum trainer, recommends walking soon after you get home from the hospital, “at least 1 to 2 miles a day. It’s a great way to get out of the house and get the baby used to their stroller.” This should be a graded return. Start slow and work your way up to 1 to 2 miles a day over the course of about two weeks.
In addition to getting some much-needed exercise, getting out for a walk every day can also help with your mental health, says Bowmar. “Sunshine helps so much when it comes to serotonin and melatonin levels, two brain chemicals that help regulate feelings and sleep cycles. And sunshine can also contribute to “overall happiness due to increased vitamin D levels. And movement simply feels amazing.”
Dr. Randy Fiorentino, an OB-GYN with Providence St. Joseph Hospital in Orange County, California, adds that the sooner you can get back to exercise, the better. “Physical activity postpartum can be very helpful in preventing depressive symptoms or disorders that are common among women in the postpartum period.”
All that said, if you had complications from your pregnancy or delivery, it’s best to ask for tailored guidance, Isquick says. “For individuals who experienced complications during a birth such as third- or fourth-degree tears, excessive bleeding or who have preexisting medical issues, it’s best to ask your health care provider about when it is safe to start exercising postpartum.”
Bowmar agrees: “You should listen to your doctor and your body, especially if you’ve had a C-section.”
Exercises to Include After Pregnancy
With so many choices for exercise activities, it can be difficult to know what the best exercises you can do right after giving birth .
Ward recommends focusing on exercises that target the following areas:
- Core. Core strengthening exercises like planks, crunches and various yoga poses that target the core muscles can be helpful for stabilizing and rebuilding the abdominal muscles that often weaken during pregnancy. However, Isquick cautions that you should avoid doing sit-ups or crunches “for at least the first six weeks after a vaginal birth and potentially longer after a cesarean birth.”
- Pelvic floor. Kegel exercises are a series of contraction and relaxation movements of the pelvic floor muscles that can help you rebuild those muscles after childbirth. The pelvic floor muscles are the ones you can engage to stop the flow of urine mid-stream. Diaphragmatic breathing is also good for strengthening the muscles of the pelvic floor.
- Glutes. Glute bridges help build up the glutes, or butt muscles, which further help stabilize the core and pelvic floor.
In addition, “mid-back and posture exercises can help avoid the discomforts and pain that are common in the early phases of postpartum,” Ward says.
As you create a return-to-fitness routine, Isquick recommends “working up to a routine of 30 minutes of aerobic exercise – activities that get your heart rate up and make you sweat – at least five times per week. Start slowly with walking and build up to more vigorous activities.”
And she notes that “if you have a specific concern like a diastasis recti, also called persistent separation of the abdominal muscles, after pregnancy, there are more focused exercise regimens that you can use.” Talk to your doctor if this is an issue for you.
Postpartum Exercises to Avoid
On the other hand, there are some exercises that you’d be better off avoiding until you’ve gotten a little farther postpartum. Ward notes that exercises to avoid after having a baby include:
- Anything that’s painful.
- Anything that causes abdominal doming, another term for diastasis recti.
- Anything that causes pelvic pain.
- Anything that causes any urinary leakage.
“These are all signs of dysfunction and would warrant an assessment from your health care provider or a pelvic floor physical therapist,” Ward says.
Bowmar adds that “when it comes to your pelvic floor, if you haven’t been relaxing and contracting it while pregnant, you should be contacting a physical therapist to go over proper rehab to ensure you’re not lifting too much too soon and damaging an unstable pelvic floor.”
Benefits of Diaphragm Breathing
Bowmar notes that “you also want to ensure you’re doing proper diaphragmatic breathing to restore your core.” Also called belly breathing, diaphragmatic breathing engages the large muscle in the abdomen to help fully fill the lungs. Practicing belly breathing regularly offers many benefits, including building strength in the diaphragm during or after pregnancy.
Here’s how to perform diaphragmatic breathing:
- Lie down on a flat surface or sit up tall with your back straight.
- Place one hand in the middle of the upper chest and the other on the stomach just under your rib cage.
- Inhale slowly through the nose and guide the breath down toward the stomach. Feel the hand on your belly being pushed outwards.
- When you exhale, tighten your abs and let the stomach fall inwards as you breath out through pursed lips. The hand on the upper chest shouldn’t move during the breath.
If you’ve had a C-section, Isquick says it’s best to “avoid vigorous aerobic exercise or lifting anything heavier than your baby for the first six weeks.”
Fiorentino adds that “as with all exercise, excessive use of weights or strenuous activity can increase risk of injury in the immediate postpartum period and all exercise should be begun and with appropriate stretching to prevent muscle injury.”
Still, he notes that “physical activity is largely without risk and associated with significant benefit to new moms and helps encourage lifelong healthy habits.”
What to Know When Starting to Exercise
When you do start getting back to your workout routine, Ward cautions that you need to take it slowly. “Having a baby is an amazing, wonderful thing, but it can also be traumatic to your body. Whether you have a vaginal delivery or C-section, your body has gone through an amazing process that takes time to recover from. It’s OK to take time to heal and bond with your baby.”
Bowmar notes that how long it’ll take to get back in shape postpartum “varies from person to person.” Rather than worrying about “getting back” to your pre-pregnancy body, it’s important to think about it as remaining as healthy as possible for yourself and your baby, she says.
Ward also notes that you should go easy on yourself. “Your body is different than it was before you had the baby, so it may also take time to adjust and return to your previous fitness levels.” And it’s not a good idea to compare yourself to other new moms.
“Getting back in shape after having a baby varies for each individual,” based on certain variables, Ward says. The time it takes to get back in shape can vary from pregnancy to pregnancy for the same woman too.
For example, “if you breastfeed, your hormones will stay elevated longer to allow you to breastfeed, so it can take longer to ‘get back in shape.’ If you were very fit before having a baby, it can take less time than someone who stopped working out during pregnancy.”
Isquick agrees that there’s a lot of variability when it comes to postpartum fitness. “Pregnancy and having a baby cause dramatic changes in a person’s body. Try to ease back into an exercise routine and avoid overexertion as it will take time to build your strength and endurance back up to pre-pregnancy levels.”
She adds that you’ll need to “be patient and kind to yourself as you’re working back up to your pre-pregnancy exercise routine.”
Starting slowly with walking is best, Bowmar says. “Work on recovery from birth, and don’t put so much pressure on yourself.”
There are some practical considerations too, Ward says. For example, “if you’re breastfeeding, you want to be sure you have a very supportive bra when returning to exercises.”
With all these considerations, Ward says six to 12 months is a reasonable time expectation for most people for getting back to pre-pregnancy shape. “Give yourself time. You may not be able to return to running right away, or back to lifting as much weight as you may have been able to right away, and that’s OK. You can get there.”
Keep in Touch With Your Doctor
Along the way, if you have any signs that something’s wrong, seek help. “If you’re experiencing any pelvic symptoms, like urinary leakage, pelvic pressure or any pain with intercourse, please seek care with a pelvic floor physical therapist. There is help out there,” Ward says.
Isquick adds that if you’re “experiencing pain, leakage of urine or stool, prolapse (weakening of the bladder, uterus or rectum, resulting in downward movement in the pelvis) or notice heavier bleeding while exercising, follow up with your provider who may encourage you to slow down or recommend pelvic floor physical therapy.”
Lastly, Isquick notes that exercising postpartum can be a great new lifetime habit. “If you didn’t have consistent exercise practice before or during pregnancy, the postpartum period is a great time to start building healthy habits for you and your family. In addition to helping to lose excess baby weight, having a regular exercise routine promotes better sleep, reduces stress, boosts your mood and may help to prevent postpartum depression.”