When can you start to exercise after birth
Once you have rested and recovered from birth and settled your baby into a routine you may wish to commence a gentle exercise programme to help rehabilitate and retrain your body. If you have had a healthy pregnancy and normal vaginal delivery with no complications then you can start to commence Kegels immediately and gentle exercise within a few days after birth. However, there is usually a period of 6-8 weeks following a vaginal birth and 10 weeks after caesarean section in which a formal exercise regime is not commenced so as to allow for the post-partum check and clearance for exercise to be granted by your medical practitioner. This is because not only do you need rest to recover from birth but your uterus needs to descend and return to its normal position within your pelvis and your organs, tissues, tendons, bone and joints need time to normalise, reposition and restabilise. After this period, it is up to you to decide when you feel ready to commence an exercise programme. Rest assured that it is never too late to start and that you are always considered postnatal once you have had a baby o matter how old your baby is!
Benefits of postnatal exercise
There are many benefits associated with postnatal exercise that can help you whether your baby is months or years old.
Providing oxygen to healing tissues
Strengthening and stretching of pelvic floor (improving and healing incontinence issues)
Healing of Diastasis recti (closing the gap)
Strengthened core and protected spine
Increased strength and stamina
Improved coordination and balance
Improved body image
Relief of musculoskeletal aches and pains Improved confidence and feeling of capability
Weight management (lose excess weight)
Self-nurturing Time to self
Increased energy for baby/motherhood
Social interaction and making friends
Reduced symptoms of postnatal depression
Support and motivation to make lifestyle changes
What sort of exercise should you be doing?
Once you have been cleared for exercise initially the entire focus of any physical programme should be to reconnect & rehabilitate your breathing muscular sequencing and neuromuscular control and integration. This is so that your body can work as it is supposed to with efficiency control and stability allowing you to: breathe deeply, maintain a strong core, move with ease, and manage increases in pressure so that you do not pee your pants every time you cough!
Hence you should seek out low impact, gentle exercise that will allow you to rebuild your core, integrate your whole body and consider your breathing, Pelvic floor activation and then progress to bodyweight strength training and later external load training.
Before you start to add any heavy external load such as dumbbells it is important that you focus on the following:
Reconnecting to your pelvic floor and gaining conscious control
Reconnecting to your abdominal muscles and gaining conscious control
Re sequencing the triggering of core muscles so that they become active at the right time
Practising correct breathing strategies
Connecting your breath with the conscious and unconscious activation of your core muscles and pelvic floor muscles
Managing core pressure under the load of your own body weight
Generating core tension and managing pressure with a diastasis recti
Stability in your joints and balance
It is vital that you have all of these aspects dealt with and working correctly before you look at progressing the intensity of your exercise by adding external load (weights), impact (jumping/running) or bodyweight activities that increase internal pressure e.g. planks. Otherwise you risk delaying your recovery or causing damage to your body that can be long lasting and life changing such as pelvic organ prolapse.
This is a time for focused, mindful movement and an attitude of kindness and acceptance towards your body as you nurture it back to a state of efficient functionality. There are many exercises that can be performed safely for this stage and it can be fun to challenge yourself without the need for plyometric, ballistic or heavy loaded movements.
Retrain & be realistic
Once you have reconnected and rehabilitated your breathing, PF and core muscles and can move with stability and balance then you can start to progress your exercise and increase intensity. This stage allows you to have fun broadening your repertoire of exercises, activities and sports. With the correct programming you can start to build your strength, stamina, flexibility, balance and coordination and have the potential to be even fitter than you were before.
What sort of exercise should you avoid?
Anything that progresses the intensity of your exercise too quickly by adding external load (weights), impact (jumping/running) or bodyweight activities that increase internal pressure e.g. planks. Otherwise you risk delaying your recovery or causing damage to your body that can be long lasting such as hernia or life changing such as pelvic organ prolapse
High impact jumping, hopping, bouncing, running (for 3 months post birth)
Twisting or oblique exercises if you have diastasis recti
Crunches, sit ups or planks
Ballistic movements or quick changes of direction (unstable joints)
Any exercise where you hold your breath
Heavy external weight lifting
Swimming (when you still have Lochia blood loss)
Signs and symptoms to look out for?
You may find that upon commencing any gentle return to movement or exercise your body feels weak, less stable, not as coordinated and reactive-this is normal. Your organs bones, muscle joints, nerves have all been stretch and repositioned and they need time to heal and return to their normal state. You also need time to replenish your stores and ability to generate energy. So, you may feel week and less capable however this is all normal and usually temporary.
However, there are potentially life‑threatening symptoms that should you experience, you should immediately seek emergency medical assistance:
Faintness, dizziness or heart palpitations (irregular beats)
Fever, shivering, abdominal pain and excessive blood loss (potential fever)
Headaches along with visual disturbances, nausea or vomiting within 72hrs of giving birth (potential Pre-eclampsia)
Calf pain (in one leg), redness or swelling, shortness of breath and/or chest pain (potential blood clot)
Sudden loss of blood loss or persistent increased blood loss (potential Postpartum haemorrhage)
Tips for postnatal exercise
If you are unsure then wait until after your 6-8 week check and clearance to exercise
Seek out a specialist Postnatal exercise specialist divulge all information during your screening process
Wear comfortable non-restrictive clothing and a decent sports bra
Check your trainers still fit as your feet may have increased a size during pregnancy!
Eat a light snack 1hr before and drink a glass of water 30 mins before
Breastfeed before class so that your breasts feel more comfortable
Take water with you and pause for a water break regular and drink a glass after your session
Do exercise that you think you will enjoy so that you stick to it
If you feel totally wiped out, then rest instead but remember that exercise can pep you up if you need a boost
Stop immediately if you feel pain or unusual discomfort, you can try an alternative exercise
Commit to doing exercise regularly for a total of 150 mins per week (e.g. 5 x 30 mins sessions) per week and try to increase your daily activities such as walking etc.
Be patient and let your body heal first
Be realistic and work toward manageable goals and timescales
Enjoy the process and journey of self-nurturing and self-discovery
How can you find a safe and effective exercise programme?
As your body has undergone such huge physiological and anatomical shifts you will serve yourself best by finding an exercise professional who is trained specifically in postnatal rehabilitation. They should be able to screen you thoroughly for breathing, postural, pressure and pelvic floor issues as well as diagnose diastasis recti, address muscle imbalances and create a safe programme for you that will protect your body as you recover and regain strength. You can also find a wealth of resources online, but nothing can substitute the coaching a good professional can provide face-to-face when creating a bespoke programme for you that addresses your unique situation and requirements. If you are fortunate they may also provide further support beyond exercise and consider a more holistic approach to your wellness.