RETURNING TO EXERCISE POSTPARTUM

You have reached the end of pregnancy and it is time to consider a return to exercise, but when is the right time to return? How quickly can I return to my normal exercise routine and can I still perform all the same exercises I was previously doing? If you have recently just had a baby and find yourself asking these questions, then you have come to the right place. In this final blog post of my mini blog series about exercising through pregnancy, I will address these questions and provide some insight about how to safely return to exercise after giving birth. 

If you have been following along with my previous blog posts, I have broken down the important changes that occur with each trimester and how to safely adapt your exercise program to meet the new physiological needs of your body. We have talked about how to properly do Kegels to build up the pelvic floor, how to strengthen the lower body, how to be mindful of proper posture, and how to be mindful of identifying when a rest period is needed. Following the birth of your child, all these same principles apply.

When is it Safe to Return to Exercise?

The transition period of pregnancy is defined as the first six weeks after the birth of the baby. For some women who are used to an exercise routine, they might be itching to get back to it. For others, exercising might be the very last thing on their mind. Either situation is completely okay, but it’s important to emphasize that during this time you should listen to your body and do what’s best for YOU. Every mother is going to feel different during this postpartum period. The ACOG (The American College of Obstetrics and Gynecology) advises that if you have had a normal vaginal delivery and are no longer feeling any pain, no longer bleeding, and are not showing any signs of infection, then it is safe to gradually return to very light exercise and walking as soon as you feel ready. This can be as soon as a few days post-delivery! However, exercise should not be very strenuous for the first six weeks. If you had a caesarean delivery or any complications during delivery, it is advised to consult with your physician first before returning to walking or light exercise. However, as a general rule of thumb, it is best to consult with your physician first in either situation to get proper permission and alleviate risk of injury.

What Exercises are Safe to do Post-delivery?

Kegels

When first returning to exercise, it is important to focus on strengthening the abdominals and pelvic floor. The delivery process puts much stress and trauma on these areas and Kegels are the most important exercise that you can start doing right away post-delivery. For a refresher, a Kegel is a quick and easy exercise to strengthen the pelvic floor. To do a Kegel, imagine a long muscle that spans from your hips down to your tailbone. Now lift that muscle and hold for five seconds then relax. (Some women visualize this exercise like trying to stop the flow of urine). Do this consecutively 10-15 times and try to do them several times a day. This exercise might be very difficult the first few days after delivery but keep trying! It will get easier.

Abdominal Contractions

The transverse abdominis (the most interior abdominal muscle) is important for posture and core stability. This muscle, in addition to the external/internal obliques and rectus abdominis, is severely weakened and overstretched during pregnancy. To start restoring abdominal strength in the first week post-delivery, you can “hollow out your abs” by simply drawing your belly button up and back into your spine. Start by holding this for five seconds then gradually build it up to 20 seconds at a time. Perform these exercises several times throughout the day. 

The Fourth Trimester

The fourth trimester is a relatively new term that describes the first three months of the baby’s life. This time can often be the most difficult for the mother as she’s adapting to motherhood while also still healing from the physical trauma of childbirth. During the fourth trimester, women still might experience some of the same physiological changes while pregnant: weakened abdominals and pelvic floor, achy joints, weight gain, and extreme fatigue. The good news is that returning to exercise will help to alleviate some of these effects as well as decrease your chances of developing postpartum depression. Exercise during this fourth trimester should remain light and focus heavily on building back core strength. 

The Postpartum Period

13-25 Weeks

At this point post pregnancy, the most common complaints are backaches, incontinence, and weakened core muscles. Backaches (especially in the lower, lumbar region) can stem from an increase in breast size, weakened abdominals, and poor posture when changing diapers, carrying the baby, sitting for long periods of time while feeding, etc. Being mindful of posture, stretching the hamstrings, glutes, hip flexors and strengthening the abdomen will help to alleviate some of this back pain. 

Incontinence is involuntary loss of urine, often experienced when sneezing, laughing, or jumping. Exercises like jumping jacks, jumping rope, running, and jogging should be avoided until the incontinence begins to alleviate. Uphill walking, climbing stairs, and performing squats and lunges at a faster pace are alternative exercises that will still work to get the heart rate up but not increase incontinence. To help with incontinence it is important to keep doing your Kegel exercises to strengthen the pelvic floor. Interval training may also start to be incorporated again into exercise programs during this time. 

During pregnancy the four types of abdominal muscles: external obliques, internal obliques, transverse abdominis, and the rectus abdominus are all overstretched and elongated, resulting in weakness due to a loss of tension. Incorporating modified planks and other core exercises will be crucial to help quickly strengthen the core musculature.

25 Weeks and Beyond

At this point postpartum, the mother should be completely recovered from labor. Back pain and incontinence may still persist, but she can return to activities like running and as well as jumping exercises. Additionally, strength training with weights can be re-introduced at this point in time. It is crucial to listen to your body during this time and to still take it slow when progressing with increased weight. 

Final Toughts

It is so important that you give yourself some grace during this time. Your mindset should shift from “how you look” to “how you feel.” Your body just went through a traumatic change, and it is going to take some time to get back to looking and feeling back to your normal. Don’t rush it and listen to your body. 

Whew! We’ve made it. I hope you have found these blog posts informative and have learned a thing or two. I am excited to continue to work with pregnant mothers during this exciting and everchanging time in their life. If you or a loved one would like to begin your exercise journey, please reach out. I would love the opportunity to share my knowledge and create a workout plan that is suitable to YOU! 

Yours in Wellness,

Taylor