Postpartum Exercise: 6 Things You Need to Know

You might be anxious to hit the gym again in order to lose some of those pregnancy pounds, but exercising after giving birth isn’t just about achieving that “perfect” post-baby body (despite what those celeb tabloids say). Postpartum exercise provides health benefits such as strengthening and toning your abdominal muscles, boosting your energy, helping you sleep better and relieving stress. But due to weak muscles, an achy body and just plain exhaustion, you might not feel ready or maybe even feel a little scared to start working out again. To help you get up and running, here’s what you need to know about beginning a postpartum exercise routine.

Since every woman’s postpartum recovery is different, Dr. Huma Farid of Boston's Beth Israel Deaconess Medical Center says that the time to start exercising after giving birth depends on “how much the woman exercised during pregnancy, what kind of delivery she had and whether there were any complications during delivery.”

Also, your fitness level pre-pregnancy can be a determining factor. If you were exercising regularly and in good physical condition before you got pregnant, you'll probably have an easier time getting back into it after giving birth. But “don’t try to do all you did before or begin a strenuous new routine for at least a couple of months,” says Dr. Felice Gersh, founder and director of the Integrative Medical Group of Irvine and author of PCOS SOS: A Gynecologist's Lifeline to Naturally Restore Your Rhythms, Hormones and Happiness. 

“In general, for women who had an uncomplicated vaginal delivery, they can start exercising gradually as soon as they feel ready,” Dr. Farid says. “Most women are able to resume exercising about four to six weeks after an uncomplicated delivery.” Be sure to check with your doctor about starting an exercise routine (usually during your standard six-week postpartum checkup), especially if you had a cesarean birth or other complications. “For women who have had a C-section, that [start time] may be extended to six weeks after delivery. Women can return to the gym safely by six weeks postpartum, but their joints and ligaments may not return to their pre-pregnancy state until three months postpartum.”

That’s because of relaxin, the hormone that loosens your joints in preparation for labor. It can remain in your body well after birth, which means you might be wobblier and experience more aches and pains. So keep that in mind as you begin your postpartum workouts. Dr. Farid suggests starting with a brisk walk around the block to give you an idea of how your body has healed. Overall, you’ll want to start off gradually and gently. No new mom will be ready to run a marathon right away, but you may feel like you just ran one. 

“I advise my patients to listen to their bodies and exercise as much or as little as they feel is reasonable,” Dr. Farid says. “If exercising is causing pain, I recommend that they wait one to two more weeks prior to starting again. They should increase the amount of exercise gradually, and for women who have had a C-section, I recommend avoiding heavy lifting (such as weight training) for six weeks. I would recommend starting gradually with brisk walks about 10 to 15 minutes in duration and increasing gradually.”

Dr. Gersh also recommends taking a well-paced walk after each meal and starting with “light weights at six weeks postpartum for vaginal deliveries and eight weeks after a C-section.” You might also want to work up to bodyweight exercises like push-ups, pull-ups and squats.

Other low-impact aerobic activities to consider include swimming, water aerobics and gentle yoga or simply stretching. At the gym, hop on the stationary bike, elliptical or stair climber.

During pregnancy, as your belly expands, the tummy’s connective tissue is stretched out and the rectus abdominis (the muscles that run vertically down the sides of your abdomen) get pulled apart and separate down the middle. This is known as diastasis recti, and most pregnant women experience it. For some women, the gap closes up quickly, while others may have separation up to six months postpartum. If your belly still looks pregnant months after you’ve delivered your baby, you probably have diastasis recti. And this is why getting that six-pack back (or for the first time) will be challenging.

Instead of doing a million crunches, which can actually make the condition worse by pushing the muscles further apart, try doing planks and focus on strengthening your deepest abdominal muscles (known as the transverse abdominis or TVA muscle) to regain your core strength and stability. But ask your doctor before attempting any ab exercises since you may need to see a physical therapist who specializes in postpartum training, depending how severe the diastasis recti is.

Besides stretched-out ab muscles, your pelvic floor will also be weak. To help strengthen the bladder muscles that can be damaged during pregnancy and childbirth, Dr. Farid recommends practicing Kegel exercises. In addition to walking, Kegels should be one of the first exercises you incorporate into your postpartum routine. To do them, pretend you’re trying to stop the flow of pee by tightening your pelvic floor muscles from front to back. Hold and release. Do this about 20 times for ten seconds each time, five times a day. This will help with bladder and bowel control as well as prepping your vagina for postpartum sex.

According to the U.S. Office of Disease Prevention and Health Promotion’s Physical Activity Guidelines, adults should get at least 150 minutes of exercise per week (about 30 minutes a day, five days a week or three ten-minute walks each day). “But realistically, many women with new babies struggle to carve out the time to exercise,” Dr. Farid says. “If a woman cannot find time to exercise and has just given birth, I would encourage her to give herself a break and exercise when she can. Taking walks with the baby in the stroller or the carrier is a great form of exercise. And when she has time, she can resume more vigorous physical activity at the gym.” Some gyms even offer babysitting services, or you can look into mommy-and-me fitness classes like a baby boot camp program, once your little one is old enough. Also, keep in mind that some classes like spin may include movements that are too intense for postpartum moms, so notify the instructor that you’ve recently given birth and they can offer adjustments if necessary.

Studies have shown that moderate exercise doesn’t affect your milk supply and milk composition. But since breastfeeding does burn calories (up to 500 a day), you may need to up your overall calorie intake to account for that plus any extra physical activity. Also, you might want to feed your baby before you work out (or express milk) to avoid any discomfort if your breasts are engorged. Plus, wear a supportive sports bra (or two for extra support) to help make exercising more enjoyable and less painful. And be sure to stay hydrated.

Although mentally you might be ready to dive back into your pre-baby workout routine, your body might not be. So be sure to rest and allow your body time to heal and recover, and don’t do too much, too soon. If you’re exhausted after a workout and notice prolonged soreness or shaky muscles, take a break and talk to your doctor.