Introduction
As you begin to think about exercising after giving birth, you may be wondering: Is my body ready? When can I start? Where do I start? What kind of exercises can I do? How much exercise should I do? Many doctors “clear” you for exercise after 6 weeks. The reason is that it takes 6-8 weeks after delivery for the uterus to return to its pre-pregnancy size, for your body to heal internally from delivery, and for c-section incisions to heal. According to the American College of Obstetricians and Gynecologists (ACOG), it is important to introduce light exercises even a few days after birth if you’ve had a normal vaginal delivery. So, what does that progression look like?
The Timeline
In the first six weeks postpartum, it is important to prioritize recovery and rest. Your body is healing in many ways as you are also navigating taking care of your baby, so sleep should be your number one priority, especially in the first few days. Many women follow the 5-5-5 rule as a general guideline for moving their bodies postpartum: 5 days in bed, 5 days on the bed, 5 days around the bed.
For the first 5 days in bed, this would be a great opportunity to introduce diaphragmatic breathing into your routine to reconnect to your ribcage, diaphragm, and biomechanics of breathing as these structures return to their pre-pregnancy state. In addition, diaphragmatic breathing helps to increase oxygen levels and improves core stability. In the next 5 days on the bed, it is important to restore your pelvic floor muscles by introducing light isometric contractions and relaxations of the pelvic floor in coordination with your breathing.
Around week 3-4 postpartum is when you can begin to restore full body mobility (gentle stretching), deep core activation, and walking. My first walk involved just going down the street and back. After that I made it a point to try to go on a short walk daily and added a small distance each day as my cardiovascular endurance improved. Remember, gradual progression of activity is imperative. Do not jump into an activity you are not ready for.
At 6 weeks postpartum you will most likely be cleared to start exercising by your ob-gyn. Now, you may start returning to a more “normal” exercise routine, including pilates, yoga, cycling, swimming, low-impact aerobic activities, and gradual progression of weight training. Again, gradual progression is important, so start with light weights and slowly increase to your tolerance over the next 6 weeks. This is a great time to be consistent with your strengthening program, especially if you plan to incorporate high-impact exercise into your routine after 12 weeks. It is also important to keep practicing your pelvic floor and deep core strengthening at this phase at well.
Once you have reached 12 weeks, it is generally accepted that you may now begin to incorporate high-impact exercise into your routine (running, jumping, HIIT, etc.). At this stage, your pelvic floor and core should be strong enough to withstand the increased forces of these activities. Again, gradual progression is so important to ensure you aren’t putting any excess stress on your body. Below, I have added a sample return to running progression that may help guide your routine.
Things to consider
If, at any point in your recovery, you start experiencing any leaking, pelvic pressure, bleeding, or pain, discontinue exercising and seek help from a physical therapist or your doctor to ensure you are practicing an exercise routine that is safe for your body. Generally, if you are progressing well with your exercise routine, you should aim to stay active for 20-30 minutes daily.
One way I loved incorporating exercise into my postpartum routine was by following exercise videos at home during my baby’s nap times and going on walks with the baby in the stroller. This is an easy way you can navigate mom duties and prioritize taking care of yourself. Remember, the postpartum period is a precious time for bonding with your baby and healing yourself, so take it slow, listen to your body, don’t overdo it, and give yourself grace.
Resources
- Exercise after pregnancy. ACOG. (n.d.). https://www.acog.org/womens-health/faqs/exercise-after-pregnancy
- Selman, R., Early, K., Battles, B., Seidenburg, M., Wendel, E., & Westerlund, S. (2022). Maximizing recovery in the postpartum period: A timeline for rehabilitation from pregnancy through return to sport. International Journal of Sports Physical Therapy, 17(6). https://doi.org/10.26603/001c.37863
