Exercise After Birth: Your Questions Answered
Safe and gentle exercise can help you recover postpartum
reviewed by Lisa Larkin, DNP, CNM, ARNP
One of the most common questions after giving birth is, “How long until I can start exercising again?” Birthing a baby is hard work! It takes a lot of physical effort to give birth. Your body has undergone a tremendous amount of stress and exertion, not to mention numerous physical, emotional, and hormonal changes. It’s important to prioritize time for rest and recovery.
Gentle exercise is a great way to manage stress and make you feel better postpartum. There are many benefits to exercising after birthing a baby. Some are quite obvious, such as stronger muscles and improved heart (cardiovascular) health. Others may be counterintuitive: exercise has been shown to actually boost your energy levels. Reduced stress and better sleep are two other benefits of exercise. The many benefits of exercise all help to reduce your risk of severe postpartum depression or anxiety.
Before diving into exercise, it can be helpful to know some things you may feel in the weeks (or even months) after birth. Everyone recovers differently, but there are some common sensations that you may have.
Postpartum bodies go through a lot!
Body aches from the strain of labor and everything that comes with it (contractions, vomiting, and crying or vocalizing, just to name a few!) are common after labor or vaginal births. You may also feel sore from lack of sleep or spending a prolonged time in a hospital bed. Your uterus contracts back down to its standard size during the weeks following birth, which can be painful. Everyone also experiences lochia, or bleeding and spotting, in the first few weeks after birth. Lochia is what your uterus expels as the wound from your placenta heals and your uterus shrinks to its standard size. While these symptoms can make exercising difficult, they can make daily living hard, too!
Reduced stress and better sleep are two benefits of exercise.
Another common symptom is swollen feet, legs, or hands. After birth, there may be extra fluid in your body. The fluid often gets pushed out into your tissues. Because of gravity, excess fluid tends to collect in the lower parts of your body, like your feet. Your feet or legs can be mildly swollen and only somewhat annoying to severely swollen and excruciating.
Along with general aches and pains, you may also experience back pain, especially if you received an epidural. Your abdominal muscles, which normally provide support to help you sit and stand, are stretched and unengaged. As a result, your back may take on most of the effort to hold up your body.
No matter how you gave birth, you may also experience vaginal pain or urinary incontinence (peeing when you don’t mean to) from carrying and birthing a baby. Even if you didn’t have any major tearing, microtears can still cause pain and itchiness while they heal. Vaginal recovery after birth varies significantly from person to person. Pelvic pain is also common; consider seeing a pelvic physical therapist after birth to help aid your recovery.
A cesarean birth is considered a major surgery, and you may have other side effects related to your incision site. However, many of the sources of discomfort listed above still apply to any recovering postpartum body.
When to start exercising after giving birth
Unfortunately, societal pressures in the United States set unreasonable expectations about what postpartum recovery looks like. By 6 weeks, many people have already returned to work. It’s easy to feel like everything else should resume, too.
The 6-week myth
You may have heard that the benchmark for “returning to normal” is 6 weeks. The common perception is that at 6 weeks you should be returning to normal activities. However, those first 6 weeks are when your body is doing the most physical healing. It’s essential to prioritize rest during this time. In reality, 6 weeks (or 8 weeks if you had a surgical birth) is when you should start exploring your new postpartum normal.
For your information
At Quilted Health, we think 6 weeks is too long to wait for postpartum care! We typically schedule the first follow-up call within the first 3-5 days after birth. We provide postnatal care up to a year after birth.
The standard 6-week checkup may be the only time you see your primary care provider following birth. At this checkup, most providers will clear you for exercise because that’s typically your final visit for that particular pregnancy. Regardless of when you are medically cleared to begin exercising, you should start slowly. It’s okay if you don’t feel ready at the 6-week mark. If you want to start exercising before you are medically cleared, talk to your provider before doing so.
Those who had an uncomplicated pregnancy and birth might feel well enough to start gentle movement, such as a walk around the block, a week or so after giving birth. Generally, for people with no complications, walking short distances is perfectly fine. Some simple stretches that don’t put too much strain on your abdominal region are good, too.
After 6 weeks (or 8 for cesarean births), a general guideline for working out is to stop what you’re doing if it hurts. If anything feels uncomfortable, take a break. Pause to breathe and check in with yourself.
Lochia is another great indicator. If your lochia was lighter but it returns to being heavy and bright red after exercising, you’re doing too much. Heavy, red lochia is an indicator that you have opened up the healing wound from the placenta.
Gentle workouts for your post-birth body
Once you and your provider have decided you’re ready to exercise again, where should you start? Starting small is a great way to relieve stress and ease yourself in. Take extra time to warm up and cool down, and start slowly. You can gradually increase your exercise intensity over time. Be sure to drink lots of water, and wear supportive clothing. You may find you need nursing pads, too.
It’s best to start with low-impact exercises. Walking, swimming, or stationary biking are good ways to get moving again. Avoid high-impact exercises like running or jumping. Group postpartum classes, such as postpartum yoga or Pilates, are a fun way to meet other new parents while working out safely.
There are lots of simple exercises you can do at home, too. Here are some movements to help get you started.
Pelvic tilt or bridge pose
Lie on your back on the floor with your knees bent. Flatten your back against the floor by tightening your abdominal muscles and bending your pelvis up slightly, tilting towards yourself. Hold for up to 10 seconds. Repeat five times and work up to 10 to 20 repetitions.
If this feels comfortable, try lifting your hip bones off the ground.
Start on your hands and knees. Place your hands underneath your shoulders and your knees underneath your hips. With your spine in a neutral position, start to engage your abs by drawing them towards your spine. Keeping your abs engaged, inhale to move your belly button towards the mat. Lift your gaze and your tailbone (the end of your spine). Then as you exhale, draw your belly button towards the ceiling and arch your back.
Repeat this sequence as many times as you’d like, continuing to move with your breath.
These exercises help tone your pelvic floor muscles and decrease instances of incontinence.
Contract your pelvic floor muscles as if attempting to stop urinating midstream. Hold for up to 10 seconds and release, relaxing for 10 seconds between contractions. Aim for at least three sets of 10 repetitions a day. Note that you should not do this while urinating, as it is not recommended for bladder and pelvic health.
Other postpartum workouts
Other types of workouts that are good during the postpartum phase include yoga, Pilates, barre, or other low-impact aerobic classes. Swimming, walking, and many of the activities you did while pregnant are wonderful ways to move after pregnancy, too. Even weight training with low to medium weights can be a safe way to move your body.
For your information
Wait to start swimming until your bleeding has stopped and you are at least 6 weeks postpartum to reduce your risk of infection.
It’s always a good idea to check in with your midwife or doctor before starting exercise. If possible, stick to movement your body is familiar with. Introducing new exercises during the postpartum time can be difficult for your healing body.
Postpartum exercise precautions
It may be tempting to return to your pre-pregnancy workout routine, but take it easy when you’re first starting to exercise.
Skip high-impact movements
In general, avoid high-intensity or high-impact exercises at first. After giving birth, your joints are still loose from the hormone relaxin. Too much heavy lifting or high-impact movement can lead to tissue damage for your yet-unstable joints. Your internal organs are also stretched and shifted from carrying a baby. They need time to move back into place before taking on any hard impacts. In short, too much intense exercise can disrupt your normal healing.
Exercise after cesarean birth
If you gave birth via cesarean, your recovery will be different. While your incision is healing, you should avoid abdominal or core muscle work or heavy weight lifting (or even taking out the trash!). These types of activities can put pressure on your incision and the organs and tissues around it.
Exercises to avoid
Some exercises to avoid doing when freshly postpartum include sit-ups, crunches, and planks. While strengthening your core postpartum is important, these abdominal exercises put too much pressure in the middle of your abdomen. They can actually make diastasis recti, or separation of your abdominal muscles, worse.
Regardless of how you gave birth, your pelvic muscles have been stretched out by carrying a baby during pregnancy. They need time to heal!
Overhead weight lifting and wide squats should also be avoided, because they put too much pressure on the pelvic muscles. Regardless of how you gave birth, your pelvic muscles have been stretched out by carrying a baby during pregnancy. They need time to heal more than your legs or arms, for instance.
Lastly, high-intensity interval training (HIIT) workouts are often just too much for a newly postpartum body. Between the cardiac effort and the impact levels of many of the movements, HIIT workouts are not a great way to start moving again.
Ready to get moving?
You may be jumping with joy at the idea of starting to exercise again, or you might be feeling like you need a year to do nothing but sleep. Wherever you are on your postpartum journey, remember that it’s yours. There are many benefits to exercise, and there are many ways to do it. Find something that brings you joy, like a walk with your neighbor or a group workout class. Most of all, don’t worry about “getting your body back.” Your body just did an amazing thing!
Pregnancy is roughly 9 months of physical, emotional, and hormonal changes. You can expect your postpartum recovery time to last at least as long, if not longer. It’s completely normal to take up to or more than a full year after birth to find your “new normal.” Give yourself plenty of time to heal, rest, and recover. Hopefully, some enjoyable exercise will be part of your recovery.