Forest Trees

Postnatal exercise guidelines

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When can you start to exercise after birth?

 

If you want to support your physical recovery the best way to start your journey is to then prioritise rest and recovery during the 4th trimester (first 3 months after birth). During this you’re your body and tissues a are healing and your uterus is descending back into your pelvis. This is a time to support the healing process by hydrating and nourishing your body and spending time bonding with your baby, settling into your new routine, and adapting to new lifestyle changes.

It is also a good time to lay the foundations for a safe return to exercise as you can start to embed gentle and appropriate activity into your daily and weekly routine to help your recovery.

 

The postnatal recovery duration will differ for all women but a general guideline, that is safe

and appropriate, for most women, is to start doing pelvic floor exercises, walking and normal

daily activities as soon as possible after birth.

 

1+ days after birth

During your 6-8 week postnatal check you can ask your GP whether it is an appropriate and safe time for you to start adding in gentle exercise. If your GP gives you the go ahead then it is important that you practise exercise that is safe and specifically designed for postnatal recovery, so that you support your body to rehabilitate and reduce the risk of causing any setbacks or delays.

 

If you were previously exercising right up until birth you could return to exercise sooner, but your regime should be scaled back (modified) and you should start slowly with a focus on rehabilitation first and foremost.

 

You can expect to start a gentle postnatal exercise plan:

  • 6-8 weeks following a vaginal birth

  • 10 weeks following caesarean section

 

But it is important to consider when you feel well rested enough and when any conditions such as a perineal tear or C-section has fully healed. You can start with gently increasing your level of physical activity and reducing sedentary time e.g. stretching and mobilising your body whilst boiling the kettle, light gardening, housework, walking to the shops etc.

Benefits of Postnatal exercise

Exercising regularly will provide you with many health benefits that will boost your physical, mental, and emotional health. This will help to improve your current sense of wellbeing and reduce your risk of developing various conditions and diseases in the future.

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Some of the many health benefits include:

  • Increased oxygen to help tissue heal

  • Strengthening & stretching of your pelvic floor

  • Healing of diastasis recti

  • Strengthening of your core & protecting your spine

  • Increased strength & stamina

  • Improved coordination & balance

  • Improved posture

  • Improved body image & body confidence

  • Relief from musculoskeletal aches & pains

  • Weight management (lose excess weight)

  • Self-nurturing Time to self

  • Increased energy for your baby/motherhood

  • Improved mood and reduced symptoms of postnatal depression

  • Social connection & making friends (group classes/programmes)

If you can establish a commitment to exercise, then you will also set a good example for your family that can become an enjoyable shared pastime and eventually a habit that is second nature- benefitting the health and wellbeing of your entire family for life. 

Preparing to exercise

It’s important to set yourself up for exercise success by preparing as best you can so that it is as easy, convenient, and safe as possible to exercise.  There are several things that you can do to help facilitate your activity ad exercise sessions.

 

  • Do your research and find an appropriate postnatal exercise programme/class in person or online.

  • Find the type of activity, movement, or exercise style that you will enjoy.

  • Schedule non-negotiable time in your diary to exercise.

  • Hydrate well and drink a glass of water 30 minutes prior to your exercise session.

  • Eat a healthy snack or meal 30mins-3hrs before a workout. Including protein, carbohydrate, fibre and healthy fats.

  • Wear comfortable, non-restrictive, supportive clothes & shoes and a well-fitting bra.

  • Be realistic and gentle in your approach - its best to progress slowly and safely.

  • Remember that little and often is better than nothing at all.

  • Be kind to yourself and do not compete with others.

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Exercising safely

Postnatal exercise needs to be safe for it to be effective. Safety applies to your own physical and mental state, the appropriate type of exercise and the state of your environment and equipment.

Whether you decide to exercise at home, in a community class or in a gym environment you will want to ensure that you are set up to exercise safely in your environment.

 

The following guidelines will help you ensure that you engage in exercise safely.

 

  • Follow the timeline guidelines for when to start exercise safely after birth (see above).

  • Check that the environment or childcare is safe for your baby if they are with you.

  • Check that your instructor is qualified in postnatal recovery and modifications.

  • Seek out a diastasis recti or C-section specific programme if you have either condition.

  • Share any relevant medical history or information with your instructor so that they can make safe modifications and suggestions for you specifically.

  • Take water and a snack with you to replenish hydration and your blood sugar as needed.

  • Warm-up (at the beginning) & cool-down (at the end) effectively.

  • Pay attention to instructions and focus on controlled precise technique rather than speed.

  • Be mindful of how you feel and if in doubt or pain, stop immediately and seek advice.

  • Ensure that there is enough space to exercise and carry out the movements required.

  • Check that your equipment is safe to use.

  • Check for slippery or uneven surfaces indoors & outdoors.

  • Exercise with a friend, or in a group if exercising outdoors or in secluded areas and let someone know where you are going.

How to progress your exercise plan

It can be helpful to think of exercising in stages to best support your recovery. This will guide you to take a slow and steady approach that will allow your body to first heal and repair whilst it is gently rehabilitated. Once it is rehabilitated you can then think about progressing your goals to amplify your fitness.

 

Remember that exercise will be safe to start after you have been cleared for exercise by your GP/medical consultant.

 

  1. Rehabilitation: rehabilitate your core to improve your core strength, core stability, breathing pattern and pelvic floor activation. Focus on walking, breathwork, pelvic floor exercises and postnatal core exercises.

  2. Body conditioning: improve your overall body conditioning whilst you engage in functional movement patterns that support daily living and increase your strength, stamina and mobility. Focus on balance, technique, precision and control.

  3. Progression: increase the intensity of your exercise by adding a range of activities, exercise styles or sports to best suit your preferences. Focus on increasing the range of movement, speed, load, variety, or duration of your exercise/activity.

What type of exercise should you do?

There are many different types of activity and exercise that will help you to rehabilitate your body and improve your strength, stamina and mobility. So, you should be able to find something that appeals to you. In the early stages of your recovery the most important consideration is to find exercise that is safe and appropriate for postnatal recovery.

See if any of the following exercise modalities appeal to you:

 

  • Walking & walking workouts

  • Yoga

  • Pilates

  • Barre

  • Dance or dance fitness

  • Body conditioning (body weight, exercise bands, wrist/ankle weights, dumbbells etc.)

  • Strength training

  • Interval training (can be applied to any cardio-based exercise)

  • HIIT (once you have fully rehabilitated your core & pelvic floor)

  • Cycling (once perineal tears and vaginal soreness has healed)

  • Swimming (once lochia has stopped)

 

You can combine any exercise styles that you enjoy, whilst trying to ensure that you are receiving several different health and fitness related benefits. Ideally a well-balanced exercise programme will enable you to work on the following:

 

 

 

 

 

You are always advised to seek out an instructor (whether in-person or online) who is trained and certified to deliver postnatal exercise and diastasis recti recovery workouts. This will ensure that you build a solid foundation and do not engage in any exercise, activity or movement patterns that will delay your recovery or cause you further problems. It will also speed up the process and help you achieve your postnatal health and fitness goals sooner.

What sort of exercise should you avoid?

There are certain activities, movement patterns and sports that can delay your recovery, increase your risk of developing injury e.g. pelvic organ prolapse, or worsen conditions such as diastasis recti.

 

Try to avoid the following activities early on in your recovery, so that you can build your physical capability as safely and quickly as possible:

 

  • High impact jumping, hopping, bouncing, running (up to 3 months post birth).

  • Crunches, sit ups or planks.

  • Twisting exercises (if you have diastasis recti or C-section).

  • Ballistic movements or quick changes of direction.

  • Any exercise where you hold your breath.

  • Heavy weightlifting.

  • Swimming (when you still have Lochia blood loss).

  • Any exercise/movement that causes you pain or cause for concern.

What can happen if you don’t take it slow?

Being patient with yourself and having realistic expectations will be a supportive mindset to nurture. It will help you to take it sow and steady so that you can gently and effectively progress your exercise and achieve your fitness goals without potential setbacks.

 

It's worth remembering that if you don’t allow time to recover and rehabilitate your body first, and start to do inappropriate exercises or progress too fast, then you may cause injury to yourself including:

 

  • Delayed recovery or worsening of diastasis recti.

  • Delayed recovery or worsening of incontinence.

  • Increased risk of pelvic organ prolapse.

  • Damage to ligaments, tendons and joints (which may prevent you from exercising).

  • Exhaustion and burnout.

  • Demotivation from trying too much too soon.

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  • A range of functional movement patterns

  • Co-ordination & control

  • Precision & technique

  • Balance & stability

  • Cardiovascular fitness

  • Muscular stamina & endurance

  • Muscular Strength & power

  • Mindful movement

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C-Section recovery exercise tips

If you have birthed your baby by C-section then you will have undergone major abdominal surgery and will first need to complete a period of healing and recovery. You will need to consider a few guidelines in the early stages to best help facilitate your recovery, so that you can rebuild a strong core and body as you heal.

  • Don’t over-exert yourself during the first 3 months post-surgery.

  • Start with gentle walking, breathing and pelvic floor exercises.

  • Correct your breathing technique and exhale on exertion to brace your core.

  • Correct your postural realignment from head to toe.

  • Progress to core exercises that are specifically designed for C-section recovery (after your wound has fully healed and you have been cleared by your GP (10-12 weeks).

  • Don’t lift heavy objects (until after 12 weeks) and/or exhale on exertion to naturally brace your core.

  • Don’t do movements and exercises that put extra pressure on your abdominal wall e.g.

  • Twisting exercises.

  • Crunches, sit-ups, or planks.

  • Heavy weightlifting.

  • Running within 12 weeks after birth.

 

Ask your midwife for advice if you're unsure when it's safe to start returning to your normal activities. You can also ask a GP at your 

6-8 week postnatal check.

Diastasis recti recovery exercise tips

A Diastasis recti is a separation of the two sides of your rectus abdominis muscles (six pack)

that forms a gap down your midline connective tissue (Linea alba) wider than 2 finger widths.

Having a diastasis recti will likely affect many of your physical functions and needs to be

considered when you choose which types of exercise to do as your recover and rehabilitate

your postnatal body.

When you have a diastasis recti it is important that you try not to do activities that will place too much strain on your abdominal tissues, twisting or pressure on your core as this can make the gap bigger or delay the healing process. You should try to follow the guidelines below:

 

You should try to avoid the following activities:

  • Correct your postural realignment from head to toe.

  • Correct your breathing technique and exhale on exertion.

  • Don’t lift heavy objects and/or exhale on exertion to naturally brace your core.

  • Start a safe and gently progressive postnatal exercise programme after 12 weeks postpartum.

  • Don’t do movements and exercises that make diastasis recti worse or delay healing (see below):

  • Twisting exercises.

  • Crunches, sit-ups, or planks.

  • Heavy weightlifting.

  • Running within 12 weeks after birth.

 

Once your diastasis recti gap has reduced, and/or you have restored your core strength, then these activities can slowly and gradually be added back into your exercise routine. 

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Red flags - when to seek help

 

It is vital that you take care of yourself and focus some of your time and attention on your physical rehabilitation. This will help you to speed up the conditioning or your body.  Familiarise yourself with the list below and make sure that you tell your GP if you experience any of these symptoms, as they could indicate a problem that requires further investigation or support.

  • Musculoskeletal aches or pains whilst exercising.

  • C-section or perineal tear tear/pain during/after exercise.

  • Worsening of, or persistent Diastasis recti.

  • Opening, oozing, inflammation or pain of your C-section scar.

  • Abdominal lump or bumps protruding as this could be an abdominal hernia.

 

If you experience the following potentially life‑threatening symptoms you should seek emergency medical assistance immediately:

  • 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).

How you can support your partner

You can support your partner by ensuring that they are well nourished, well rested, have the supplies and emotional support that they need and are watchful of their health.

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Below are some ways that you can be supportive:

  • Ask your partner how you can help and support them.

  • Help them schedule time to focus on exercise.

  • Plan family exercise opportunities e.g. walks & swimming.

  • Remind your partner to be well hydrated.

  • Prepare nutrient dense foods for meal and snacks.

  • Clear a safe space for exercise at home.

  • Borrow or buy exercise equipment if desired/required.

  • Invest in a postnatal exercise class, subscription, gym membership or programme.

  • Help your partner to find a postnatal exercise class, personal trainer, or programme.

  • Encourage your partner to be patient and self-supportive as they rehabilitate their body.

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