Postnatal exercise

About postnatal exercise

Regular exercise has numerous health benefits, all of which apply equally to the new mother as at any other stage of life. These benefits include assistance with weight loss, increased aerobic fitness, social interaction and psychological wellbeing. Exercise after giving birth can also hasten recovery, and assist with muscle strength and toning.

Always consult with your doctor or midwife before starting any postnatal exercise program. It is recommended that you wait until the 6-week postnatal check with your doctor before commencing a group exercise program, returning to the gym or personal training. Whether or not you are ready to exercise depends on individual factors, along with any postnatal complications.

The benefits of postnatal exercise

Exercising after you have your baby can improve your physical and mental wellbeing. It can:

• help restore muscle strength and firm up your body
• make you less tired because it raises your energy level and improves your sense of wellbeing
• promote weight loss
• improve your cardiovascular fitness and restore muscle strength
• condition your abdominal muscles
• improve your mood, relieve stress and help prevent postnatal depression.

When to start postnatal exercises

Gentle exercise (such as walking) can generally be started within a few days after giving birth, or as soon as you feel comfortable. Start when you feel up to it. Some women will feel able to start exercising early. Talk with your doctor about when is a good time for you to restart an exercise program.

Six weeks after giving birth, most of the changes that occur during pregnancy will have returned to normal. If you had a caesarean birth, a difficult birth, or complications, it may take a little longer to feel ready to start exercising. If you did not exercise during pregnancy, start with easy exercises and slowly build up to harder ones.

Keep in mind your lower back and core abdominal muscles are weaker than they used to be. Your ligaments and joints are also more supple and pliable, so it is easier to injure yourself by stretching or twisting too much. Avoid any high-impact exercises or sports that require rapid direction changes.

Types of postnatal exercises

Recommended postnatal exercises include:

• first few weeks postnatal walking
• pelvic floor exercises
• deep abdominal/core training.

Post 6-week doctor or midwife check-up

• gym programs – ensuring to maintain posture, light weights, no breath holding
• swimming – once bleeding has stopped
• aqua aerobics – once bleeding has stopped
• yoga
• pilates
• low impact aerobic workouts.

12-16 weeks postnatal

Can progress to higher impact exercise such as running and sport, as well as increase load and volume if pelvic floor is considered optimised. This should be assessed by a women’s or pelvic health physiotherapist.

After 16 weeks postnatal

Gradually increase exercise intensity at a rate that considers pelvic floor and abdominal levels, and any ongoing postnatal complications.

Talk to your doctor or midwife for further recommendations and cautions.

Breastfeeding and exercise

Studies have shown that vigorous or regular exercise does not have adverse effects on a mother’s ability to successfully breastfeed as long as fluid and caloric intake are maintained. Some research, however, suggests that high-intensity physical activity can cause lactic acid to accumulate in breast milk and produce a sour taste a baby might not like.

If you're breastfeeding, you can prevent this potential problem by sticking to low- to moderate-intensity physical activity and drinking plenty of fluids during and after your workout.

Pelvic floor

The pelvic floor may be adversely affected by pregnancy and childbirth. Most women are taught pelvic floor exercises during pregnancy and these are important to learn correctly and can be resumed immediately after giving birth.

Pelvic floor exercises

The pelvic floor muscles are tightly slung between the tailbone (coccyx) and the pubic bone, and support the bowel, bladder, uterus (womb) and vagina. Childbirth can weaken these muscles and cause problems, such as incontinence, later in life.

To exercise them, you must first direct your attention to these muscles. To help you identify these muscles, they are the ones that you tighten to stop urinating (weeing). These exercises can be performed lying down, sitting or standing.

Try to relax your abdominal muscles. Don’t bear down or hold your breath. Gradually squeeze and increase the tension until you have contracted the muscles as hard as you can. Release gently and slowly. Then perform the exercises, which include:

• Squeeze slowly and hold for between 5 and 10 seconds, then release slowly. Repeat 10 times.
• Perform quick, short and hard squeezes. Repeat 10 times.
• Squeeze, then clear your throat or cough lightly. Repeat 3 times.
• Aim for 5 or 6 sets each day.

Creating time for postnatal exercise

When you're caring for a newborn, finding time for physical activity can be challenging. Some days you may simply feel too tired for a full workout. But that doesn't mean that you should put physical activity on the back burner. Do the best you can. Suggestions include:

• Seek the support of your partner, family and friends.
• Exercise with a friend to stay motivated.
• Walking is a good way to get back in shape – all you need is a pair of comfortable shoes. It is free, and you can do it almost any place or time. You can also take your baby along.
• Include your baby, lying next to you on the floor, while you do abdominal exercises.
• Exercising 10 minutes at a time is fine. We know 150 minutes each week (as per the Physical activity and exercise guidelines for all Australians) sounds like a lot of time, but you don't have to do it all at once. Not only is it best to spread your activity out during the week, but you can break it up into smaller chunks of time during the day.
• Don’t be too hard on yourself if your exercise plans go awry. Just do the best you can and remember – you will get more time to yourself as your baby settles into a predictable routine.
• Tummy and pelvic floor exercises can be done while you’re doing other tasks, either sitting or standing. To help you remember, try performing the exercises whenever you do certain things, such as breastfeeding or driving the car.
• Walk your baby in the pram rather than use the car for short trips.
• Consider building up a home library of online exercise workouts. It might be a good idea to include a few shorter workouts (such as 15 or 30 minutes), just so you don’t always have to find a full hour or more to exercise.

General exercise safety suggestions

Be guided by your doctor or midwife, but general suggestions include:

• Wear an appropriate bra that offers good support. Don’t rely on your pre-pregnancy sports bra because your back and cup size are likely to have changed. Get measured for a new one.
• Your exercises should not hurt. If you experience pain or any other unexplained symptoms, stop the exercise and consult your doctor or women’s health physiotherapist.
• Be aware of postnatal depletion – a term used to describe symptoms that arise from nutritional depletion, sleep deprivation, and the significant changes of a new mother’s role, which can affect your wellbeing.

Warning signs to slow down

Don’t overexert yourself. Your body gives out warning signs if you are exercising too hard, and these signs may include:

• increased fatigue
• feeling unwell
• muscle aches, strains and pains
• breast lumps or tenderness
• colour changes to lochia (post-partum vaginal flow) to pink or red
• heavier lochia flow
• lochia starts flowing again after it had stopped.

Where to get help

• Your GP (doctor)
• Your midwife
• Physiotherapist
• AUSactive Find a Professional