Postpartum Exercises

By Alison Heyerdahl

After the birth of your baby, there’s a good chance that you are keen to get moving again but are feeling overwhelmed with all the new challenges the postpartum period presents.  You may be reeling from pregnancy hormones, swelling in your feet, excess weight, and a heavy feeling in your pelvic floor, never mind recovering from a C-section, diastasis recti, or postpartum depression. 

In fact, studies show that a third of mothers suffer from diastasis recti following birth, and one in nine women experience postnatal depression, according to the Centers for Disease Control and Prevention.  All these changes, plus adapting to life with a newborn and a lack of sleep, can interfere with your ability to find the time or motivation to exercise.     

This article will outline the benefits of a postpartum exercise regime and provide guidelines for getting you back to your pre-pregnancy state.

What are the benefits of a postpartum exercise?

Postpartum exercise provides a host of benefits for your mind and your body.  Although it may seem counterintuitive, prolonged inactivity and rest contribute to feelings of fatigue and a lack of vigor.  Emerging evidence indicates that postpartum exercise:

• Reduces fatigue and improves your sleep.

• Improves mood and mental acuity – this is due to the release of endorphins, or ‘happy hormones.’

• Improves fitness.

• Reduces the risk of developing chronic health conditions.

• Promotes return to pre-pregnancy weight.

• It gives you a feeling of being in control of your life and an outlet to recenter and focus on yourself.

• Reduces stress.

When to Start Postpartum exercise

Before jumping into a postpartum exercise regime, it is important to get your doctor's approval.  Most doctors recommend waiting six to eight weeks after birth before starting with any exercise.  This may vary, depending on whether you've had a vaginal birth, C-section or may be suffering from diastasis recti. 

The timelines are often slightly different for women who have undergone a C-section because it counts as major surgery.  You must allow your body the time it needs to heal.  Women who have had a C-section may start exercising as soon as six weeks post-surgery, but it is imperative to get the go-ahead from your gynecologist.  Complications such as slow healing at the incision site or infections may ensue.  To assess whether you are ready to start exercising after a C-section, perform the Straight Leg Raise Test. 

To perform the Straight Leg Test, lie on your back with both legs straight out.  Gently lift one leg, ensuring that you keep your back flat on the floor.  If you feel any pain – specifically at the incision site, it’s too soon to start exercising.  Repeat this test weekly until you feel no pain, at which point you can start with gentle exercise.

Diastasis recti is another common condition that can make it difficult to get back into an exercise regime.  It is a gap between your right and left abdominal wall muscles and often results in a protruding pouch-like shape.  Doctors recommend avoiding any movement or exercise that places strain on the midline or causes the belly to protrude outwards, like sit-ups, planks, or lifting heavy objects. 

To check for the presence of diastasis recti, lie on your back with your knees bent.  Place your hand just above your belly button, and press gently down into the muscles.  Slowly lift your head and shoulders, feeling for the two edges of your muscles.  You may notice a protrusion in the middle of your stomach.  If the space is less than two finger widths, this is considered within the normal range.  If the space is more than two finger widths, it may indicate diastasis.  The good news is that the separation will resolve for most women within the first eight weeks after birth. 

What types of exercises can I start with postpartum?

As a general rule, you can start with low-impact exercises such as swimming, yoga (as long as it's not too vigorous), and walking around six to eight weeks post-delivery.  Avoid high-impact exercises such as running and burpees or heavy weight lifting until around the eight to ten-week mark.  Again, this also depends on whether you have had a C-section or have diastasis recti.  Furthermore, a third of women battle with prolapse after pregnancy.  This is due to the weakening of the structures in the pelvic floor.  A pelvic floor strengthening program post-delivery can significantly reduce the prolapse.  We suggest performing the following pelvic floor exercises before each workout:

1. Lie on your back with your knees bent and feet flat.

2. Imagine you are trying to stop yourself from passing wind – by contracting the muscles of the anus as tightly as possible.  Remember to keep your buttock muscles relaxed.

3. Next, imagine you are trying to stop yourself from passing urine.  Pull your muscles inwards and upwards towards the pubic bone.  Now let go.

4. The muscles that prevent you from passing wind or passing urine constitute your pelvic floor.  Now contract both muscles at the same time.

5. Remember to breathe normally while contracting the muscles of your pelvic floor.

6. Hold the contraction for a period of 10 seconds, and repeat the exercise 10 times.

Once you have successfully engaged your pelvic floor, you can begin with the following simple, functional exercises:

• Single-arm rows:  Holding a light dumbbell, hinge forward at the waist, lean forwards, keeping your knees locked and your bottom out.  Engage your core and pull your elbow upwards.  Retract and repeat for 10 reps on each arm.  

• Wall planks: Stand about 2 feet away from a wall.  Lean forward until your elbows are resting on the wall, and you feel your abdominals tighten.  Slowly rotate outwards until you are in a side-lank position.  Hold for two counts before returning to the starting position.  Repeat for 10 reps.

• Wall pushups: In the same position as the wall-planks, place your hands against the wall so you-re in a pushup plank position.  Bend your arms as you would do for a pushup and lower your body towards the wall.  Straighten your arms and push back into an upright standing position.  Repeat 10 times. 

• Bridging:  Lie on your back with your knees bent and your feet flat.  Tighten your buttocks and engage the pelvic floor.  Slowly lift your hips off the ground.  Hold this position for two seconds, then lower your hips.  Remember to breathe normally while performing this exercise.  Repeat for 10 reps.

• Wall squats: Sit against a wall with your legs at a 90-degree angle.  Keeping your back flat against the wall, hold this position for 30 seconds.  Slowly return to a standing position.  Repeat this exercise 5 times. 

In conclusion, no matter how fit you were before and during your pregnancy, always exercise caution when beginning any postpartum workout regime.   Your body is vastly different from your pre-pregnancy state, so be patient with yourself and don't get frustrated if it takes longer than you expect to get back into shape.  Listen to your body, and don't push too hard too soon.