Postpartum Exercise: Getting Started
Physical activity after pregnancy is safe and healthy. But before jumping back into your pre-pregnancy exercise routine, it’s important to make sure your body is prepared and ready. Following pregnancy and birth, muscles in your abdomen and pelvic floor are weaker. You may have had muscle tearing or surgical intervention during birth, making it even more important to go back to the basics.
Preparing Your Body to Exercise
Get the green light from your healthcare provider. A general rule of thumb is to begin exercise six weeks after giving birth with clearance from your physician. But the amount of recovery time you need postpartum can vary depending on any health issues you experienced during pregnancy and birth, your pre-pregnancy fitness level, and the types of exercise you want to do. When you resume regular exercise, it’s best to start gradually and ease back in.
Benefits of Exercise Postpartum
Strengthen and tone abdominal and pelvic floor muscles
Promote better sleep
Improve mood and possibly help decrease the risk of postpartum depression and anxiety
Help with weight management
Improve overall function during activities of daily living and tending to your newborn
Getting Started: Gentle Exercises
Right after your baby is born, you can start some breathing and pelvic floor-strengthening exercises to increase mobility and blood flow to the healing area. Establishing a strong core and coordination between the muscles in the abdomen and pelvic floor is essential for returning to prior physical activity levels. The first goal of postpartum exercise is core recovery, then progressing into low-impact strength and aerobic exercise.
On a yoga mat, lie on your back with your knees bent and your feet flat on the floor.
Rest one hand on your chest and the other on your belly.
Slowly inhale as you fill your belly with air so the hand on your belly rises up toward the ceiling. The hand on your chest should remain mostly still.
Stay relaxed as you hold that breath in your belly.
Then slowly breathe out so the hand on your belly lowers with you.
You should feel the hand on your belly move more than your hand on your chest.
Repeat for 10 breath cycles.
Pelvic Floor Contraction (Kegel)
Lie comfortably on your back with your knees bent so they point toward the ceiling.
Squeeze the muscles around your vagina as if you were stopping your stream of urine or holding back gas. You can also imagine you are picking up a marble from the ground using your pelvic floor
As you do this, you may feel your pelvic floor muscles pulling “up and in,” but be careful not to move your hips or low back.
To finish, relax your muscles. Let go of the contraction as if you were allowing your urine to flow again or trying to slowly pass gas. This may cause you to feel like your pelvic muscles are "dropping downward” ‒ that’s normal.
Hold for five seconds, relax, and repeat five times.
Note: Many women have poor sensation or even no sensation when they do a Kegel in the early postpartum period.
While on your back, inhale and expand your belly.
As you exhale, press your low back into the floor and draw your belly inward toward your spine to tighten your stomach muscles.
Place your thumbs two inches inward from your pelvic bone to feel the muscle contracting.
Hold for five seconds, relax, and repeat five times
Alternating Pelvic Tilts
Lie on your back with your knees bent and your feet flat on the floor.
Relax your abdominal muscles to arch your lower back away from the floor. Focus on relaxed breathing as you hold this position.
Return to the starting position.
Next, tighten your abdominal and butt muscles to flatten your lower back toward the floor. Focus on keeping your abdominal muscles engaged as you hold this position.
Relax and return to the starting position.
As you do each rep, you might feel your hips, core, and pelvic floor muscles working.
Hold each position for three seconds, relax, and repeat 10 times
Progressing to an Exercise Program
At Hinge Health, we follow the FITT principle for exercise progression. Your physical therapist can help you determine the right intensity and frequency to follow based on your personal situation.
Aerobic exercise: Start with three to five days of exercise, then work up to five to six days as tolerated. Frequent, consistent physical activity is key to optimizing a healthy routine, with a goal of 150 minutes each week.
Strength training: Include at least one to two sets of 10-15 repetitions of strength training exercise, two to three times per week.
Flexibility: Do stretching exercises daily. Work on slow, gradual movements, especially focusing on motions that move in the opposite direction from hunched-over positions (such as baby care and feeding). Examples of such stretches include seated cat cows, the seal stretch, and scapular squeezes.
Start with low-intensity exercise, then progressively increase to a moderate to high intensity. A general guideline for moderate intensity: You’re a little breathless, but still able to hold a conversation, speaking a few words at a time.
Avoid increasing intensity too quickly and listen to your body as it is still healing and changing on a regular basis.
Start with a duration of 10-15 minutes, then work up to 30 minutes, increasing by increments of five to 10 minutes each week.
Type of Exercise
Choose exercises you enjoy and that fit into your lifestyle, such as:
Stroller walking with baby (mall or outside in your neighborhood)
Stationary equipment such as treadmills, ellipticals, and recumbent bikes
Strength training that uses your body body weight, resistance bands, or free weights
Your Hinge Health playlists
Complications During Postpartum Exercise
Consider meeting with a Hinge Health physical therapist if you experience any of the following:
Leaking urine or feces while sneezing, coughing, lifting, etc.
Upper or lower back pain or pelvic pain
Abdominal weakness or separation of abdominal muscles
Pelvic organ prolapse (you feel a bulge in the vaginal area)
General deconditioning postpartum
Difficulty with ergonomics while lifting, carrying, or holding your baby
Exercise after having a baby can help your recovery by strengthening the pelvic floor and abdominal muscles, improving sleep, mood, and energy, and enhancing your quality of life and participation in daily activities.
Start gradually with short bouts of low-intensity physical activity, then progress to more intense and frequent physical activity.
Incorporate physical activities into your daily routine with your baby.
Exercise after pregnancy. (2022, March). American College of Obstetrics and Gynecology. https://www.acog.org/womens-health/faqs/exercise-after-pregnancy
Cram, C. (n.d.) Postpartum fitness program design PowerPoint Slides. Medbridge.