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How soon after giving birth can I start exercising?
This is the biggest question women have. The answer might surprise you.
The first and most important thing you should do is begin exercising your pelvic floor and stomach muscles as soon as you feel ready.
This is crucial. Strengthening the pelvic floor helps to prevent incontinence, can heal tears due to giving birth, and reduce hemorrhoids if you have them. It is also essential if you want to regain a normal sex life.
Given how important this is for a woman, it's amazing how little attention is paid to it. In France for example, a woman who has given birth is entitled to 10 free postnatal sessions with a physiotherapist, paid for by the state. These one-on-one sessions ensure that all women are given the necessary information and advice on post-natal diet and exercise.
When you can resume other exercise depends largely on how much you exercised while you were pregnant (Davies & Ringdahl).
However, while some obstetricians tell you to wait until your six-week postnatal check before trying other forms of exercise, most recognize that getting out and about is good for you, not only physically, but also mentally. Walking, with your baby in a pushchair or stroller, is one of the best forms of exercise you can do, especially during the first few weeks.
The American College Of Gynecology suggests that if you exercised without problems right up until the end of pregnancy, you can probably safely perform your pregnancy workout - or at least some light exercise and stretching - as soon as you feel ready (ACOG 1994). Swimming is best avoided for the first six weeks, however, to minimize the risk of infection.
For those who did not exercise regularly during pregnancy, it is best to ease into exercise. Start with the pelvic floor with the pelvic floor exercises and some walking for the first six weeks, then as you begin to feel stronger, you can move onto other types of exercise.
Reasons to Delay Exercise:
There are some factors that might delay your return to exercise. These include:
If you experienced back or pelvic pain during pregnancy - check with your doctor before starting an exercise program.
If you find it difficult to do pelvic floor exercises, or leak urine at times (e.g. when you cough, sneeze or laugh) - in this case, strengthen the pelvic floor before attempting vigorous exercises such as sit-ups, or exercise classes.
If this problem persists, consult your doctor. They may need to refer you to a women's health physiotherapist if the problem persists.
After a cesarean delivery your doctor will give you specific instructions about activities you can and can't do - you have to allow time for your incision to heal.
What about exercise classes?
Exercise classes can vary greatly in terms of intensity and what they involve. As a general rule it is best to avoid exercise classes until after the postnatal check. The exception would be one taught by a specialist in the field of postnatal exercise, or a women's health physiotherapist, or a low-impact class with plenty of toning and stretching. In this case be sure to let the teacher know you have just had a baby, and avoid any vigorous movements or bouncing.
Exercise and Breastfeeding
Women are often concerned about the effects of exercise on breastfeeding. There are two issues here. The first is how it makes you feel, the second is the effect on the flow of milk and thus the baby.
The first step is to avoid and exercise that makes your breasts sore. The best way to do this is to be sure that you wear a supportive bra. Feeding bras are often not supportive enough for exercise, so look for a comfortable, supportive sports bra. You might also find that breast pads will make you more comfortable.
The other issue concerns the baby's feeding. It is recommended that you always try to schedule your exercise for after you have fed your baby. Firstly, your breasts won't feel uncomfortably full, and secondly, your baby is more likely to feed properly. There is evidence that if you attempt to breastfeed immediately after rigorous exercise, the baby may shun the breast completely or feed less vigorously. Allowing 60 minutes after the workout before attempting breastfeeding will resolve this problem (Wright, Davies & Su).
How much exercise can you do?
There are no set rules on how much exercise you should do. As we said earlier, it will partly depend on your activity levels during pregnancy. You also have to listen to your body - if the exercise you do leaves you feeling wiped out for hours afterwards, it is too much. You should feel comfortably tired after a workout, but return to your normal energy levels within an hour.
Another sign of overdoing it during the first few weeks after delivery is a change in your vaginal flow. Called lochia, this is normal after childbirth, but if you exercise too hard it can become pink or red and flow more heavily - this is clear signal from your body to slow down. You should always check with your doctor if vaginal bleeding or lochia restarts after you thought it had stopped.
