Safe return to exercise after pregnancy

Exercise can help you recover after childbirth. It can make you stronger and improve your mood. If you are feeling strong and healthy this can help you care for your baby.

Regular exercise (Opens in new tab) benefits everyone and has lasting positive effects on your health. Exercising after you've had a baby will:

• strengthen and tone your muscles
• help you recover from labour if you gave birth vaginally
• raise your energy levels so you feel less tired
• help you to lose weight and become fitter

Exercise is good for your mental wellbeing (Opens in new tab). It can relieve stress and help prevent postnatal depression. You are also more likely to get outside and meet people.

Even if you're tired and not feeling motivated, there's plenty you can do to get your body moving. However, every pregnancy is different. How soon you're ready to start exercising depends on your individual circumstances. You should always check with a health professional first.

When you feel ready to exercise, it's very important not to overdo it. Your body has been through some big changes. You will need time to recover, even if you're feeling great after having your baby.

A supportive, properly fitted bra can help you feel more comfortable when exercising.

Pregnancy hormones affect your joints and ligaments. This effect can continue for up to 6 months after the birth. This can put you at greater risk of injury.

Caring for a newborn requires many new and repetitive movements such as lifting, holding and nursing. This may lead to inflammation of your hand and wrist. Daily motions can be painful and make it difficult to return to exercise. You can speak to your doctor about solutions.

Your abdominal muscles may have separated during the pregnancy. They usually go back to normal after the birth, but sometimes they can stay separated. You will need to do exercises to strengthen these muscles to avoid back pain and injury.

Pelvic floor issues

Your pelvic floor is a group of muscles, ligaments and tissues that lies across the bottom of your pelvis.

Your pelvic floor the muscles and ligaments that support your:

• bladder (Opens in new tab)
• uterus
• bowel

A weak pelvic floor can lead to lower back pain. Some people have problems with bladder control after giving birth. It is best to avoid heavy exercise — gentle exercise is best.

The pelvic floor can be weakened after pregnancy, especially if you:

• had a large baby
• gave birth to twins or more
• pushed for a long time during labour

Regular exercises will help to strengthen your pelvic floor. However, you should take care not to do more damage by exercising too vigorously too soon.

Be careful of using heavy weights or doing high impact exercise. These can increase your chance of prolapse (Opens in new tab). This is when an organ, such as the uterus (womb), drops down from its normal position.

Mental health challenges to exercising after pregnancy

Having a baby can change your everyday schedule. New parents often have:

• less sleep
• changes in eating patterns and habits
• lack of daily routine
• increased nutritional demands, if breastfeeding

This can make it difficult to find the time to exercise. You may also feel that you don't have enough energy.

While many new parents feel tired or overwhelmed, some experience postnatal depression. This can make you feel sad, numb and hopeless. It can drain your energy levels and reduce your motivation to exercise.

Returning to exercise after giving birth requires a similar mindset to returning to exercise after an injury.

How quickly you can return to exercise depends on:

• how fit you were before you had your baby
• your labour and delivery
• other complications

For at least 3 months, try to avoid:

• heavy weights
• sit-ups
• high intensity aerobic activity such as running and tennis

It's best not to return to your previous level of physical activity until 4 to 6 months after the birth. If you did not exercise during pregnancy, it is especially important to start slowly and increase gradually.

After vaginal and caesarean births, avoid swimming until your bleeding has stopped and you have healed completely.

0 to 6 weeks

You can start doing gentle pelvic floor and abdominal exercises in the first few days after the birth. If you feel any pain, stop. It is important to let your body recover.

When you feel like it, start with a gentle walk (Opens in new tab), perhaps while pushing the pram. Then, at your own pace, gradually increase the time and pace of your walks. Build up to a 30 minute walk every day if you can.

Be aware of your posture (Opens in new tab) when moving around in the first weeks after birth. Try to stand and sit with a straight back.

6 to 12 weeks

Wait until your 6 week postnatal check-up with your doctor or obstetrician before:

• going back to the gym
• joining a group exercise program (Opens in new tab)
• starting personal training

After your check-up with your doctor, you can start doing low intensity, low impact exercise. It is important to continue walking and doing pelvic floor exercises to regain your strength.

12 weeks to 6 months

Continue exercising as in the 6 to 12 weeks guidelines. You can start to increase the intensity and weights.

Before returning to higher intensity exercise, it's important to have your doctor assess your abdominal muscles and pelvic floor.

A caesarean is a major operation and it will take you at least 6 weeks to heal. However, you can still do pelvic floor exercises from around 3 days after the birth.

You can start to exercise your abdominal muscles as soon as you feel able to. Avoid sit ups, crunches or abdominal curls. These can put pressure on your scar.

Avoid lifting anything heavier than your baby for 6 weeks after birth. Tighten your tummy and keep your back straight if you need to lift something around the house. Avoid stretching until you are totally healed.

Until around 12 weeks (3 months) after birth, you will still be healing inside. It is OK to start walking, do low impact aerobics or cycle. Stop if there is any:

• discomfort
• pain
• pulling sensation on your scar

If you experience any of this, wait a few more weeks before exercising again.

The following exercises are suitable in the days after you have your baby. Try to do them once or twice a day.

Abdominal exercises or abdominal bracing

Choose one of these positions:

• sitting
• standing
• lying on your side
• lying on your back
• kneeling on all fours

Pull in your lower tummy towards your spine. Hold for 5 seconds and breathe normally. Relax and repeat 5 to 10 times.

You can practice this throughout the day, such as when you are:

• picking up your baby
• getting in and out of bed
• standing up and sitting down

Pelvic floor exercises

1. Sit and lean slightly forward with a straight back.
2. Squeeze and lift the muscles around your vagina. This should feel like you are trying to stop a wee. Hold as you count to 5, then relax.
3. If you can't hold for 5 seconds, that is okay. Simply hold for as long as you can. You can increase the hold time as it becomes easier.
4. Repeat this about 10 to 15 times.

It is important to concentrate on doing this exercise correctly and carefully. It should not be painful. You can find instructional videos on the Pelvic Floor First (Opens in new tab) website.

You can practice tightening your pelvic floor muscles when picking your baby up, when feeding your baby and even when lying down.

Other exercises

Other exercises that are safe after pregnancy include:

• walking
• swimming and aqua aerobics (once the bleeding has stopped)
• yoga
• Pilates
• low impact aerobics
• light weight training
• cycling

Sometimes it can be difficult to find the time to exercise. Some ways that you can incorporate exercise into your day include:

• doing pelvic floor exercises while you're breastfeeding or driving
• walking with your baby in the pram rather than driving
• doing your abdominal exercises on the floor next to your baby
• using exercise as a way to catch up with friends

Don't worry about not getting enough exercise. Caring for a newborn can be hard work. You might not have the energy or time to work out as much as you'd like. Do the best you can — even 10 minutes is better than nothing.

It is important to approach postnatal exercise safely, especially during the first few months after giving birth. Before starting any high impact exercises, perform a simple check by coughing or jumping when you have a full bladder. If you don't leak urine, you're probably ready to exercise in more intensive workouts.

If you're still leaking urine, this means that your pelvic floor needs more recovery time. If this is the case and your baby is more than 3 months old, talk to your doctor or a physiotherapist. They can give you advice to help strengthen your pelvic floor.

A pelvic organ prolapse is common after giving birth. It may look concerning and can be uncomfortable, but a prolapse is not a concern to your health. You are still able to exercise with a prolapse and some types of exercise can even manage the symptoms of prolapse. For tips on exercising with prolapse visit Exercise Right (Opens in new tab) or speak with your doctor or a physiotherapist.

Listen to your body when exercising post birth — your exercise routine should not cause any pain or discomfort. If you do experience pain or any other concerning symptoms, stop exercising and speak with your doctor.

If you have questions about returning to exercise after pregnancy, you can:

• talk to your doctor, midwife or maternal child health nurse
• find a pelvic health physiotherapist (Opens in new tab)
• use the Pelvic Floor Screening Tool for Women (Opens in new tab) to check your risk of pelvic floor problems

For more information on how to look after your body after giving birth, you can:

• visit the Pelvic Floor First (Opens in new tab) website or call 1800 33 00 66 to speak to a nurse continence specialist
• check out the Fiona Stanley Hospital's physiotherapy advice (Opens in new tab) for after your pregnancy
• read the Flinders Women and Children booklet (Opens in new tab) for exercises to help you recover after giving birth
• call the National Continence Helpline on (Opens in new tab)1800 33 00 66 if you have any concerns about your pelvic floor
• find a Registered Active Health Professional (Opens in new tab) to help make an exercise plan for you