Resuming Exercise Postpartum: Getting Started FAQ

8515615966_abf608b976_oHere are some common exercise questions and answers for my mamas who recently gave birth.

How soon can I start exercising after giving birth?

The ACOG (American College of Obstetrics and Gynecology) says it is ok to resume exercise as soon as you feel ready.  Obviously, when you feel ready is going to differ for each individual and each birth.  Your doctor or midwife might want you to wait 6 weeks or more before beginning any exercise.  If you exercised during pregnancy and had a normal, uncomplicated vaginal delivery, you should be able to safely begin doing some light exercise (walking, stretching…) within days of giving birth.  You should still start slowly with low-impact activities like walking first and gradually ramp up the duration and intensity.

If you had any complications or had a c-section it may be necessary to wait a little longer before resuming exercise. Definitely check with your health care provider for how long you should wait.  Despite how common or mundane c-sections might seem they are a major surgery and may take at least several weeks to heal. Listen to your doctor’s advice and listen to your body.

There are a few exceptions, exercises that you can begin very soon after delivery including kegels and breathing exercises to help begin abdominal muscle strengthening.  I want to go over these in more detail so look for more info in a later post.

What about diastasis recti?

Diastasis recti is a separation of the abdominal muscles due to a stretching of the connective tissue (linea alba) that connects both sides of the rectus abdominis.  The rectus abdominis muscles help support your back and your organs and if the muscles are separated they cannot do this job effectively.  Some women develop this gap during pregnancy and labor.  It is important to check for the presence of diastasis recti before you begin any abdominal exercises as you could make the condition worse.  This is not to say that you can’t do any abdominal exercises but if you have diastasis recti there are certain exercises you can do to help rehabilitate the abdominal muscles.

Quick self-check for diastasis recti:

  1. Lie on your back with knees bent and soles of the feet flat on the ground.
  2. Place the fingers of either hand just above the belly button.  Other hand can rest on your thigh or place behind the head like you are doing crunches.
  3. Inhale then exhale and lift your head and shoulders off the floor as in a crunch.  This will make your abdominal muscles contract and you can feel for a separation between the two sides.
  4. A separation of more than 2 1/2 finger widths, not seeing the gap shrink as you contract the abdominal wall, or seeing a small mound protruding down the length of your midline are all signs of diastasis recti.

Pregnant and postpartum women can prevent or lessen the severity of diastasis recti by performing exercises targeting the transverse abdominis.  The transverse abdominis acts like the body’s “girdle” compressing the abdominal wall when contracted.  Strengthening this muscle during pregnancy has the added benefit of helping prepare for the pushing phase of labor because the transverse abdominis is the body’s major expulsion muscle.  Exercises for the transverse abdominis include pelvic tilts and the sahrman series of exercises. 

Will exercising have any negative effects on my ability to breastfeed?

No, it won’t.  You can exercise while you are breastfeeding.  Make sure you wear a supportive sports bra (or bras!) while you are working out.  And, you might want to feed your baby or pump shortly before you workout to reduce discomfort.  Also, make sure you drink plenty of water! Your body needs water to replace the fluids lost when you sweat and you need extra fluid to support your body’s production of milk as well.

Are there any signs/symptoms that I am doing too much too soon?

Contraindications for postpartum exercise include:

  • Increase in vaginal discharge or lochia (this discharge is normal but it exercise causes it to turn more red or flow more heavily, you may need to slow down a bit)
  • Pain–pain is different from a little bit of muscle soreness.  Some soreness is expected but pain is not normal…slow down.
  • Fever
  • Wound dehiscence (opening up)
  • Exhaustion–exercise should be stress relieving and invigorating.  You have enough going on with your new baby so if exercise becomes another source of stress give yourself permission to take it down a notch!

In summary, listen to your doctor’s advice and listen to your body!  Start slowly and gradually increase the duration, intensity and frequency of exercise.  When did you start exercising after your baby was born?

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