Childbirth is a such an exciting, but scary event that brings us big physical and emotional changes. While many new mommas are eager to regain their pre-pregnancy fitness levels and return to their regular exercise routines, it is important to approach postpartum exercise and movement with caution. Jumping back into high-impact or even more strenuous daily activities too soon can cause us serious risks, both medically and for pelvic floor recovery. It’s crucial to allow adequate rest while also finding a happy balance of gradual movement to optimize your recovery and also prevent medical complications.
The 6 Week Rule:
Pelvic rest is recommended for the first six weeks postpartum to allow the body to heal from the significant physical trauma of childbirth, whether through vaginal delivery or cesarean section. During this period, the uterus, which has undergone substantial stretching and potential tearing, needs time to return to its pre-pregnancy size and repair any damage. For vaginal births, the perineal area may have experienced tears or an episiotomy, requiring time to heal properly to prevent infection and promote tissue repair. In the case of c-sections, the surgical incision on the abdomen and uterus needs adequate time to heal to prevent complications such as infections or wound dehiscence. Additionally, the cervix, which remains dilated after childbirth, needs time to close fully, reducing the risk of uterine infections. Overall, pelvic rest helps ensure that these critical areas heal correctly, minimizing complications and promoting long-term reproductive health.
The pelvic floor muscles undergo significant strain during pregnancy and childbirth, whether you had a vaginal or cesarean birth. These muscles support the bladder, uterus, and rectum, and play a vital role in maintaining continence and providing core stability. Not only that, but the abdominal muscles have been stretched to their maximum potential throughout pregnancy and have either been strained to assist with pushing or have been affected from a c-section. Postpartum, these muscles have to heal, requiring time, but also specific exercises to recover properly.
Risks of Returning to Exercise Too Soon:
1. Pelvic Floor Dysfunction: Returning to high-impact activities too soon like running or jumping can make weakness in the pelvic floor muscles more apparent. This can lead to issues such as urinary leakage, urinary urgency, and pelvic pain.
2. Delayed Healing: The pelvic floor, abdominal muscles, and uterus need time to heal from the trauma of pregnancy and birth, whether belly birth or vaginal. Engaging in strenuous activities too soon can disrupt the healing process and prolong recovery.
3. Increased Risk of Prolapse: Overloading the pelvic floor with high-impact exercise can increase the risk of pelvic organ prolapse, where the bladder, uterus, or rectum can descend into the vaginal canal, causing discomfort and can affect your ability to take care of your baby and yourself.
Beyond the risks to pelvic floor recovery, there are broader medical concerns associated with returning to exercise too quickly after childbirth. These include:
1. Diastasis Recti: Otherwise knows as the separation of the abdominal muscles. Intense core exercises can contribute to the slow healing of this separation if done before the muscles have had time to heal properly.
2. Joint Instability: Pregnancy and breast feeding hormones continue to affect joint stability postpartum. High-impact exercises can increase the risk of joint pain due to lingering laxity.
3. Bleeding and Infection: The postpartum period involves significant healing, including the healing of the uterus and any perineal tears, episiotomies, or c-sections. Strenuous activity can increase bleeding, wound opening, and the risk of infection.
Should I actually rest postpartum?
Rest is a critical component of postpartum recovery. It allows the body to heal from the rigors of childbirth and helps to restore energy levels. Not only that, but it is hard work to keep a new born baby comfortable!
Overall, we want our tissues to heal, hormones to adjust, and have just general emotional wellbeing. Our muscles, ligaments, and tissues stretched and were strained through pregnancy and birth and need time to repair. Our hormones are regulating and rest helps our body adjust to these changes more efficiently. Also, this is a HUGE change in our lives. Rest is essential for bodily and mental health. This period of transition is emotionally challenging with relationship and self changes, lack of sleep, and caring for a newborn baby. Allow yourself time to recover and rest so your body isn’t overloaded with stress hormones from doing too much, too quickly which can delay your overall physical health that can then affect your mental health too.
But isn’t too much rest a problem too?
While rest is crucial, complete inactivity is not advisable either. Gradual movement is important to prevent health issues associated with prolonged inactivity, such as deep vein thrombosis, physical deconditioning, and other medical problems..but again, it can help with improving your overall mental health too.
Finding a healthy balance of rest and light/ comfortable movement is key in allowing your blood to circulate and prevent blood clots while also maintaining some muscular tone and overall lung/ heart health necessary for when you are ready to return to some more rigorous exercise later. Light movement also can help improve your mood and reduce symptoms of postpartum depression.
Usually it’s advisable to start with small walks around your house where you can rest if you are tired or have increased urinary leakage, vaginal bleeding, or pelvic heaviness/ pain. As tolerated, you can start with small walks into your driveway and back and then progress to gradually into your neighborhood. Always start off small and build up as tolerated.
Starting a light exercise program such as our Early Postpartum Rehab Program can allow for some guidance in comfortable movements to help heal your pelvic floor muscles, core muscles, and increase strength and stability in surrounding muscles too.
How do you find a healthy balance?
Balancing rest and gradual movement is key to a healthy postpartum recovery mentally and physically. The best ways to find a healthy balance is to test your body, read how you are feeling with your symptoms and stress levels, and follow medical advice.
1. Start with Gentle Activities: Begin with light activities like short walks that you gradually increase daily, gentle stretching, belly breathing and 360 rib cage breathing, and light core and pelvic floor awareness.
2. Listen to Your Body: Pay attention to how your body feels. If you experience more pain or discomfort in your perineum or c-section incision, increased bleeding, or even vaginal bulging, pelvic heaviness, or dragging sensation, it’s a sign to slow down and rest.
3. Follow Medical Advice: Consult with your healthcare provider if you are worried about starting any exercise routine. They can provide personalized recommendations based on your individual recovery based off of your birth experience.
4. Incorporate Pelvic Floor Awareness Exercises: Begin with pelvic floor relaxation and elongation with inhalation. Then gradually start using your exhale to work on contracting your pelvic floor up and in as if grabbing a blueberry and pulling it up with your vagina. If this is comfortable then coordinate your pelvic floor contraction with abdominal wall draw in as if zipping up from pubic bone to belly button. Learning to reconnect to these muscles are critical in your recovery postpartum and returning to life activities.
5. Avoid High-Impact Activities for first 12 weeks: Hold off on high-impact exercises like running, jumping, or heavy lifting until you have regained sufficient strength and stability in your pelvic floor, core muscles, and surrounding muscles throughout your upper and lower body to feel strong enough where your pelvic floor muscles don’t have to do all the work.
So, should I just avoid all exercise for the first 6 weeks?
This is really up to you, your recovery, your medical history, and your desire to move. Consulting with your birth provider on any red flags for avoiding exercise (most of which are noted above) can help clarify any hard stops for exercise or movement.
In general, there are certain conditions and situations where postpartum exercise should be avoided or delayed. We want to avoid exercise if we have heavy bleeding, possibly infection, elevated temperature or extreme soreness/ pain in perineum or cesarean incision, significant bladder or bowel leakage after 1 month postpartum, excessive tailbone/ hip/ low back pain, pelvic heaviness/ dragging sensation, or vaginal bulging sensation. If we aren’t experiencing these issues then typically we are clear to start off with light movement and walking to allow us to transition to more general exercise and strengthening once we are cleared medically before starting higher impact activities.
Returning to exercise postpartum requires a careful balance between rest and gradual movement. While it is essential to avoid the risks associated with returning to high-impact activities too soon, incorporating gentle movement and walking can prevent mental and physical health issues related to inactivity. Prioritize pelvic floor recovery and reconnection, read your symptoms and your want to return to movement, don’t return just to “loose weight” or “return to your pre baby bod”, make sure you are returning to the type of movement that will make your feel good mentally and physically, and seek professional guidance if you are worried about any symptoms your may have to ensure a safe and effective postpartum fitness journey.
If you want more guidance, look into our 6 week Early Postpartum Rehab program, designed specifically for new moms in the immediate 6 week postpartum time or even after the 6 week check up for some guidance on light movement, pelvic floor and core reconnection, and a guided approach to getting back to exercise.
Empower yourself with the tools and knowledge to navigate postpartum fitness safely and confidently. Your body has been through an incredible journey, and with the right approach, you can recover and thrive!
