If you’ve recently had a baby, chances are you’re getting bombarded with messages that go like this: Lose that post-pregnancy belly! Get your body back! Shed the excess baby weight!
Cue the side-eye.
Real talk? You’re exhausted, stressed and hurting in places you didn’t even know you had. Getting out of bed — let alone attempting some form of physical activity — can feel like someone is asking you to hike up Mount Everest.
“Postpartum, there’s just so much,” explains Tina Allen, P.T., a physical therapist at the University of Washington Medical Center’s Urology Clinic. “Moms aren’t getting enough sleep, they have this new being that they’re looking after and their bodies and muscles don’t work like they used to.”
On top of that, you’re navigating your new family dynamic with a little one and have a whole ton of hormones to boot. So, yes, while you know that exercising after giving birth is good for you, it’s way easier said than done.
“Our bodies change from being pregnant,” adds Sarah Prager, M.D., M.A.S., an obstetrician-gynecologist at the Women’s Health Care Center at University of Washington Medical Center-Roosevelt and a professor in the Department of Obstetrics and Gynecology at the UW School of Medicine. “The pelvic floor is going to be in a slightly different location. Breasts are going to be different. Things might not look or feel exactly the same.”
To help you navigate your new postpartum self and safely get moving again after birth, Allen and Prager share their top tips for getting back into the fitness swing of things.
Listen to your postpartum body
While celebrity moms may be posting pictures of their flat stomachs shortly after delivery — insert another side-eye here — that’s just not realistic.
Frame your physical fitness expectations with long-term goals in mind.
In those first few weeks after giving birth, it’s most important to prioritize your general recovery, well-being and sleep needs over any exercise routine.
And just like your labor and delivery is unique, how quickly you heal after having a baby is highly dependent on your personal birth experience.
Moms who have a smooth delivery with minimal complications may have an easier time resuming physical activity than those who need major interventions like a caesarean.
“Your ability to start activities is largely based on what your body is telling you,” Prager says.
That means paying close attention to how much pain you feel after doing certain movements, your level of bleeding and the amount of extra energy you can muster up between diaper changes and feedings.
Once your doctor clears you for more intense physical activity at your final check-up — usually around 6 to 8 weeks postpartum — you can progress to other types of exercise.
How quickly and intensely you start exercising again also depends on your previous fitness level. If your idea of a good workout before pregnancy was a brisk walk, you won’t have the same starting point as, say, a marathon runner — and that’s totally fine.
The most important thing is to find a level of physical activity that you feel comfortable with and go from there.
“I recommend starting at 75 percent effort of what your baseline had been,” Prager says. “If it feels like too much, back it off a bit more. If it feels OK, increase it a little bit.”
Start easy with short walks
It may not seem like much, but taking a short walk can help tremendously during your postpartum recovery.
“I encourage patients to be getting up and walking around almost immediately after delivery,” Prager says. “Even if it’s a 10-minute walk around the block, it can be extremely helpful for the healing process. It can decrease that risk of blood clots that is even more prominent postpartum if a woman has had surgery.”
Walking not only lets you test out how well your body feels after delivery — looking at you, vaginal tears — it also eases you back into physical activity without risking major injury.
“Walking is great,” Allen adds. “In general, movement helps everything.”
A simple stroll — with or without baby — can also provide a huge mood boost, something that’s especially helpful during those first few exhausting weeks.
An analysis of 16 different studies found that light exercise during the postpartum period helped reduce the odds of developing mild to moderate depressive symptoms by as much as 54 percent.
From a short walk around the block, you can work your way up to longer distances, faster speeds or steeper inclines.
Don’t push yourself too far too fast
While it’s good to work in some exercise, trying to do too much too quickly is not.
“There’s a difference between a good pain like, ‘Yes, I’ve worked my muscles hard and that feels great,’ versus ‘I’m straining my muscles in a way that they’re not ready for,’” Prager explains.
This is an especially important distinction to make if you’ve had a C-section, which means you shouldn’t lift anything heavier than your baby for the first 6 to 8 weeks.
“If you have increased urine leakage after exercising or any kinds of swelling happening, that’s something you should talk to your doctor about,” Allen notes. “If you’re having shooting pain, ripping, tearing or a sharp feeling, that’s really an indication to stop what you’re doing and back off. You’re being too intense too soon.”
When a red flag pops up, ease back on the physical activity until you feel better. From there, you can slowly build back up the duration or intensity of your exercise.
But if the pain doesn’t go away or get better on its own, talk to your doctor or physical therapist to check on your injury.
Another thing to watch out for? Your hydration and nutrition needs, particularly if you’re breastfeeding.
To keep those sudden hunger pangs at bay, it’s a good idea to tuck a water bottle and some snacks into your purse or stroller, just in case you suddenly feel depleted in the middle of a walk.
Make safe adjustments to postpartum exercises
Once your doctor gives you the green light to get your sweat on, you might be tempted to dive back into your usual workout routine. But remember, your body is different now and still healing in various ways.
To avoid injury, focus on exercises that won’t damage sensitive areas like your core or pelvic floor and adjust them as needed.
Remember that whole celebrity mom comparison thing? This is where those unrealistic expectations can get you into trouble.
Don’t launch right into aggressive core exercises in an effort to lose your post-pregnancy belly as quickly as a Kardashian.
“Ab muscles are like big rubber bands that have been stretched out for 40 weeks,” Prager says. “If you immediately start exercising with dynamic exercises, you can damage them.”
That means avoiding crunches, jumps, twists and leg lifts. Instead, focus on more gentle, static core exercises like planks, bridges and pelvic tilts.
“Think about how you hold in your core as you zip up a tight pair of pants and how that keeps your core engaged,” Allen says. “Now try keeping your core engaged like that while breastfeeding, washing dishes or engaging with your little one.”
Another common post-pregnancy concern is incontinence, courtesy of your still-healing pelvic floor. Gee, thanks.
Incontinence, when you can’t control urine leakages, is an issue that most moms have after giving birth. Usually, this will improve on its own over time.
Basic balance exercises and yoga can help, as well as another tried-and-true favorite: Kegels.
Allen says its best to do Kegels in various situations and positions — while lying down, sitting in your car or standing at the sink — to maximize their impact.
But when incontinence doesn’t go away on its own, specialized care like pelvic floor physical therapy can make a huge difference. Ask your doctor for a referral if you’re still experiencing issues several weeks postpartum.
Another postpartum issue you may need to accommodate? Those extra-tender (and sometimes leaky) breasts.
Make it a point to breastfeed or pump before you exercise to alleviate some of the discomfort. Nursing pads are also helpful to prevent any embarrassing wet spots from appearing mid-yoga pose.
And if your chest still feels a little unsupported, try doubling up on sports bras or opting for ones specifically made for nursing moms.
“I frequently have women who say they have back pain, neck pain and headaches postpartum,” Prager says. “That’s because the common position they are in is breastfeeding or looking down at their baby.”
When you sit or stand, focus on having a straight alignment, rolling your shoulders back and keeping your rib cage down. Adding props like breastfeeding pillows to support your arms and baby can help ensure you’re not hunched over for long periods of time, too.
Prager also suggests adding in chest-opening stretches and gentle neck rolls to your daily routine to help keep the tightness at bay.
“It’s still possible to gaze adoringly at your child and stretch your neck out a bit,” she says.
Finding time for self-care while nurturing your little one? Well, that’s the definition of #momlife.
Originally published at https://rightasrain.uwmedicine.org/life/parenthood/exercise-after-baby on March 25, 2019.