How soon can I exercise after giving birth?
A couple of years ago, while out walking my dog in the local neighborhood, I noticed a woman jogging towards me. She looked familiar, it took me a few minutes to realise she was one of the mums from my pregnancy yoga class. I was shocked! This woman had just given birth 4 weeks ago! We stopped and chatted. She told me she just HAD to get back to exercise because she couldn’t stand her post-pregnancy body. I asked her if anyone had told her about taking care of her uterus after birth. She stared at me blankly as if I was speaking a foreign language. I felt sad for her and sad for our culture which sees it so important to educate every young girl to understand pythagoras theorem but not to understand and care for her own body. It never ceases to amaze me how little most women know about their uterus despite the fact that we all have one and its condition is so important to our overall health and wellbeing.
The question of when to return to exercise after giving birth is one you may not consider when you are pregnant. When you do get round to thinking about it you may be coming from a place of frustration and we all know decisions made during times of frustration are not always the best ones. Starting an intense fitness regime when your baby is just a few weeks old is not very wise regardless of what the Kardashians are doing. While it’s true that some women find it hard to lose weight after birth, for most women this isn’t a problem and their bodies return to normal again within a reasonable amount of time. There are plenty of things you can do to lose weight quickly after birth but doing the wrong kind of exercise can cause long term damage to your body.
Your body took nine months to make a baby. It is not going to suddenly go back to its pre-pregnancy state in a few weeks. I was blown away by the fact that I could get up and move around within minutes after pushing a ten and a half pound baby out of my body but I knew there was still a lot more going on inside. It wasn’t until I did my advanced training in the physiology of pregnancy and birth did I realise the massive hormonal and physiological changes a woman’s body goes through for up to a year after giving birth. Working in harmony with those changes and phases is a lot wiser in the long run. Lets consider some of those changes:
Right after your baby is born the placenta which nourished your baby through the pregnancy is released. Your body goes to work immediately to heal the site where the placenta was attached. The uterus continues to contract after the birth in order to seal off the open blood vessels at the placental site. This can go on for a number of days, until the wound is completely healed. You may feel the uterus contract when you breastfeed your baby caused by the release of the hormone oxytocin from the stimulation of the nipples when the baby is feeding. Yes, it’s the same oxytocin which caused the uterus to contract during labour, hence why nipple stimulation is recommended to get labour going and now you can prove that it works!
During the early days after birth the vaginal discharge called lochia gradually decreases until it stops completely. This can take anywhere from ten days to six weeks, even longer for some women. The reason for this is because the cervix is still open and the uterus is still healing and shedding. As well as being open the uterus is still floppy and heavier than normal. Please think about that for a moment… open, heavy, floppy uterus… would you really want to go jogging while your uterus is in such a vulnerable state? Especially since the pelvic floor muscles that normally support it are overstretched and weak from the birth. A prolapse waiting to happen (prolapse = part or all of the uterus is pushed down and out of the vagina).
The uterus will gradually close and shrink smaller and smaller until it can no longer be felt through the abdominal wall. Your midwife will check this in the first few hours and days after birth and it will be checked again at your six-week checkup. Even after you have passed your six week checkup the uterus may still be vulnerable for quite some time. No amount of exercise can help the uterus to shrink faster. It just takes time. The only thing that will contract your uterus postnatally is breastfeeding. Breastfeeding also burns up to 500 calories a day. This is one of the reasons why women who breastfeed lose weight and regain their shape faster. It’s nature’s way of taking care of everything. And since resting helps produce breastmilk then the best thing we can do in the early days is rest with our baby. That’s what we instinctively want to. We do not have an instinctive urge to put on running shoes and go jogging a few weeks after having a baby. It’s something in our head that tells us to do that. Perhaps we have a fear that we’ll never lose the weight or regain our fitness levels. Perhaps we are afraid our partner will not find us attractive. Perhaps we are feeling a bit emotional due to hormonal fluctuations and our mind is searching for a reason. ‘It’s because you’re fat’ she might say. These are just thoughts. Ignore them and follow your instincts. Nature has a perfect design for us.
Every time you feed your baby your uterus contracts. This can be felt strongly during the first few days and weeks, especially after your second or third child. As the weeks go by, the sensation of the uterine contraction becomes more subtle and harder to detect. If you are not breastfeeding the process is slightly different and it takes a bit longer to shrink back but rest assured that it will go back to normal as long as you don’t do anything to upset that such as doing the wrong kind of exercise eg weight lifting, gym, jogging, dancing, zumba, bootcamps. Doing these types of exercise in the early weeks can cause long term damage.
Even after a c-section the uterus will still be floppy for several weeks and there is also a fresh scar from the surgery. Perhaps some abdominal organs have been yanked around a bit to get the baby out. These need to be treated with loving care and allowed plenty of time to heal and settle back into place before beginning intensive exercise regimes.
The next thing to consider is our pelvic floor. This hammock-shaped group of muscles which supports our lower back and pelvic organs is normally very strong. It will however have been weakened even in the easiest vaginal birth due to being stretched to the max to facilitate the baby coming through. It needs time, patience and a bit of work to heal and be restored fully so that it can once again support our pelvic organs while we engage in high impact exercise such as running, jumping and dancing. The uterus will also be at risk of a prolapse if we engage in gym-type exercise involving abdominal crunches, weight lifting or deep repetitive squatting. It doesn’t take a genius to figure out that a floppy uterus can easily be displaced and pushed out of the vagina if you put too much internal pressure on it. Especially since the pelvic floor muscles, the hammock that usually supports it has been stretched and weakened from the birth process. So your granny was right about the dangers of lifting anything heavy after chi
ldbirth. A prolapsed uterus is very difficult to correct and may need surgery. Listen to your granny!
If you had a vaginal tear or episiotomy during the birth the site also needs time to heal, engaging in intense workouts can put undue pressure on the site is very risky. Gentle postnatal yoga helps to heal the site. The same is true if you have had a c-section. Once the initial healing of wounds has taken place the scar can be numb for some time. Doing gentle postnatal yoga will bring blood flow to the area and help restore damaged nerve endings. You should always follow the advice of your midwife or physiotherapist in caring for more serious damage to the perineum.
If your abdominal wall has separated too much during pregnancy you can cause permanent damage to it by doing inappropriate exercise during the early postnatal period. Even gym exercise such as spinning can put too much pressure on a post pregnancy abdominal wall if done too early. The best and safest exercise to restore your pelvic floor and rehabilitate the abdominal muscles properly is gentle postnatal yoga combined with walking or swimming. Those are all you need in the early weeks and months.
Now that you know how awesome your body is during pregnancy and birth you will understand why in some traditional cultures a woman in her reproductive years is treated as if she is a precious gem, carrying and caring for the future of the tribe. She is not expected to do any household duties at all. She may go and live with her mother or a sister for a few weeks where she is taken care of with nutritious food and massage while she rests and takes care of her baby. How strange then that we in the west expect our bodies to suddenly spring back to their pre-pregnancy state and resume normal activities within weeks.
Most women find they lose the extra weight without dieting or extreme exercise routines within a year after having a baby. If you are not breastfeeding it may take a little longer to lose the weight and you may have to make a little extra effort. To speed up postpartum weight loss in the early months you should focus on eating a healthy diet, keeping hydrated with good clean water, getting plenty of rest, getting some suitable aerobic exercise such as walking or swimming and doing some postnatal yoga for toning and strengthening.
Pelvic floor exercise should be started as early as possible, within days of giving birth. You can safely do light exercise such as walking and stretching within days. C-section mums will need to follow the precautions given by their doctor or midwife. Start slowly with short walks once a day. Maybe just up and down your street to begin with. As you regain strength, you can gradually increase the length and number of walks. You can start a postnatal mum and baby yoga class after your 6 week checkup (8 weeks for c-section). This is a really nice way to get out and socalise with other mums as the classes are usually fun and relaxed with tea and chats afterwards. The class is focused on healing the mothers postnatal body by strengthening the pelvic floor, helping the uterus settle back in to a good position and gradually building core strength. Hence why this is the most appropriate exercise. The babies come along to the class but the exercise is for the mothers.
You should continue with your walking to get some aerobic exercise and increase the frequency and length of the walks if you want to burn extra calories. Soon you can include some swimming but still no high impact exercise such as running, dancing, aerobics, Zumba, astanga, or hot yoga for several months. This will be different for every woman. If you did yoga during your pregnancy your body will recover faster. You will also be more in tune with your body and so you’ll know yourself when the time is right for you to introduce more high impact or intense workouts.
Tempting as it might be to go back to gym or bootcamp workouts you should avoid them completely for at least 6 months. And when you do return to more intensive style workouts you should do so very gradually while paying full attention to your body and staying within your comfort zone.
Rest, rest, rest, I cannot state this enough to new mums. First time mums especially don’t get how important it is to rest and sleep when your baby sleeps. It’s not as easy on your second or third child, you have to settle for catnaps on the couch while older one plays or watches tv. First time mums are often used to a corporate work schedule and they try to work that into how they do their days as a new mother. It doesn’t work and they often end up exhausting themselves before they realise they have to slow down, do less and sleep more. Here is one of the least known facts about weight loss. According to research published in the Annals of Internal Medicine, weight loss slows down when you don’t get enough sleep because you burn less calories. On top of that, cravings increase so you are likely to overeat. In the study, dieters were put on the same diet but different sleep schedules. When their bodies received adequate rest, a significant portion of the weight lost was from fat. However when they cut back on sleep, the amount of fat lost was cut in half. What’s more, they felt significantly hungrier, were less satisfied after meals, and lacked energy to exercise. They had a 55% reduction in weight loss compared to their well rested counterparts. Now there’s some food for thought.
If you are still experiencing a lot of lower back pain or other pain in your body after several months you should talk to your doctor about it or see a physiotherapist. If you are still carrying a lot of extra weight after a year then you can get down and dirty with some more intense workouts and diets but please do so under the guidance and supervision of an expert.
Lastly and most importantly, please consider the fact that you will NEVER get back those first precious months with your baby. Do you really want to spend that time fighting with your postnatal body and/or fighting with your partner to mind the baby while you go to the gym? There are lots of ways you can get safe postnatal exercise while keeping your baby closeby. Attend a Mum and baby yoga class or do some postnatal yoga at home with a dvd. Find another new mum to go out walking with the babies in the buggy or in a sling. I know a couple of new mums who team up and go swimming together. They take turns to watch the babies in the car seat or buggy by the pool while the other one swims. A bit of creative thinking and you will come up with the best solution for your lifestyle but most importantly make it a fun and joyfilled experience keeping a positive attitude towards your body rather rather than hating or fighting with it.
About the Autor
Carmel O’Dwyer is a yoga teacher who specialises in prenatal and postnatal mother and baby yoga. She has been teaching yoga in Co Wicklow since 2001. You can contact her through her company YogaMums.ie Email: firstname.lastname@example.org Phone: 0861257843.
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