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Considerations for Safe Return to Exercise Post Pregnancy
By Courtenay Schurman, MS, CSCS
If you were able to maintain your activity levels during pregnancy, you will find it far easier to return to normal levels of exercise compared to women who for whatever reason had to reduce or stop exercising altogether. Most health care professionals err on the side of caution and suggest no heavy physical activity (beyond general baby care, light housework, or walking) until your bleeding has stopped and you are no longer in pain, which for a woman who had an episiotomy, difficult delivery, or C-section can take up to six weeks. However, if you had a fairly routine delivery and relatively easy pregnancy, most experts would agree you do not have to wait until your six-week checkup to resume an exercise program.
Remember that the faster you can return to normal exercise, the better you will feel and the more quickly you will shed those pregnancy pounds. Be extra patient with yourself, however, if you had a complicated delivery or C-section and as you learn to handle the stresses of caring for your newborn without much sleep. Listen closely to your body, and when in doubt, consult with your health care provider for the most accurate information for you, given how active you were before and during pregnancy, and how physical your typical daily lifestyle is. Most doctors would agree that you can begin a walking program within days of delivery. Many active women return to exercise within two weeks after the birth of their babies without detrimental effects (Clapp, 1998.) As long as your exercise does not cause you to bleed heavily and you do not experience any pain, feel free to re-introduce other favorite activities at a reduced intensity level, always listening carefully to your body.
One of the biggest questions on all new moms� minds (other than those pertaining to parenting issues!), of course, is how long will it take to return to nonpregnant fitness levels. It depends on many factors, including how much weight you gained, your diet before, during and after pregnancy, your exercise program and intensity, care available postpartum (i.e. the first six weeks following birth), and whether or not you are breast-feeding. �The six-week recovery myth is just that � a big, fat fiction that has done easily as much damage to women�s self-esteem as airbrushed photographs of models and the invention of Lycra� (Graves, 1999). Give yourself a full six months to a year to regain all your abdominal tone and reach nonpregnancy fitness levels. While there will certainly be a few lucky women who seem to shed all the weight very quickly, having high expectations that you, yourself, will be one of them only adds unnecessary stress and pressure. If you are breastfeeding, count on holding onto roughly five extra pounds to be sure you have adequate fat stores for producing milk; once you wean your baby you will find it easier to shed those last pounds.
Benefits of Exercise for New Moms
There are as many benefits of exercise postpartum as there are pre-pregnancy and during pregnancy, including:
- Helping you lose weight gradually, safely, and naturally without dieting. As long as you are breastfeeding you will need to consume an extra 500 calories per day above pre-pregnancy caloric intake--at least 1800 calories/day (Kulpa, 1994); dieting too soon after birth can cause a decrease in milk supply.
- Toning muscles neglected during pregnancy, especially your abdominals (see www.bodyresults.com/e2pregnancyabs.asp for exercises safe in the third trimester and immediately following postpartum). Remember that it takes your uterus about six weeks to shrink back to nonpregnancy size.
- Speeding healing and contributing positively to self-esteem. Exercise within the first six weeks of delivery should focus on time for relaxation and even personal time away from the baby, rather than on trying to increase performance levels. Three to five short sessions a week is optimal as long as you are getting adequate rest and not overdoing it (Clapp, 1998).
- Staving off postpartum depression by elevating endorphins, your natural �feel-good� hormones, so long as trying to fit exercise in an already busy schedule does not increase your stress levels. �Women who are physically active before their six-week postpartum checkup may adapt more easily to motherhood and the recovery process� (Cowlin, 2002.)
- Assisting you in burning additional calories at the safe rate of loss of 1.5-4 pounds a month during the first four months after delivery. Any faster than that and you risk losing precious energy that you need to keep up in order to tend to your newborn.
- Reducing frequency and severity of hot flashes, night sweats, and emotional instability until ovarian function returns to normal (Clapp, 1998.)
Consequences of Breastfeeding on Exercise
- Support: Invest in some good sturdy support athletic bras to prevent discomfort during aerobic exercise. You might even consider wearing one on top of the other for additional comfort. Be sure to change out of your athletic garb immediately after exercising to prevent chafing; avoid bras with seams over the cups; and to prevent nursing pads from sticking, try moistening each pad before removal.
- Postexercise Breast Milk: Some babies may be sensitive to lactic acid buildup in breast milk following exercise, although there are no good data to suggest that exercise has detrimental effects on the quality of milk or its production (Kulpa, 1994). However, one source suggests that the immune-system booster IgA seems to decrease 30 minutes following strenuous exercise but returns to normal within an hour. To err on the safe side, consider nursing before exercise to prevent engorgement, or try expressing a bottle of milk prior to your workout if you must feed your baby immediately afterwards. (Graves, 1999).
- Hydration: Since you are the main source of nutrients (including fluids) for your baby, you need to pay special attention to staying adequately hydrated yourself. Try to have diluted juice or water handy when exercising and when breastfeeding to ensure that you are not becoming dehydrated. As your baby�s caloric needs increase, so will your milk supply and your hydration requirements.
Post-Partum Fluid Loss
Pregnant women retain a lot of fluid in the form of increased blood volume during pregnancy. On average, expect copious discharge (lochia) for roughly three weeks (Kulpa, 1994; Cowlin, 2002), as well as extra fluid loss in the form of hot flashes, night sweats, and frequent visits to the bathroom for up to two months. These are your body�s natural ways of returning to its normal blood volume and fluid levels. When choosing appropriate forms of exercise, keep these �fluid facts� in mind, and exercise in places where you can 1) drink frequently, 2) stop often to use the restroom, and 3) be sure that blood flow diminishes and does not increase. If bleeding becomes more abundant or seems to increase in redness following exercise, decrease the intensity of subsequent workouts to promote healing.
If you feel overwhelmed by all your new responsibilities, not to mention lack of precious sleep, you can still include a healthy dose of exercise without requiring a solid hour for the gym. You might want to consider trying some of the following:
- Dance and sing with your baby
- Load baby into a Baby Bjorn or sling and go for a walk around the neighborhood
- Have your husband or partner take over one feeding each day (once breastfeeding is well established and you�re able to express enough for a bottle) so that you can do an exercise tape
- Exercise with baby � hold your newborn in a carrier and do squats, step ups and lunges with the baby�s added resistance; add pushups, tricep dips, and abdominal exercises or even yoga as your baby rests on a comfortable blanket near you
- Break up your workout into small 10-15 minute chunks throughout the day as you can squeeze in time between diaper changes, naps, and feedings
After six to eight weeks following delivery, or whenever you have established a comfortable pattern with your new baby and have been able to resume your activity, it will be time to set new exercise and fitness goals for the next year. Make sure they fit into your new lifestyle. Keep moving, and above all else make sure you are getting enough rest. If you remember to put yourself and your own physical and mental needs first, everyone will benefit.
Clapp, James F. III, MD. Exercising Through Your Pregnancy. Human Kinetics: Champaign. 1998. p. 205-222.
Cowlin, Ann F. Women�s Fitness Program Development. Human Kinetics: Champaign. 2002. p. 189-245.
Graves, Ginny. Pregnancy Fitness: Mind, Body, Spirit. Three Rivers Press: New York. 1999. p. 153-186.
Jones, Katina Z. Everything Get Ready for Baby Book. Adams Media Corporation: Holbrook. 1998. p. 224-225.
Kulpa, Patty, MD. �Exercise During Pregnancy and Post Partum,� in Medical and Orthopedic Issues of Active and Athletic Women (ed. Rosemary Agostini). Hanley & Belfus, Inc: Philadelphia. 1994. p. 191-199.