6 Weeks - 3 Months Postpartum

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Overview

At this point during recovery, it’s possible you have been cleared for exercise and to return to sex.* Not feeling ready for that? Totally normal! Your body took 9-10 months to create a human being, it takes more than 6-8 weeks to fully recover. Full recovery can take up to a year, and that is incredibly important to remember as you continue to return to exercise. 

By 6-8 weeks, the uterus has mostly shrunk back to its normal size though can continue to shrink back to its original size (that of about a pear) through 12 weeks. This is the case whether you had a vaginal or cesarean delivery. 

You may be wondering about getting back to pre-pregnancy weight. This takes time though you may be noticing changes by now.

Read on to learn more about this phase of recovery.*

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Core

As we stated during weeks 2-6, the core and abdominal muscles take months to fully recover. During this stage, it’s normal for the abdomen to feel loose or flaccid but your muscles will continue to regain tone as you return to activity and work on gentle core and pelvic floor exercises. 

As the abdominal muscles come back together, around one third of women will notice that there is still a separation of the abdominal muscles, called a diastasis recti. Diastasis recti occurs when a separation between the “6-pack ab” muscles remains after the baby is born. If you notice a protrusion or doming in the middle of the belly when you do a small crunch, you may have a diastasis recti. For more information, check out Alex’s self-screening video.

If you are wondering what core exercises you can do during this phase of recovery, click here to jump to the exercises section. 

Pelvic Floor

While the pelvic floor has not yet returned to normal completely and may not actually be the same as it was pre-pregnancy, a lot of healing occurs by this timeframe. During this phase, muscle tone and tissue continue to return to pre-pregnancy states.

As recovery continues, the following are common but not necessarily normal pelvic floor complaints some women deal with:

Pelvic Pressure

Pelvic or vaginal pressure could be a sign of prolapse. Prolapse can occur in many forms but happens when the pelvic floor muscles are unable to support the organs above them. Common symptoms include pain, pressure in the pelvis or abdomen, and/or a sensation of heaviness or dragging.

Painful Sex

As some may consider returning to intercourse, it is common to experience some discomfort with intercourse. Discomfort or pain may be present especially if you experienced more than a second degree tear during birth.

Leaking Urine

  • Urge Incontinence: Leaking urine, sometimes called incontinence, due to being unable to make it to the bathroom on time or having very strong urges to urinate that make it hard to get to the bathroom. 
  • Stress Incontinence: Leaking urine with activities such as coughing, laughing or sneezing.

Tips to help restore your pelvic floor at 6 weeks - 3 months postpartum:

  • Reconnect to your pelvic floor with breathing/ relaxation and strengthening exercises. Practice relaxing the pelvic floor on the inhale and drawing the muscles up and in as you exhale. Practice this 5-10 times.
  • Pelvic Floor Therapy is essential to many women’s recovery after baby. While it can provide the most benefit to those dealing with issues like those listed above, pelvic floor therapy is incredibly helpful for moms wanting to return to pre-pregnancy activity without causing pelvic floor issues. Need help finding a PT? See the Locate a Pelvic Floor PT Near You section of our Resources Page.
  • Returning to sex can be challenging. Working on pelvic floor relaxation can help decrease pain. Using lubrication and keeping an open line of communication with your partner can help improve the experience. See 2-6 weeks for more tips on this topic.

Adjusting to Motherhood

Many moms feel like they are turning a corner at 6 weeks. You may feel like you are making progress with your physical recovery from birth, sleep, and possibly your maternity leave. You may also be noticing a desire to discuss how you divide responsibilities in your relationship. Here are a few ways you can tackle these changes, including actionable tips on how to get your partner more involved and how to make time for your needs at the end of this section.

Why you might not be ready for sex and exercise

If were cleared to resume your usual activities (including sex and exercise) at your 6 week appointment, for the reasons discussed in the other sections, don’t fret if you are not mentally or physically ready! Moms generally do not need one more thing to feel guilty about, so be sure to use the information you learn on this page to keep your expectations for yourself realistic. It is actually uncommon to have no problems with sex after having a baby (Romano et al, 2010). For some, these issues can last up to 18 months (Romano et al, 2010). Don’t forget that there is help out there if pain is stopping you from being intimate with your partner in the way that you desire. Need help finding a PT? See the Locate a Pelvic Floor PT Near You section of our Resources Page.

How's your sleep?

Speaking of realistic expectations, what improvements can you expect from your baby after 6 weeks? Some babies may be graduating to a 6 hours stretch of sleep at night (Nattress, 2022). If this is you, congrats! If this is not you, work with your partners or support system to get additional sleep if you can. Sleep can not only improve your physical recovery, but also your mood!

As your baby nears 3 months of age and their stretches of sleep lengthen, you may find yourself with small bits of free time. While you may be tempted to tackle ALL of the things that you have put on the back burner as you survived the newborn period, it’s a good idea to keep your expectations realistic, prioritize your time, and continue taking time to rest when needed.

Not sure how to prioritize? Consider revisiting 1 area of change in your life that you are ready to tackle or Journaling Your To Do List from the previous guides. 

Returning to work (or not)

Now let’s talk about another elephant in the room, returning to work. We recognize that returning to work is a very personal decision – the best person to decide what is best for your family is you! If returning to work is part of your story, here are some tips to help you prepare for another big life transition. Many moms feel very emotional about returning to work. Know that you are not alone and lean on veteran moms and your support system to help you through this transition!

Offloading the Mental Load of Motherhood

Returning to work or not, the mental load of motherhood can feel overwhelming. The way you divided responsibilities with your partner prior to your baby’s arrival may not be working now. Many moms, including myself, struggle to communicate about this topic, take on responsibilities by default, and may even become resentful of this new dynamic to their relationship. This can be a tough issue to tackle. Know that figuring out the new division of responsibilities in your relationship takes time. Both you and your partner are likely learning new roles on less sleep than normal. When possible, try to give yourself and your partner room to grow, make mistakes, and to keep communicating.

Here are two ways that my husband and I have found helpful to share the load:

Weekly Family Check-ins

  • Set aside 10-30 minutes each week to “check-in” with your partner on key areas of your lives and plan together for the week ahead
    • If you and/or your partner are struggling with communication, this allows you to reflect together on your past week, proactively ask for support for the week ahead, and keep issues from being “swept under the rug”
    • Need a step by step guide? Here is how we do it.
      1. Copy our Spreadsheet. Customize it to fit your needs over time.
      2. Pick a time to “check-in” at a regular frequency
        • I recommend weekly (Sunday nights work best for us), but starting with a regular frequency that feels doable to you is most important as you establish this new routine
        • It’s ok if you miss a week, just communicate with your partner that you are intentionally skipping the formal meeting and do a brief check-in on anything that can’t wait until the next scheduled meeting
      3. In the week before the meeting, jot down items you want to touch base with your partner about in the Pre-meeting Thoughts section
      4. Keep your check-ins brief – shorter meetings increase your chances at continuing this habit
        • If you have topics that require more discussion, schedule a future time outside of your meeting to discuss them
      5. After checking in on all items on your Spreadsheet, review your calendars for the week.
        • Where do you need to coordinate? Where do you need support?

Weekly Schedule with Nights that you can “take off” if needed

  • If you have trouble taking any time for yourself, scheduling at least one time a week that you can do that (if you choose) makes it easier for you to follow through!
    • It took me at least 9 months to ask my husband to regularly put my daughter to bed 2 nights a week, but now we are to the point where he puts her down the same 3 nights each week and wakes up with her 1 weekend morning. Those are times that I can schedule time away from my family if needed.

We are not experts in mental health,* although we strongly believe that it is just as important to your wellbeing. Here are some amazing resources to check out if you are looking for more support or just want to learn more on this topic:

Common Struggles

Vaginal Dryness

Vaginal dryness is very common, especially if you’re breastfeeding. Estrogen is low postpartum and even more so with breastfeeding. This hormonal change causes lubrication to decrease. Vaginal dryness can make things like using a tampon or intercourse uncomfortable or painful. Here are some things you can do:

  • Avoid personal hygiene sprays or douches- your vagina can take care of itself without any extra support!
  • Stay hydratedConsider a water based lubricant for intercourse 

Decreased Energy

Obviously energy stores can be understandably low postpartum. Lack of sleep and caring for a human, again, can limit your energy. Try these quick pick-me-ups to help boost energy:

  • Take 10-20 minute power naps as able
  • Take a walk outside
  • Take a shower
  • Eat a healthy, well-balanced diet
  • Drink water- all day
  • Accept visitors but wisely! Too many visitors (and ones who don’t offer to help with anything) can totally zap your energy.

Returning to Exercise

Returning to exercise postpartum can be challenging, especially if you’re used to a very active lifestyle pre or during pregnancy. Pelvic floor and core weakness can make it hard to do the things you may want to do. Here are some tips as you get back into exercise postpartum:

  • Start with low impact exercise (i.e. walking, light swimming, elliptical, non-jumping exercise)
  • Incorporate core and pelvic floor strengthening into your routine
  • Consider using a workout guide or program
  • If an exercise causes pain, heaviness, dragging, or pressure in the pelvic floor or abdomen, modify or change exercises.

Decreased Libido or Sex Drive

It is incredibly common to experience a decreased libido postpartum There are also a variety of factors at play when it comes to diminished sex drive. Regardless, it’s recommended to wait 4-6 weeks at least to allow for enough recovery to resume intercourse without too many issues. Potential causes of decreased libido can include (but are not limited to) the following:

  • Caring for a small human
  • Fatigue
  • Poor sleep 
  • Decreased estrogen levels
  • Postpartum body image

If you’re experiencing low libido and would like to change things, here are some suggestions:

  • Communicate with your partner about how you’re feeling and any areas that might help you get some more time to relax during the day.
  • Try to reconnect in other ways. Take some time after baby goes down to hang out with each other (without phones! gasp!). 
  • Find other ways to be intimate: kissing, cuddling, holding hands. Start small to try to reconnect.

Postpartum Depression

If you aren’t feeling like yourself, you can find self-assessments and resources for mental health in the section above or in our Maternal Mental Health Resources.

Exercises for 6 Weeks - 3 Months Postpartum

By this stage of recovery, it’s likely that you were cleared for exercise by your midwife or doctor. However, it’s best to gradually increase intensity and demand of workouts rather than trying to jump right back into what you were doing before you were pregnant. 

Why can’t I jump right back into pre-pregnancy workouts?

Your body, muscles, and tissues are all continuing to heal. At this stage of recovery, your body has certainly made a lot of progress towards healing, but muscles such as your core and pelvic floor aren’t strong enough yet to support your body in high intensity exercise. Additionally, while there are things you can do to optimize your recovery, you can’t actually make tissue and muscle healing happen any faster.

Low Impact Exercise

Low impact exercise is recommended for the first 3 months (i.e. limiting jumping, running) and then using a return to running or high impact exercise protocol for months 3-6 (Groom et al, 2019). With that being said, if you experience any of the following symptoms at this point, it’s important to see a pelvic health provider before returning to running:

  • Heaviness/ dragging in the pelvic area
  • Leaking urine or not being able to control bowel movements
  • Doming or gap in the abdomen
  • Pelvic or lower back pain
  • Blood loss after 8 weeks that is not a menstrual cycle  (Groom et al, 2019)

For more general guidance on exercise postpartum, see our Guidelines for Postpartum Exercise.

Sample Exercises for 6 Weeks - 3 Months Postpartum

Core/ Pelvic Floor

Relaxation/ Stretching

General Strengthening

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    CREDITS

    References

    Groom, T., Donnelly, G., & Brockwell, E. (2019, March). Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population. Absolute.Physio. Retrieved August 27, 2022, from https://absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdf

    Nattress, K. (2022, April 15). How much sleep does a six-week-old baby need? Motherly. Retrieved August 27, 2022, from https://www.mother.ly/parenting/baby-sleep-schedule/two-month-old-baby-sleep-guides-schedules/6-week-baby-sleep-schedule/

    Romano M, Cacciatore A, Giordano R, La Rosa B. Postpartum period: three distinct but continuous phases. J Prenat Med. 2010 Apr;4(2):22-5. PMID: 22439056; PMCID: PMC3279173.

    *Note: We provide information on postpartum recovery not healthcare advice. We encourage you to discuss any content with your healthcare provider – we value their role in your recovery and this site is not a replacement for healthcare services like obstetricians, gynecologists, midwives, primary care providers, physical and occupational therapists, and mental health providers. See our Terms & Disclaimer and our Resources for more information.