Guidelines for Postpartum Exercise
Many moms have questions when they are returning to exercise. What can I do? What shouldn’t I do?
While there are no single set of hard and fast answers to these questions that apply to every mom, we have gathered some general guidelines that are meant to empower and not restrict you. Please keep in mind that everyone’s pregnancy, childbirth, and postpartum journeys vary greatly. You may even have experiences that vary greatly from one child to the next. We provide information on general postpartum recovery not healthcare advice. We encourage you to discuss specific guidelines 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.
Red Flags after Birth
While most women recover without any serious complications after birth, there is always the risk of developing more serious complications. While these are rare, it’s important to be aware of signs that are considered “red flags.” These red flags, if present, would be a reason to reach out to your provider or visit the ER. According to March of Dimes, do not ignore the following red flags:
- A headache that does not get better with over-the-counter medication
- A fever higher than 100.4 degrees
- Increased vaginal bleeding or foul smelling vaginal discharge or incisional discharge
- Pain in one area of your breast
- Pain in your lower leg
- Seizures, fainting, increasing abdominal pain
- Persistent cough, chest pain, or shortness of breath
- Having thoughts of hurting self or the baby
- An incision or episiotomy that is not healing or is red (“Warning Signs”, 2022)
Overdoing it after baby is a common struggle. Especially if you have another little one at home, it can be very hard to balance getting things done with your own recovery. There are a lot of factors that can go into doing too much, too soon, but here are a few signs that you may have overdone it in those first couple of weeks:
- Pain that increases significantly (i.e. if you start with 2/10 pain and do an activity and your pain goes up to 5-6/10 pain, that is too high)
- Significant increase in vaginal bleeding after or during an activity is a sign of too much. While you’ll have some bleeding in the early weeks postpartum, a large increase in bleeding is a sign of too much activity.
- Not being able to easily carry on a conversation while walking or moving can be a sign of doing an activity with too much intensity. For example, if you go for a walk (which we encourage) but are walking so fast that you cannot carry on a conversation, this is too much in the early days.
Considerations during Exercise:
- Pay attention to signs of overdoing it: heaviness in the abdomen or pelvis, worsening diastasis (belly muscle separation) during or after exercise, soreness that lasts more than 24-48 hours
- Focus on breathing and posture. If you have to hold your breath or compromise posture during exercise, then you may not be ready for that one just yet.
- Do not pull in your belly button or clench your pelvic floor during exercise. Try an exhale during the challenging part of the exercise instead.
- 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).
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
Warning signs of health problems after birth. March of Dimes. (2022). Retrieved August 27, 2022, from https://www.marchofdimes.org/pregnancy/warning-signs-of-health-problems-after-birth.aspx#:~:text=Life%2Dthreatening%20conditions%20that%20can,severe%20headache%20and%20extreme%20pain