For many people, exercise after pregnancy is an important part of the post-birth plan. It was for me! After my first baby was born, I was chomping at the bit to get back to my half-marathons and kettlebell training. But I learned the hard way, there’s more to postpartum exercise than getting an “all clear” from the doc at 6 weeks.
If you’re like many parents, you may be wondering when it’s safe to resume exercise after giving birth. Or maybe you’re looking for guidance on how to go about it safely and effectively. Either way, you’ve come to the right place!
This guide will provide tips and advice on exercise during the Fourth Trimester – that crucial postpartum period following childbirth when your body is readjusting and recovering.
Table of Contents
◾️Slow Is The New Fast
◾️Postpartum Exercise Timeline
◾️Exercise After Pregnancy: The First Two Weeks
◾️Exercise After Pregnancy: Weeks 2-6
◾️Exercise After Pregnancy: Weeks 6-12
◾️Postpartum Exercise Guidelines
◾️Special Considerations For Exercise After C-section or Perineal Tearing
◾️Can I Exercise While Breastfeeding?
◾️Beyond the Fourth Trimester
◾️Take Action: Your Return-To-Exercise Checklist
Your New Postpartum Mantra: Slow Is The New Fast
Let’s start by setting expectations.
A full physical (and lets face it, emotional) recovery from pregnancy can take 6 months to a year, or even longer. Exact timing depends on a lot of things, like whether you experienced a surgical or vaginal delivery and whether or not there were any complications or injuries. It’s a tall order to expect to return to pre-pregnancy levels, or even pregnancy levels, of activity in the first few weeks after giving birth.
I urge you to take adequate time to rest, recover, rehab and progressively retrain in order to reduce your chances of injuries and setbacks. A slow approach is the fastest one!
So how soon after giving birth can you begin to exercise? And what should the process look like?
Let’s break it down:
Postpartum Exercise Timeline
Exercise After Pregnancy: The First Two Weeks
Rest and Recover: The 5-5-5 rule
In the first days and weeks postpartum, whether recovering from a vaginal birth or a C-section, I I hope that your top priorities will include rest, recovery and care of baby. Pregnancy and childbirth put so much stress and strain on your body, particularly the core and pelvic floor muscles. These muscles need to rest in the days after delivery to allow healing to begin.
Some people use the 5-5-5 rule to guide their initial postpartum recovery: 5 days in the bed (spend most of your time laying down, sleeping when you can, etc), 5 days on the bed (sit up more, nurse the baby in bed if you can, limit your time on your feet), 5 days near the bed (plan to still be in your home, continue to rest as frequently as you can). 5-5-5 could be 7-7-7. It’s not a set of magic numbers. The point is, take the first 2-3 weeks postpartum VERY easy.
If you are absolutely itching to do SOMETHING during this time, it is usually safe and appropriate to begin breathing exercises and gentle pelvic muscle exercises during the first days after delivery. If these gentle activities cause pain, discomfort or increased bleeding, please stop exercising and get in touch with your medical provider.
The Best Core and Pelvic Floor Exercise: The Connection Breath
The first rehab priority should be retraining the breath and coordination of the diaphragm, pelvic floor and innermost abdominal muscles using the Connection Breath. If you’re unfamiliar with this breathing technique, here are the Cliffs Notes:
1) Find a stacked alignment.
You’ll want to perform your breathing exercises from the starting place of a “stacked” alignment. In a stacked alignment, your ribcage and pelvis are both in a neutral orientation, stacked vertically in relation to each other.
Three different postural variations. Left: Ribs are positioned in front of the pelvis. Middle: Ribs are stacked over the pelvis. This is the “stacked alignment”! Right: Ribs are positioned behind the pelvis.
Try this trick to find a stacked alignment:
How Can I Correct My Pregnancy or Postpartum Posture? Try This Easy Hack
2) Breathe into you diaphragm.
Lay on the floor with your knees bent or sit tall in a chair, in a stacked alignment. Focus on expanding your rib cage 360 degrees (like an umbrella opening) during your inhale breath.
3) Practice gentle pelvic floor contractions (kegel exercises).
Kegels are pelvic floor contractions followed by a release. Use them to bring awareness back into your pelvic muscles and perineum (and I’m talking a few sets of 10, not 500).
You’ll find all my best kegel-cues here.
4) It all comes together in the Connection Breath.
Coordinate your breath and pelvic floor contraction through the Connection Breath.
On your inhale think: expand your ribs 360 degrees, relax and release abdominal muscles and pelvic floor. On your exhale think: gentle pelvic floor contraction.
Exercise After Pregnancy: Weeks 2-6
Reconnect and Rehab
During weeks 2-4, begin to practice the Connection Breath (if you haven’t already).
When you feel ready, begin introducing short bouts of gentle walking (5-20 minutes, start on the shorter end and progress longer).
If you are feeling well, want to move more and it doesn’t exacerbate any symptoms (bleeding, pelvic discomfort, fatigue) it is also safe to begin introducing some exercises that roughly align difficulty-wise with your activities of daily living. These might include stretching (of chest, hamstrings, hip flexors or glutes) and body weight exercises (such as glute bridges, squats, heel slides and banded pull-aparts).
As you reintroduce these simple exercises, incorporate a Connection Breath (exhale + kegel) just before or on exertion to help cue coordination of your breath with your movement.
As you begin to move more, make sure you “listen to your body”.
Look out for the 4 Ps:
- Peeing (any unwanted leaking)
- Pain (in vagina, pelvis, tailbone, or anywhere else) or
- Pressure (in pelvic floor or perineum)
- Peaking, doming or coning through the abdominal midline. Read more about Diastasis Recti.
If you notice any of these symptoms, don’t panic. Take them as a sign to take a step back and ask questions. Have you recently increase your exercise intensity or volume? Could you tweak your biomechanics or breathing to be more efficient?
If you have trouble troubleshooting on your own, reach out to a pelvic floor therapist or qualified postpartum personal trainer.
The Six-Week Check-Up
Around 6 weeks, you will go for a standard postpartum check up with your OB or midwife.
At this visit, your provider will examine you to see that you’re recovering well and all of your bleeding has stopped. Often times, they will “clear you for exercise”.
It’s an exciting time, but I want you to understand a bit of nuance.
Primary care providers are not trained to evaluate the condition of your pelvic muscles or to advise in their rehabilitation (unless they’ve received special training). When they clear you for exercise, consider that a green light to do mobility exercises, bodyweight work, or light resistance-banded exercises.
Postpartum Pelvic Floor Physical Therapy
Before beginning vigorous exercise or high-impact activity you should check in with a pelvic floor or women’s health physical therapist. Pelvic floor physical therapists are the only professionals qualified to gauge your readiness to return to high-level or high-impact exercise.
Whether you had a vaginal birth or cesarean section, I recommend booking a pelvic physical therapy appointment around 6 weeks, to coincide with your OB check-up.
Learn more about postpartum core and pelvic health considerations including diastasis recti, pelvic organ prolapse and urinary incontinence (leaking urine):
Pelvic Floor “Dysfunction” in Pregnancy and Postpartum and Why You Probably Need a Reboot
Learn more about pelvic floor physical therapy:
A Pelvic Floor Physical Therapy Primer: What Is It? Who’s It For? What Should You Expect?
Exercise After Pregnancy: Weeks 6-12
Return to Exercise(🎉)
Barring contraindications from providers, most new parents can begin adding in structured strength training after their 6 week check-up..
During this phase, focus on learning to control your movements and coordinating them with your breathing (for example, exhale on exertion). Continue to look out for the 4 Ps.
During the second half of the Fourth Trimester, rest remains a high priority. Before increasing your exercise intensity, consider not only your physical comfort and pelvic health symptoms, but your overall stress, nutrition and sleep.
Until you are sleeping well, eating well and have a handle on your life-stress, it’s a good idea to keep your exercise stress moderate.
Postpartum Exercise Guidelines
The American College of Obstetricians and Gynecologists (ACOG) recommends that postpartum people get 150 minutes of moderate-intensity aerobic activity each week. In addition, they recommend at least two strength training sessions a week.
I couldn’t agree more!
After pregnancy, the two best forms of exercise are going to be walking (that’s your moderate-intensity aerobics) and strength training. Both of these will prepare you for a return to higher impact or higher intensity activities later.
Walking is so beneficial because it is restorative. It gets you outside and relieves stress without putting extra burden on your recovering core and pelvic muscles. It has a low barrier to entry, which is so essential when you’re learning how to be a parent. And yes, it absolutely counts as exercise!
Start with short walks (5-10 minutes) and work up to 20-30 minute walks most days of the week. You can also break up your longer walks into two short walks a day.
If you want to know WHY I enthusiastically recommend strength training as the first type of structured postpartum exercise, check out this article:
The Best Postpartum Exercise: Cardio vs. Weight Training
If you’d like a sample early postpartum workout, you’ll find it here.
For something a little more challenging, check out:
A note on exercise selection:
Initially, resistance should be provided by bodyweight, resistance bands or light weights (no heavy lifting quite yet). Cardio can take the form of longer walks (progress slowly to 45 minutes – 60 minutes in length), swimming or biking.
Choose exercises that target your deep core muscles, your glutes (max and medius), and your upper back.
A note on postpartum ab exercises:
As you work to strengthen your core, begin with breathing exercises and exercises that target the deepest abdominal muscles, the transverse abdominals. These are the muscles you feel firing when you cough or suck your tummy in to squeeze into tight jeans.
My favorite early postpartum exercises to target the deep abdominals include Pallof presses and heel slides.
Traditional abdominal exercises like planks and sit-ups are too aggressive for an early postpartum body, particularly for someone who is still re-establishing their deep core connection and breathing mechanics.
Special Considerations For Exercise After C-section or Perineal Tearing
If you are returning to exercise after a C-section or a perineal tear (2nd degree tear or greater), you will find that your return to exercise timeline is a little bit expanded. Your “Rest and Recover” period is likely to be closer to 4 weeks and your “Return to Exercise” is likely to be at least 6-8 weeks post-birth.
These guidelines are generic. If you experienced a C-section or severe vaginal tear during childbirth, it becomes even more important that you schedule an appointment with a pelvic floor physical therapist to aid in your recovery.
Not only can a pelvic floor physical therapist provide personalized guidance based on an examination of YOUR body, they’ll also be able to guide you with scar massage.
Scar massage can help you feel better by improving sensation at the scar sites, reducing adhesions that may impact pelvic muscle function and improve the appearance of the scar. Scar massage is important for C-section scars AND perineal scars.
For more detailed guidelines:
C-section Recovery Timeline and Return to Exercise After a Cesarean Birth
Can I Exercise While Breastfeeding?
You can definitely exercise and breastfeeding or chestfeeding.
Exercise should not impact your milk supply or the taste of your breast milk. The most important considerations are related to your comfort since your breasts will be larger and heavier while lactating. You many want to pump or nurse your baby immediately prior to a workout. You’ll also want to invest in a great nursing sports bra.
For a more in-depth consideration of breastfeeding and exercise, click this link.
Beyond the Fourth Trimester
Everyone’s postpartum trajectory is unique. It’s difficult, if not impossible, to provide an exact roadmap to your specific return to your sport or activity of choice.
If you follow the guidelines here, if you’ve reconnected to and begun to rehab your core and pelvic floor, if you’ve begun to reintroduce strength training and longer bouts of sustained moderate-intensity cardio, you are well on your way.
As you progress, think “slow is fast”. Remember: your goal is not to run a marathon at 3 months postpartum, but to be able to run a marathon in 5 years. Or 10. Progressively increase the demands of your strength training and other activity and seek help if you notice any pelvic health symptoms or setbacks.
The fourth trimester is considered early days with respect to postpartum healing and exercise after birth. Even if you had the easiest pregnancy and a complication-free delivery, your body needs time to recover. During this phase, you want to rebuild slowly and intentionally, to set yourself up for success in the long term.
Take Action: Your Return-To-Exercise Checklist
Now you know all the considerations for returning to exercise after pregnancy. Don’t sit on this info. Take action!!
Here is a simple checklist to guide you over the next few months:
- Rest and Recover
- Reconnect to your deep core muscles. Rehab and retrain these muscles as a first priority.
- Obtain medical clearance from your medical provider
- Book an appointment with a pelvic floor physical therapist.
- Walk. Start with short walks, progress up to 30 minutes daily.
- Start with low-intensity exercise and progressively add volume, load and intensity.
- Be mindful about your return to sport. Remember, slow is fast!
👋🏾 Before you go!!
1) Don’t miss out on the No B.S. Guide to a Stronger, Drier Pregnancy and Postpartum (sign up below). It contains the fundamental lessons I teach all of my postpartum clients. Seriously, this is good stuff!
2. Take a sec to leave a comment (scroll to the end of the page)- Let me know what type of exercise routine you are MOST excited to return to postpartum!!
Learn more about safely returning to exercise:
7 Considerations to Guide Your Postpartum Return to Running
5 Things You Should Know About Your Remarkable, Resilient Postpartum Body
5 Great Mid- to High-Impact Nursing Sports Bras
Next on your reading list:
The 21 Best Books To Read About Pregnancy & Postpartum (2022)
27 Postpartum Care Products to Speed Up Recovery and Make Life Easier (2022)
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My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Contact me if you have questions about exercise or pelvic health pertaining to pregnancy or postpartum. I work with people locally (Seattle’s Eastside: Redmond, Bellevue, Kirkland and surrounding areas) and online to develop personalized pregnancy and postpartum personal training plans.
