We know that finding your way back into your body after giving birth can feel like uncharted territory. While we can never “go back” to the body we had before pregnancy and birth, we can most certainly move forward into a new body that feels strong and empowered. We chatted with three different movement experts — all of whom specialize in working with postpartum mamas. Chloe, a physiotherapist, master Pilates instructor and founder of online Pilates studio Go Chlo Pilates, Darlene, a NASM and AFAA certified personal trainer and group fitness trainer and founder of Girl Up, a fitness app for women and RISE Training LLC, and Corinne, a classically trained yoga instructor, the founder of Birthing Mama and the owner/director of Yoga Center Amherst. We are super excited to hear more from each woman about how to safely begin moving again after giving birth, and how to exercise effectively while postpartum. Check out how you can get started…
How soon can a woman get back to exercise post birth?
Chloe:It depends what type of birth they had. For uncomplicated vaginal births, women can return to exercise after two weeks, as long as they have had clearance from their midwife or obstetrician to do so. For c-sections, it’s important to wait 6 weeks before returning to exercise. There is a lot of healing that needs to happen before exercising so use the time to rest and recover. It’s important to note however, that while this is when women are physically “safe” to return to exercise, they might not feel ready to at this point, and that is ok! There’s no rush and women should return to exercise when they feel ready to do so.
Darlene: Six weeks with a doctor's approval. The Department of Health and Human Services recommends at least 150 minutes a week of moderate-intensity aerobic activity — preferably spread throughout the week — after pregnancy. Consider these guidelines:
- Take time to warm up and cool down.
- Begin slowly and increase your pace gradually.
- Drink plenty of fluids.
- Wear a supportive bra, and wear nursing pads if you're breast-feeding in case your breasts leak.
- Stop exercising if you feel pain.
Regular exercise after pregnancy can:
- Promote weight loss, particularly when combined with reduced calorie intake
- Improve your cardiovascular fitness
- Strengthen and tone abdominal muscles
- Boost your energy level
Staying physically active can also help:
- Relieve stress
- Promote better sleep
- Reduce symptoms of postpartum depression
Corinne: While modern postural yoga can fit into the category of exercise, the true meaning and practice of yoga is much more than exercise. Yoga can also be experienced as a deep spiritual practice, and thus a woman can begin immediately post birth. I usually recommend joining a postnatal/parent and baby yoga class around 4 weeks after a vaginal birth and about 6-7 weeks after a cesarean birth. It’s important to remember, though, that no two people are exactly the same, and some are ready sooner than others. I encourage mamas to listen to their body and inner knowing about when to join a class - and sometimes, women will join after two weeks solely for the emotional/mental/spiritual support of the class.
What are the general modifications that must be made soon after birth - and do they differ between c-section and vaginal birth?
Chloe: There are some important modifications to make soon after birth! Due to pregnancy, the abdominal muscles at the front of the belly and the layer of tissue between the muscle, called your rectus abdominis and linea alba respectively, can stretch. This is called a diastasis rectus abdominis, or is sometimes referred to as abdominal separation. After a baby, it’s important to heal any separation and rebuild strength in the core muscles slowly and safely. This includes avoiding exercises like curl ups, front planks, roll downs and crunches until appropriate strength is built back up. Some modifications are toe taps (keeping the head flat), kneeling side planks, and bridges.
Pregnancy and often childbirth, places a lot of load on the pelvic floor muscles, the group of muscles in the pelvic region that control our continence (the ability to hold on when needing the toilet). As a result, high impact activities should be avoided soon after birth. Instead, modify the exercises to make them low impact. For example, squat instead of squat jump, walk instead of run, step lunge instead of jump lunge. With time, you can return but it’s important to only return when your body is ready.
There are no major differences in the modifications between c-section and vaginal birth. If there were complications in the birth however (e.g. tearing, episiotomy), it’s important to get individualized advice from a women’s health physical therapist.
Darlene: After giving birth (for c-section and vaginal birth) the pelvic floor needs exercises that aim at strengthening it. These are strength exercises that are safe to do right after childbirth. Kegel exercises aim to tone the muscles that support your bladder, bowel, and uterus. They consist of contracting and relaxing the muscles. If possible, try doing 10 repetitions three times a day. Other exercises that are acceptable after giving birth are: walking, pelvic tilt, modified side plank (with bottom knee bent) and bridge.
Corinne: Postnatal yoga addresses and nurtures the body, mind and soul. We take the slow and steady approach when entering into any movement or posture, and I like to encourage my students to ask themselves questions like, “how does this feel” and “do I feel inwardly supported enough to proceed with this next action”. Awareness of breath is super important, and then the physical movement linked to the breath enables a mindful practice. We start small and simple, only to build upon what is right for each individual woman. Various options for each pose are always offered, while encouraging the breath to be the guide. Everyone will require something different based on vaginal vs. cesarean, but also simply because every birth is unique! Because our bodies are in a time of healing post-birth, safe body mechanics around picking up or carrying your baby, how to work with handling the car seat carefully, positions for nursing or feeding your baby and transitioning from one posture to the next, safely, are all important things to take into consideration as well.
Given that many mamas are juggling babies/older kids with their exercise routines, what are the most effective exercises they can do in a 10-15 window of time?
Chloe: A Go Chlo Pilates Movement Snack of course! These classes were designed with busy mums in mind! They are short (under 15 minute) workouts that are designed to be done from home, at any time, and with minimal equipment. Just roll out your mat during nap time! All Movement Snacks address different goals like rebuilding core strength safely, glute strength, postural strength or upper back mobility. You can try one here!
Darlene: For short periods of time, you can do any of the exercises already mentioned...just reduce the reps and sets or if you are walking, reduce the time.
Corinne: For a 10-15 minute practice, I would suggest:
- Seated Circles, linking breath to movement (use victorious breath/ujjayi to ground and balance the nervous system) while beginning to engage the root lock/belly pit (if familiar with)
- Hands and knees with cat/cow extension and flexion – can add-in leg extensions like the moving sun bird and modified bow, (if familiar with), followed by a few breaths in child’s pose to direct air into the side and back lungs with pelvic floor toning
- Transition mindfully and breathfully to downward dog and then walk feet to hands and slowly make your way to standing
- Few rounds of modified sun salutations with continued ujjayi breathing (classical, A or B)
- Seated Twist
- Supine with some abdominal toning practices, pelvic floor toning, and close with 5-10 breaths in a yummy restorative posture like supported fish
What are the three best exercises or poses a mama can do for optimal postpartum health?
Pelvic floor and deep core engagement with the breath
- Find a comfortable position and close your eyes
- Inhale into the sides of the ribcage, and let the body fully relax
- Exhale and engage through your pelvic floor (by drawing in through your vagina and anus), and your deep core (by drawing your belly button to spine)
- Inhale and fully relax again
- Repeat x 20, once a day
- Lay on your back, knees bent and feet flat on the mat
- Maintain neutral spine, with a small space between the low back and the mat
- Engage through the pelvic floor and deep core muscles
- Inhale and prepare
- Exhale and float one leg to tabletop
- Inhale lower the leg
- Exhale and float the other leg to tabletop
- Inhale lower the leg
- Repeat x 10 each leg, keeping neutral spine and pelvis level
- Lay on your side, head on a pillow and knees bent to chest
- Start with arms in front of the body
- Lift the top arm to the ceiling and continue to open the arm, taking the head and chest with you into a twisted position
- Return the arm back
- Repeat x 10 and turn over for the other side
Darlene: My top go-to exercises for all of my fabulous mamas are bridge, modified side plank, and walking. These three, done consistently, build strength in the areas we need to build up after birth - and create a great foundation to move onto weights, resistance and cardio training.
Corinne: There are many fantastic postures, and while I will try to only suggest three, it’s hard to explain without the inner workings of them! I’ll give it a go!
1. Find and maintain spinal and whole body alignment
- First, avoid doing movements that cause any pain or that bring you out of alignment.
- Maintain neutral curves of your spine, creating spacious vertical length by gently reaching your crown and tail away from each other in all postures and movements (and in all positions relative to gravity).
- Look at your whole body alignment in mountain pose: Stand with your feet hip joint width apart and evenly distribute your weight throughout your legs/feet. Yield and push into the earth and feel the rebound rise up offering a buoyant rise through the arches of your feet and your pelvic floor. Keep your pelvic floor hovered directly over the earth (not tilting or tucking your pelvis – trying not to collapse into one pelvic half!), throat/neck floating right above your diaphragm and head sweetly rising on top. Keep this and from mountain pose try stepping back into warrior 1 or 2 (on each side) without losing all this good alignment.
2. Tone Your Abdomen
- First check to see how big of a diastasis you may have in your rectus abdominus by checking for both the amount of fingers that fit across in the linea alba space and how deep in your fingers go.
- Support your healing by trying this: Recline on your back with knees bent and press your feet firmly into the earth. Direct your breath into the side and back of your lungs instead of breathing mainly in your front lungs and doing belly breathing. Maintain awareness of breath around the navel and an engaged or wrapping in of the belly.
- Interlace your hands behind your neck and head. Inhale into your side and back lungs, exhale, and then curl up sweetly yet firmly and not too high, wrapping your outer abdomen (or transverse muscles) around to the belly button. Then use the inhale and uncurl. Do this 5-10 times.
- Add-ins: use your hands to bring your rectus abdominis together when you curl up. Place a block or soft ball between your thighs and pulse in and up and lift and engage your pelvic floor the whole time or specifically when you curl up with the exhale.
- There are many more supine practices I love for abdominal toning and I also love the ones we do on hands and knees, in lunges and even standing postures. And then of course, we can introduce breathing exercises, specifically designed to help fire up the core.
3. Tone Your Pelvic Floor
- Toning your pelvic floor starts with keeping your pelvis neutral and not allowing your pelvis to anteriorly or posteriorly rotate.
- Apply that to lunges, warriors and squats with full engagement to the root lock (or what feels like a lifting of the pelvic floor). Using your adductors by currenting or drawing them in and up will greatly support your pelvic floor.
- Learn to soften where you may be tight and try to do practices that tone the various quadrants of your pelvic floor. For example, you might try Ashvini Mudra (horse seal) while sitting in a supported squat. To do this, sit on blocks for a supported squat and inhale deeply into your side and back lungs, retain your breath and then squeeze and release your kegel/perineal muscles 1-30 times, then exhale and release. Take some recovery breaths and try one or two more rounds.
What exercises or poses are contraindicated (or not suggested) while postpartum and/or breastfeeding?
Chloe: If you do have a diastasis (you can get this professionally assessed by a women’s health physical therapist) then exercises to avoid are planks, crunches and roll downs. As you rebuild your strength, it’s best to avoid any high impact exercises like running, jumping or skipping until the pelvic floor is strong enough to handle that much force. This can take anywhere from 2 months to a year and is different for everyone. If you are breastfeeding, it may not feel comfortable to perform exercises lying on the front of your body, so avoid them!
Darlene: Exercises that create pressure on your belly, such as crunches, sit-ups, and planks, should be avoided for at least the first six weeks or until after your postnatal checkup. Check in with your healthcare provider regarding abdominal exercises. The reason for this is because of a common condition called diastasis recti that some people develop after pregnancy. It is not dangerous, but it can worsen with certain postpartum abdominal exercises. As the uterus grows, the two vertical abdominal muscles that run down your core are stretched apart, and the distance between them increases. Some people have a bulge in the middle of the abdomen between these muscles. Diastasis recti can also cause low back pain.
Moderate exercise isn't thought to affect breast milk volume or composition, or your baby's growth. Some research suggests that high-intensity exercise might cause lactic acid to accumulate in breast milk and produce a sour taste a baby might not like, but this is likely rare. If vigorous exercise is a priority during the first few months of breastfeeding, consider feeding your baby before your workout or pumping before your workout and feeding your baby the pumped breast milk afterward. Alternatively, exercise first and then take a shower, and after a half-hour or an hour, offer breast milk.
Corinne: Belly down backbends can be super uncomfortable or even painful while breastfeeding, especially in the first six months. Instead, try belly down backbends like sphinx, cobra or upward facing dog so that you get the benefits of a belly down backbend without the pressure on your breasts.
Chloe de Winter is a physiotherapist, master Pilates instructor and founder of online Pilates studio Go Chlo Pilates. You can try her on-demand platform for two weeks for free at www.gochlopilates.com and check her out on Instagram @gochlo_pilates
Darlene Bellarmino is a NASM and AFAA certified personal trainer and group fitness trainer. She has experience working with clients of all ages and fitness levels, always considering a client's personal goals and fitness experience. Darlene is experienced in instructing high intensity group workouts, one-on-one individualized sessions, and body specific workouts including boxing, TRX and HIIT. Darlene is also the founder ofGirl Up, THE fitness app for women and RISE Training LLC. Darlene is located in Bergen County, NJ where she has daily in-person and Zoom group fitness classes. She is also available for in-home and virtual training sessions. Visit www.risefitnesstraining for more information or follow her on Instagram at @risetraining.fit
Corinne Andrews is the founder of Birthing Mama and the owner/director of Yoga Center Amherst. She is the mama of two awesome people, and teaches weekly yoga classes and teacher training locally and online. She is also the author of Birthing Mama, your companion for a holistic pregnancy journey. You can find her on Instagram @birthing_mama or on Facebook @yogacenteramherst and @supportingbirthingmamas. She is also currently offering online yoga classes at Yoga Center Amherst and on the Birthing Mama website.