First and foremost: Follow your medical professional’s advice on getting back into fitness. I’m not a doctor. I can’t tell you when to re-start your fitness routine, but most doctors give the green light between six and eight weeks. Beyond that, everyone gets back into fitness when it’s right for them. There’s no specific timeline. There are many things to consider when deciding when the time is right for you to restart your fitness routine.
C-Sections vs. Vaginal Deliveries: How Your Baby Exited Impacts Your Postpartum Journey
As miserable as you may or may not have been during pregnancy, the postpartum period offers its own unique set of challenges. Caring for newborns takes precedence over our own bodies at times, even though our bodies need so much care after delivering a baby.
Moms who had C-Sections have undergone a major abdominal surgery. Fascia (connective tissue below the skin) regains 51-59% of its strength 6 weeks postpartum, 73-93% after six months, and 90% of its original strength by the end of a year according to research done by Weill Medical College of Cornell University (Department of Surgery), and New York Methodist Hospital. Another study (1) showed fascial incisions regain breaking strength faster than dermal (skin) incisions. “Breaking strength” is the ability to stay together when pulled or strained, so this means the part of the incision that can’t be seen is actually healing faster, which should be comforting. C-Section moms also may have pelvic floor dysfunction from the stress of the last several months of pregnancy.
Moms who had vaginal deliveries may have received an episiotomy or natural tearing. This takes weeks to heal and, even then, you may have pain from this trauma. Pertaining to the pelvic floor, it’s been under stress for months. During delivery, our pelvic floors literally had to move aside in order for the baby to exit. Generally, women who deliver vaginally have more pelvic floor recovery, but this isn’t always the case.
What About Your Uterus After Having a Baby?
Not only is the baby delivered but also the placenta. A placenta is substantial in size and connected to the wall of the uterus. When it detaches, think of the uterus as having a large scab left behind from where the placenta was attached. This wound is the size of a plate. You may have had an easy delivery and feel ready to start moving quite quickly. Be cognizant, though, about truly resting in the first few weeks to heal. Once the placenta is delivered, your uterus will contract back to pre-pregnancy size, and these contractions can be really painful for one to three days after delivery. Perhaps this pain is an additional reminder to take it easy.
Don’t Compare Yourself to Others
I say all the above to emphasize how important rest and recovery is in the aftermath of birth. Every woman is on their own healing trajectory after their own unique birth. The 4th trimester, or the first 12 weeks after birth, is a time spent getting to know your baby and getting reacquainted with your body, remembering that this body has created and sustained a whole new person for the last nine months.
Setting aside the physical trauma our bodies have been through, every person’s situation is different and that impacts your fitness routine. With only one baby, maybe your partner can hold the baby while you get in a workout. With two or more kids, this starts becoming more difficult. Are you going back to work and will have time when your kids are at daycare? Do you have a support system in town that can help? Are you working out at home or going to a gym? My advice is to communicate clearly your needs with those in your life that can help. It was hard for my husband and I to find time that worked for both of us to get in our workouts. We don’t have family in town and our three kids are pretty young. Since I’m staying home for the first time and don’t have daycare, we are still trying to find a system that works for both of us and our baby is six months at the time of me writing this. Luckily, we both consider fitness a priority, or we may have completely fallen off the wagon with fitness.
Where Do I Begin with Fitness Postpartum?
Here are my recommendations for getting back into fitness. I have a free postnatal core rebuilding series on YouTube. We start with belly breathing and move to exercises that are safe for everyone, even those suffering from ab separation. More on that below.
1. Start with Belly breathing (diaphragmatic breathing). I was doing this the day after birth to start working my core & pelvic floor. If you had a C-section, you only want to focus on your pelvic floor until your incision heals. Belly breathing should be completely painless and feel amazing. If it doesn’t, wait a few days or weeks. Here is a tutorial on diaphragmatic breathing.
2. Walking and stretching. Rest at least two weeks if you can and wait to walk. You want to make sure your insides heal up. Where the placenta was attached left a wound. Allow this to heal. All your insides are shifting back into place. Be patient. Then walk and stretch.
3. Rebuild your core. This includes your inner core, glutes, obliques, back, and pelvic floor. Everything is adjusting back from carrying a huge load for many months. Give your core some TLC. I personally don’t check for ab separation in the first several weeks following birth (more info on ab separation later in this article). Most likely, if you run your fingers down the middle of your stomach, it will feel squishy. You are feeling your connective tissue (your linea alba), which connects the two sides of your rectus abdominis (six-pack muscles). It’s been stretched out for quite some time. Allow it time to tighten up. When you are ready for core work, if you are really curious, you can see how substantial your ab separation is. Regardless, start with deep inner core work. As already mentioned, your body is readjusting and you want to make sure you work your stabilizing stomach muscles.
4. Move to low impact exercise (body weight, light weights, nothing that jars your body). For starters, you will be sore because you haven’t exercised in weeks or months, so I alway start with body weight exercises and progress from there. Secondly, if you are breastfeeding, it can be super uncomfortable!! To be honest, I don’t jump around/run at all while breastfeeding. No worries though - you don’t have to do those things to get back in shape. Pro tip… try to breastfeed/pump right before your workout (more on breastfeeding and working out below!).
5. When you’re ready, get back into an exercise routine you love. Weightlifting and high intensity training is what I recommend to burn fat and get strong. I also love Pilates and yoga for mental health and feeling so refreshed and stretched. Find things you love and do those things❤️
What Do I Need to Know About Breastfeeding & Working Out
You can absolutely breastfeed and complete moderate-to-heavy physical activity. The nutritional value in breastmilk and the quantity does not change from what we know from research (2). If you think you are experiencing a decrease in milk production, it is most likely due to dehydration and not eating enough nutritionally dense foods. It can be hard to eat healthy after a baby; babies are huge disruptions to our normal, scheduled lives! Try to get in front of this by making freezer meals while still pregnant and communicating with your partner, family, or friends how they can support you in this.
It is recommended you breastfeed prior to exercising. There are three reasons for this. First, if you are completing high intensity workouts, you may have lactic acid build up that passes through breast milk. This does not harm your baby, but your baby may not prefer the taste. The lactic acid dissipates 30-60 minutes after exercise. Second, there is small reduction in immunoglobulin A in breastmilk after exercise, studies have shown (3). This is an immune defense protein, but doctors don’t really know if this slight decrease affects your baby. This is just another reason to nurse before exercising. The third reason to breastfeed before exercising is comfort! It’s so uncomfortable to workout with breasts full of milk! Breastfeeding may not alleviate this problem. Believe me, I get it. I want you to know: You can still get good workouts in and make progress doing low impact exercises. That’s what I recommend if you fall in this category.
What Do I Need To Know About Ab Separation?
Every woman’s abdominal muscles separate during pregnancy to accommodate a growing baby. Your six pack abs, called your rectus abdominis, are attached in the middle by your linea alba, a stretchy, connective tissue. If you really worked your inner core during pregnancy and were pregnant with one baby, you may ultimately not end up with any separation in between the two sides of your six pack muscles. For others, you may have done everything right and the separation in your abs may linger and need some rehab.
I recommend checking around 5-6 weeks postpartum. Lie on your back. Place a hand behind your head and crunch up. Press your fingers above and below your belly button to check for separation. If there is a three finger separation, you should seek advice from a medical professional for a formal diagnosis and see a physical therapist. Here is a video from Lindsey Brin, the person I received my training from, that walks you through how to check for a diastasis. Regular abdominal exercises with crunching should be avoided. Inner core work is needed to strengthen the core. In my postnatal core rebuilding program, sessions 1-6 are safe if you are suffering from diastasis recti. All exercises should only help your condition.
Other than these things, if you kept up with workouts throughout your pregnancy, you may be shocked at how quickly you feel ready to resume regular fitness postpartum. Some women won’t have a separation that lingers, but what I have learned is you have to be your own best advocate. If you are experiencing lingering issues that weren’t a problem pre-pregnancy, seek medical advice to start feeling like yourself sooner.
How is your postpartum journey going? What have been major challenges? What have been your major successes? I would love to hear from you!
Works Cited
1 https://pubmed.ncbi.nlm.nih.gov/11174713/
2 Dewey (1998), Fly & Uhlin (1998), and McCrory (2000), qtd. in Anthony, Lenita. Pre- and Post-Natal Fitness: A Guide for Fitness Professionals from the American Council on Exercise. Monterey, CA: Healthy Learning. p. 68.
3 Gregory et al. (1997), qtd. in Anthony (2002), p. 68.
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