Exercising after Childbirth

By Ari Brown MD and Michele Hakakha MD
Adapted from their new book, Expecting 411

One of the most common questions we get from women is this one: “After I deliver, when can I start exercising again?” We’ve all see the Kate Hudson types in Hollywood go back to being stick thin just weeks after having a baby. Many of our patients expect to do the same.

We recommend, for women who had an uncomplicated pregnancy and delivery, that you wait six weeks before getting into a regular exercise routine. C-section deliveries and personal health history are two factors that can change this time equation, however. Occasionally, practitioners might give the green light a little earlier, so check with your healthcare provider before you start doing any kind of exercise after delivery.

Women can gradually resume exercising when they feel ready. Some women who have had uneventful vaginal deliveries with little perineal trauma feel well enough to take a light, brief walk a week or so after delivery. But if you have a third- or fourth-degree laceration, you may need to hold off exercising for up to eight weeks.

Once your practitioner gives her official blessing, you can resume all prepregnancy activities and exercise regimens. But remember, START SLOW. Begin with walking, yoga, mild hiking, and swimming. You can’t expect to jump back into the 60-minute weight and cardio routine that you were doing prior to getting pregnant. Remember that all of your joints and ligaments can be loose for up to five months after delivery.

And let’s talk about those abdominal muscles. Most women develop some degree of a gap between their abdominal muscles as their pregnancy progressed. That gap (called diastasis recti) takes about two months to close. In some women, it never closes and there’s always a gap. It’s important to let your body heal and close the muscle separation prior to beginning any intense abdominal workouts. Start easy and save the heavy-duty crunches for eight to ten weeks after delivery.

Once you do start exercising again, here are some tips:

Stretch for five to ten minutes before and after exercising.
Wear comfortable clothing.
Keep well hydrated with water or a sports drink.
Wear a comfortable and supportive bra.
Clear your mind of all the other things going on.
This is your time to relax, think, and meditate; give yourself this gift.
Getting back in shape takes time, so don’t rush it.

A final word from Dr. Michele. She had a patient who was determined to get back on her treadmill after a C-section. “I told her that after her six-week postpartum visit, we would decide when she could go back to exercising. But she didn’t heed this advice.” The patient decided that she felt great at two and a half weeks. When she returned to Dr. Michele’s office, her previously closed surgical incision was now gaping open. She had to wait another month to have the wound surgically repaired!

So moms–really do ease back into exercise. You have plenty of time to work off that belly. And don’t worry too much, because when your baby becomes a toddler, he or she will keep you plenty active!

* * * * *
Dr. Michele Hakakha is an award-winning obstetrician/gynecologist practicing in Beverly Hills, CA. Dr. Ari Brown, MD, FAAP, is a pediatrician in Austin, TX, an official spokesperson for the American Academy of Pediatrics, and health advisor for WebMD, Parents Magazine, and ABC News. She penned the best-selling Baby 411 and Toddler 411 book series before coauthoring Expecting 411: Clear Answers & Smart Advice for Your Pregnancy (Windsor Peak Press, 2010, www.expecting411.com).

After a  baby is born by Cesarean section, many moms are concerned that nursing after Cesarean would be much more difficult than if the baby had been born vaginally. Thankfully, with a little help, (from lactation consultants, La Leche League leaders and others), babies and moms can learn to nurse after a difficult birth.

The hardest thing to overcome when nursing after Cesarean is how to hold your baby so as not to put pressure on your very sore abdomen.

This is easily solved by using a thick pillow to support your arms when using the cradle hold. Learning the football hold is also a great way to keep baby off of your staples. To do this, position baby’s body to the side of you, under your arm, with his head coming forward and facing your nipple. If you prop a pillow under your arm in this position as well, it will give you both a more comfortable position.

You also need to make sure you have lots of help after the birth. Rely on your support team – hospital staff, your husband, friends, and family. Accept offers of help at this time, you deserve it!

Talking to other moms who have nursed their babies after Cesarean is very helpful. Here is Sarah’s story of nursing after Cesarean