Evidence 

https://www1.racgp.org.au/ajgp/2022/march/exercise-after-pregnancy 

Philippa Inge   Jessica J Orchard   Rosie Purdue   John W Orchard   

After childbirth, approximately one in three women experiences urinary incontinence, and up to one in 10 has faecal incontinence. Up to half of all women who have had a baby will have some degree of pelvic organ prolapse. Incontinence and prolapse can decrease quality of life, are risk factors for anxiety and depression and are significant barriers for returning to exercise after giving birth. 

In the postnatal period, women can benefit from individualised assessment and guided pelvic floor rehabilitation for prevention and management of urinary incontinence and pelvic organ prolapse and improved sexual function. Consequently, educating women in the postnatal period about optimal health choices, including correct pelvic floor muscle training as part of safe return-to-exercise guidance, is a priority for primary care. 

Education  

Usually, it is safe to begin exercising a few days after giving birth—or as soon as you feel ready. If you had a caesarean birth or complications, ask your healthcare team when it is safe to begin exercising again. 

These general guidelines give you a starting point to plan your return to postnatal fitness: 

0-3 weeks postnatal 

• Walking 

• Postnatal abdominal muscle bracing 

• Pelvic floor exercises 

3-8 weeks postnatal 

• It is recommended you wait until your six-week postnatal check before starting a group exercise program or going back to the gym 

• Walking 

• Low impact aerobics or postnatal class 

• Low intensity water aerobics class and swimming (once bleeding has stopped) 

• Gym program (maintain posture, light weights, no breath holding) 

• Postnatal abdominal muscle bracing 

• Pelvic floor exercises 

8-12 weeks postnatal 

• Follow the guidelines for 3-8 weeks, gradually increasing your intensity and weights 

• Progress your postnatal abdominal muscle bracing 

12-16 weeks postnatal 

• Consider visiting a physiotherapist for a postnatal abdominal muscle check and pelvic floor muscle testing before returning to high-impact exercise, running, sport or abdominal exercise programs. 

After 16 weeks postnatal 

• You can return to previous activity levels provided your pelvic floor muscles have returned to normal, and you are not experiencing any back pain, vaginal heaviness, or urine loss during or after exercise. 

• Seek further advice from a health professional if your symptoms persist. 

Please note: Sit ups, curl ups, planks, hovers and mountain climbers are not recommended exercises for postnatal mums, as they can place pressure on the lower abdominal wall and recovering pelvic floor. A pelvic floor and postnatal abdominal check are recommended before undertaking these exercises. 

It is important to check with your doctor, midwife, physiotherapist or continence professional before returning to sport or exercise after the birth. 

Other factors to consider 

You may feel more tired in the first few months after having a baby due to interrupted sleep due to waking up to express breastmilk, the back and forth to the hospital to visit your baby in the Neonatal unit and the stress of your baby’s health.  

Fatigue and over exertion during exercise can increase the risk of injury. It is important to listen to your body and how you are feeling. Be aware of any warning signs of pain or discomfort and, slow down if necessary to allow this to subside, rather than pushing through the pain. 

While your baby is in the Neonatal Unit, it’s completely normal to not feel up to exercising in the first few weeks or even months. Simply walking to and from the car, bus, or train to visit the hospital might be all the exercise you can manage right now, and that’s perfectly okay. You can also work on strengthening your abdominal and pelvic floor muscles to prepare for when you’re ready to be more active. 

It is recommended that you wait until your six-week postnatal check before increasing your intensity level. Low-impact exercise such as walking is recommended during this time. Aim to steadily increase back to high impact exercise over the 3–4-month period after the birth. It is important to check with your doctor, midwife or continence professional before returning to exercise. 

Empowerment  

When you first start exercising after childbirth, try simple postpartum exercises that help strengthen major muscle groups, including abdominal and back muscles. 

Remember, even 10 minutes of exercise benefits your body. Stop exercising if you feel pain. 

Exercise has the following benefits for postpartum women: 

• It helps strengthen and tone abdominal muscles. 

• It boosts energy. 

• It may help prevent postpartum depression. 

• It promotes better sleep. 

• It relieves stress. 

• It can help you lose the extra weight that you may have gained during pregnancy. 

Useful Links  

Special thanks to The Continence Foundation of Australia for content sharing and providing support for families.   

Continence Foundation of Australia 

www.continence.org.au 

The national peak body for continence awareness, management, education, research and advocacy. Free information and resources are provided to individuals, carers and professionals.  

National Continence Helpline 1800 33 00 66 

Pelvic Floor First 

https://www.pelvicfloorfirst.org.au/pages/returning-to-sport-or-exercise-after-birth.html 

The Royal Woman’s Hospital, Victoria 

https://www.thewomens.org.au/health-information/pregnancy-and-birth/your-health-after-birth/exercise-after-birth 

Pregnancy, Birth and Baby 

https://www.pregnancybirthbaby.org.au/safe-return-to-exercise-after-pregnancy 

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