Easing Back into Exercise After Pregnancy

The post-partum period is a time of transition for women and families. While this is an exciting time for many people, a new schedule, lack of sleep, fluctuating emotions, and all of the demands of caring for a newborn can leave many new moms feeling emotionally drained.

While the thought of exercising might seem counterproductive to an exhausted, sleep-deprived new parent, exercise actually increases energy levels and enhances mental acuity. According to the American College of Obstetricians and Gynecologists, exercise promotes better sleep, boosts energy, relieves stress, may be useful in preventing postpartum depression, and promotes return to pre-pregnancy weight.¹

Women should return to physical activity gradually. Many will be able to safely return to exercise within 4-6 weeks after delivery. However, women healing from a cesarean delivery or with other health complications generally require more time. As fitness professionals, we are positioned to help women return to exercise safely after having a baby once they have received medical clearance. Read on to learn a few strategies you can utilize to help women ease back in to exercise after pregnancy.

1. 1. Focus on Stress Management and Emotional Well-being
      While our “snap-back” obsessed culture offers quick-fix diets and vigorous exercise programs that promise a better body in 10 days, two weeks, or some other unrealistic time frame, remind your clients not to take this bait! It’s important to resist the temptation to “get your old body back” right away. This is premature thinking and could result in more set-backs than progress. Exercise during the post-partum period should not cause pain or increase postpartum-related bleeding. Stress reducing physical activity is associated with a decreased risk of postpartum depression, but stress-provoking exercise activities could have the opposite effect.² Gentle walking and stretching can generally be resumed even before the first postpartum doctor appointment. Begin with 5-10 minutes of activity, and build from there. The goal during this early period is not to improve fitness, but rather to reduce stress, enhance mood, and to prepare the body for a program of gradual exercise progression over the next several weeks.

 

1. Understand Postpartum Anatomy
   Back Pain is experienced by nearly 70% of women during pregnancy and the postpartum period.² During the prenatal period, the abdominal wall stretches to make room for a growing baby. After delivery, an overstretched abdominal wall will have a harder time supporting the musculature of the low back. Weak abdominal muscles can lead to lower back pain. Exercises that stabilize the low spine – such as spinal balance and bridge pose – will strengthen the entire core and in turn, will help to counter lower back pain.Upper back pain can be caused by increased weight in the breasts. A hunched, forward-rounded posture while feeding and caring for the baby can exacerbate this. Exercises that work the middle back (e.g. row variations) and the shoulder external rotators will strengthen the weak, passive muscles associated with forward-rounded posture. Furthermore, tight upper back, chest, and anterior shoulder muscles should be stretched to address muscle imbalances. Exercise participants should also be encouraged to wear a proper fitting and comfortable bra. Diastasis Recti – a complete or partial separation of the right and left sides of the rectus abdominis muscle – is a normal part of pregnancy. All women will experience some degree of separation to the abdominal wall, but those with larger separations should proceed with caution when returning to core training after delivery. To test for diastasis recti, have the subject lie supine with the knees bent. Place two fingers horizontally on the middle abdomen, and have the client perform a curl-up. If the fingers are able to penetrate the region no more than one to two fingers width, the separation is not severe. However, a separation of three fingers width or more is considered excessive. Women exhibiting separation greater than two fingers width should begin with a gentle core strengthening program limited to isometric exercises and pelvic tilts. Traditional core work such as crunches and reverse curls could cause more damage if resumed prematurely.Breastfeeding will impact energy and fluid intake needs for new moms. Breastfeeding requires an additional 300 to 500 calories per day. Exercise does not adversely affect lactation, and most breastfeeding mothers naturally increase their caloric intake to adequate levels.² However, adequate fluid intake is often a challenge for breastfeeding women who are physically active. Breastfeeding requires an additional 64 ounces of fluid intake per day; physical activity increases this need. Dehydration can reduce the amount of milk produced for the baby. Remind clients to drink water every time they nurse their baby and to drink at least 6 ounces of water for every 15 minutes of exercise. Hydration can be monitored by urine output of both the mom and baby. The mother’s urine will be pale when properly hydrated, and the baby should be wetting 5-6 diapers a day.Relaxin is a hormone produced during pregnancy that prepares the body to give birth by increasing the elasticity of the ligaments. Relaxin affects all of the joints in the body, and can compromise joint stability up to five months post partum.⁴ New moms should be cautioned about participating in high-impact activities that could cause damage to the unstable joints and take care not to hyperextend when stretching.Once the unique postpartum anatomy needs of the mother are addressed, you can begin working with your client to set long-term health and fitness goals. Remind your client to have realistic expectations. It takes nine months to a year – on average – to return to pre-pregnancy weight and body composition. Focus on action-oriented and behavior-based goals. Fat loss and an increase in lean body mass will happen over time.
2. Socialize
   Caring for a baby 24/7 can leave new parents feeling isolated. Paradoxically, some new parents are reluctant to spend time exercising if it means time away from the baby. Encourage new parents to enjoy the 30 minutes to an hour of physical activity as self-care. When possible, create opportunities for social interaction. Exercise produces mood-enhancing endorphins whether performed alone or in a group setting. However, the social connections present in group fitness classes, walking groups, and small group training can offer additional emotional health benefits and can help with long-term exercise adherence.³

Welcoming a baby will undoubtedly create a new normal for parents. However, with a little planning and patience, exercise and health and fitness goals can be achieved during the postpartum period and beyond.

If you would like to learn more about how to incorporate exercise during pregnancy and postpartum, check out our Home Study Course, Physical Activity and Exercise During Pregnancy and the Postpartum Period.

References
¹ACOG (2015). ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstetrics and Gynecology
²Anthony, L. (2002). Pre-and Postnatal Fitness. San Diego, CA: American Council on Exercise.
³National Exercise Trainers Association (2018). The Fitness Professional’s Manual, 5th edition. Minneapolis, MN: National Exercise Trainers Association.
⁴NCT (2018). Your body after birth. Retrieved from www.nct.org.uk.

---

Contributed By:

Jennifer Turpin Stanfield, M.A. (Exercise Science), is the Assistant Director for Fitness and Wellness at Wright State University in Dayton, Ohio, a fitness writer, and a national presenter for NETA. She has more than 15 years of experience in the health and fitness industry and is passionate about helping others live healthier lives through the adoption and maintenance of positive health behaviors.