Working Out Post-Partum

Working Out Post-Partum

Getting back into exercise after giving birth is often a scary proposition and as with most things after you have a baby, you’ll often get bombarded with advice regarding anything and everything, which may add to the apprehension of returning to exercise. Even some health practitioners will have differing views on how and when to start back exercising, with many also varying in regards to the parameters of exercising when you’re pregnant. So when can we get back into regular exercise and what is the ideal way to resume strength training? Here’s the latest evidence.

Importantly, this pertains only to those who have had uncomplicated births. In instances where you have had complications or you have had a C-section, it is best to consult your Obstetrician and Physiotherapist as there may be further restrictions as a result of your circumstances.

As many of the changes, both physiologically and morphologically, continue for up to 6-weeks post-partum we must be cautious with resuming exercise. Although this time period should be respected, it doesn’t mean that low level exercise can’t begin soon after birth. Some women will start a modified low-level exercise program within days of giving birth. Now let’s be clear, this doesn’t mean doing heavy squats and deadlifts! Pelvic floor exercises can start in this early period as well as slowly getting back to ~150mins/wk of moderate intensity cardiovascular exercise such as walking, biking or elliptical. Impact activities such as running should be avoided initially (strictly within the first 6 weeks), until a point where it is comfortable enough to slowly introduce. After this 6-week mark, it can be ok to start to increase the intensity of your exercising and this can include doing some more gym based bodyweight activity. This will obviously depend on a number of factors including pelvic floor strength and leakage, as well as comfort level. Exercises that stress the anterior torso might also interfere with the healing and resolution of any abdominal muscle separation, so these exercises are slowly brought into your exercise regime further down the line.

Around the 3 month mark is where things will generally open up and start to resemble more of your strength based gym workout, although returning to this type of programming will happen quite slowly. You definitely won’t be going back into lifting the weight you’re used to throwing around! Slow and steady wins the race and will certainly benefit you further down the line. The last thing we want is to get too enthusiastic and have a set back.

The benefit that often goes underappreciated with resumption of exercise post-partum, is the positive impact it has on your overall health. Although it’s great for your physical health, from a mental health standpoint it can be incredibly beneficial. A recent systematic review showed the benefits of exercise post-partum include:

• Improvements in emotional well-being.
• Reduced anxiety and depression.
• Improved physical conditioning.
• Reduced postpartum weight gain and faster return to pre-pregnancy weight.

Getting back into exercise after child-birth is incredibly important in a number of ways, however the resumption of exercising can be nerve wracking. Every case is different and the speed at which you return to certain activities will differ from person to person. Complications during delivery, having had a C-section, pelvic floor damage and level of abdominal separation all factor in to the timeline of exercise resumption. Whatever the case, a gradual progression is required in order to minimise any risk of complications. It is important that a thorough discussion takes place with your obstetrician regarding any contra-indications (things to avoid) when returning to activity, and if you’re not feeling comfortable or confident enough to return, your physiotherapist can help guide you through the return to exercise process.

References

American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstet Gynecol. 2015;126:135-142.

Blamey R, Daley A, Jolly K. Exercise for postnatal psychological outcomes: a systematic review and meta-analysis. Lancet. 2012;380.

Daley A, Foster L, Long G, et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. British Journal of Obstetrics and Gynecology. 2014;122:57-62.

Davies G, Wolfe L, Mottola M, et al. Joint SOGC/CSEP clinical practice guideline: Exercise in pregnancy and the postpartum period. Can J Appl Physiol. 2003;28(3):329- 341.

Evenson, K. R., Mottola, M. F., Owe, K. M., Rousham, E. K., & Brown, W. J. (2014). Summary of international guidelines for physical activity after pregnancy. Obstetrical & gynecological survey, 69(7), 407–414. doi:10.1097/OGX.0000000000000077

Sports Medicine Australia Position Statement Exercise in Pregnancy and the Postpartum Period (2016). Retrieved from: https://sma.org.au/sma-site-content/uploads/2017/08/SMA-Position-Statement-Exercise-Pregnancy.pdf