Q:
I'm eight months pregnant, still active and want to get my body back in shape as soon as possible after giving birth. If I have a vaginal delivery, can I start exercising right away?
A:
Yes and no. Many new mothers are in a rush to get their pre-baby body back quickly. It's important to be cleared for exercise by your doctor before starting an exercise program of cardiovascular or aerobic work, strength training and stretching. Your doctor may give this OK around six weeks after your baby's arrival, when your uterus and joint ligaments have returned to pre-pregnancy size and strength.
There are a few exercises you can do soon after delivery to help prepare your body for working out once you get clearance. Many doctors suggest starting pelvic-floor exercises (often called Kegels) as soon as the first week after delivery. If you had an episiotomy, a surgical cut to enlarge the vagina and aid birth, you may need to wait longer.
During childbirth, your pelvic floor, or Kegel, muscles stretch to make room for the baby's birth. Returning these muscles to their pre-baby tone will help you do more later and get your body back faster. Your pelvic floor muscles support the organs in your lower abdomen and help core function, spinal health and continence during high-impact activities such as running and jumping.
You can also do isometrics and small-range abdominal contractions to regain muscle strength. These exercises are also useful after cesarean-section deliveries; however, you should wait until your C-section incision heals and you have clearance from your doctor.
1 week after giving birth:
Pelvic Floor Activation
To activate your pelvic floor, imagine you are stopping the flow of urine. Hold muscles for 10 seconds (don't hold your breath) and slowly release. Do 20 holds 5 times a day. This exercise can be done while sitting or standing—even when nursing!
2 weeks after giving birth:
Transverse Abdominal Exercise (sitting)
Sitting with your back supported, place your hand on your upper and lower abdominals. Inhale through the nose and exhale through the mouth with pursed lips a couple of times, breathing slowly and deeply. Breathe out and tighten your abdominal muscles by pulling your navel toward your spine. Sit tall; do not allow your shoulders to round forward. Hold for 30 seconds or less. Repeat 10 times.
3 weeks after giving birth:
Transverse Abdominal Exercise (side-lying)
Same technique as above; perform exercise while lying on one side with legs slightly bent and holding a pillow between the knees. Support head with a pillow or a rolled up towel.
Transverse Abdominal Exercise (on all fours)
Same technique as above, on all fours with shoulders lined up over hands and hips over knees. Keep spine still as you pull your navel to your spine.
Pelvic Tilts
Lie on your back with knees bent, feet resting on the floor and holding a pillow or a rolled up towel between the knees. Inhale through the nose and exhale through the mouth several times without changing the natural curve in the back. Breathe slowly and deeply. Then breathe out, tighten abdominal muscles, pulling the navel to the spine. With the navel pulled toward the spine, pull your lower abs in and flatten back by tilting your pelvis. Use your abs; do not push with your legs. Hold for 30 seconds; repeat 10 times.
4 weeks after giving birth:
Leg Slides
Lie on your back and complete a pelvic tilt (see above). Keep abs tight and back lengthened along the ground; inhale and slide one leg out along the floor until fully extended if possible. Do not loosen abs or let your back leave the ground, even if you can't extend the leg fully. Exhale and slide leg back to start. Repeat 20 times on each leg.
Head Lifts
Lie on your back, knees bent, squeezing a pillow or a rolled up towel between your knees. Pull navel toward spine and complete a pelvic tilt (see above). Wrap hands around upper waist; squeeze hands together as if making a corset around your middle. Slowly lift head off the ground to look at your navel. Keep shoulders on ground. Work up to 2 sets of 10 repetitions.
Continue to do these exercises until your six-week check-up. After your doctor clears you for full activity, use these exercises as a warm-up routine prior to more intense activities.
