Postpartum, the limitations on your activity are very different. There is a great deal of variation in recommended activity and recovery time depending on what kind of delivery you had and any complications of delivery that occurred.
All women should have a routine postpartum visit within 6 weeks of delivery. Most women are medically cleared to return to normal activity after this visit barring any additional complications. If you plan to return to activity before your postpartum visit, please discuss your plans with your obstetrical provider.
For those women who had a normal spontaneous vaginal delivery without lacerations or with minimal tearing, it may be possible to return to exercise within days of delivery. For those that had more extensive lacerations or who underwent cesarian section, there is a longer recovery time. If you had a significant laceration, it may take 6-8 weeks to heal completely and you should have your laceration healing checked before starting to cycle again as being on a saddle can cause compression, pain, and delayed healing. If you had a cesarian section, exercise and heavy lifting is not recommended for at least 4 weeks to allow the abdomen and all sutures to heal completely. Most women require 6-8 weeks of healing after a cesarian section before complete return to normal activity.
When you return to exercise, please keep a few things in mind…
Most women have some degree of period-like bleeding, called lochia, for several weeks after delivery. It is not recommended to use tampons or Diva cups during this time due to risk of infection, as the cervix is still open and lacerations may be healing. This alone may make it difficult to start cycling soon after birth. Please change pads frequently and keep the area clean and dry as much as possible.
There are also many physical changes that women undergo during pregnancy and after birth, including a loosening of ligaments, resulting in joint laxity and hypermobility. This can make one more prone to strains, sprains, and other muscle injuries, so please ease into any exercise program slowly. The pelvic girdle can also become weakened and sometimes even separate in the midline. If you experiencing severe pain with walking or movement, please consult your provider for further evaluation.
Core strength is also greatly diminished because of the stretching of the abdominal cavity. The abdominal muscles can even separate at the attachment in the midline, called a diastasis recti. If this occurs, it is important to strengthen the obliques and support muscles to help bring the rectus abdominus (the large up and down muscles most people associate with “abs”) back together in the midline. Exercising this large muscle group before strengthening the surrounding muscles can result in a worsening of this separation and may require physical therapy. Your provider will check for signs of this at your postpartum visit.
Most importantly, the postpartum period is integral for bonding with your newborn, establishing breastfeeding (if desired), and learning your baby’s signals and habits. It can be a stressful and highly emotional time, and support from family and friends is integral. Many women experience “baby blues” from lack of sleep, but if you are experiencing severe depression, lack of desire to care for yourself or your baby, or any thoughts of harming yourself or others, please consult your provider immediately. Exercise in the postpartum period can be integral to a mother’s well-being, especially for those who were highly active before pregnancy, so it is important to make time for yourself to exercise once you have been cleared to do so. A healthy mom is essential to having a healthy baby.
For those that are expecting and those who are new mothers… Congratulations, and I wish you health and happiness in your endeavors!