Postpartum Exercise

The baby has been born and I still can’t see my feet! How am I ever going to get back into shape? There is a myth that all the changes to a pregnant woman's body will be resolved by the sixth postpartum week. Nothing could be further from the truth. It is the rare woman who leaves the hospital in regular size clothes. It can easily take 6 months to a year for women to regain their pre-pregnancy shape. Exercise and attention to good nutrition can help in this endeavor.

Ask your physician when you can start to exercise before you leave the hospital. If you had a cesarean section or a complicated birth he or she may want to initially limit the type or duration of your exercise regimen. To start, walking is the best exercise. I usually tell my patients that once they can comfortably walk briskly for 20 minutes they can proceed with more vigorous exercise. This might be at a fitness club, running, using exercise machines or continuing with the walking. It is important to start slowly and gradually increase the duration and intensity of any exercise.

Your heart rate is a good measure of the effectiveness of your exercise program. Count the number of heartbeats in 6 seconds and multiply by 10 to get your heart rate in beats per minute. Calculate your maximum heart rate by subtracting your age from 220. While exercising your target heart rate should be 60-80% of your maximum. Try to maintain this heart rate for 20-30 minutes. Make sure you stay well hydrated while exercising. Wear a supportive bra and clothes that allow you to stay cool. Slow your exercise down if you are getting very short of breath or developing chest and/or abdominal pain.

Stomach crunches and leg lifts will help regain the lost abdominal muscle tone. Again it is important to start slowly and gradually increase the number of repetitions. If you have had a cesarean section your physician will likely want you to wait several weeks before starting these exercises.

Kegel exercises can help regain the strength of pelvic muscles. These can be done anywhere; the hard part is remembering to do them. It is helpful to associate Kegel exercises with something you do on a regular basis (e.g. feeding the baby). Tighten the pelvic muscles for 5-10 seconds and then release. Do 5-10 repetitions several times a day. Some women have a hard time doing the Kegel exercises correctly. If you are not sure you are doing the exercises correctly ask your doctor or midwife to check at your postpartum visit.

Breast feeding mothers can safely exercise. In fact breast-feeding can help mothers lose weight. A recent study published in the New England Journal of Medicine showed that babies of breast feeding women who exercised regularly had no difference in weight gain compared to women who did not exercise. It is not suprising that the mothers in the exercise group lost more weight than the mothers in the non-exercising group.

Exercise can improve both your physical and mental health. Getting out with the new baby for a brisk walk in the stroller can improve both your physical fitness and help decrease some of the stress associated with being a new mother. Be realistic about your weight and exercise goals. Remember it can easily take 6-12 months for you to return to your pre-pregnancy fitness level. It is important to establish an exercise program you can maintain for your long-term fitness goals.