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How to Exercise After Giving Birth


Postpartum Exercises

You won't be ready for strenuous exercise within the first few weeks of delivery. But your body will crave some sort of activity -- even something as simple as stretching while still in bed -- to tone your muscles and to relieve tension. Unless your doctor tells you otherwise, a series of gentle, low-impact exercises will be safe for you, and your body will thank you down the road.

You should start body conditioning and toning exercises in bed, the day of delivery. The sooner you start, the sooner your body responds with firm, toned muscles, especially pelvic floor and abdominal muscles.

Follow the exercises in "Exercises for Immediately After a Vaginal Delivery" or "Exercises for Immediately After a Cesarean Delivery," depending on the type of delivery you had. Unless you experienced multiple complications and find yourself extremely fatigued, you can begin performing these movements as suggested.

Once you get home, don't wait to exercise until the baby is asleep. Just lay out two blankets -- one for each of you -- and begin. The baby enjoys the movement, the music, and your smiles. If baby tires, she'll drop off to sleep.

If your physician says not to exercise for six weeks or more after delivery, show him or her the list of exercises you want to do. Do not just ask to "exercise" -- be specific. These exercises are so gentle and safe, your doctor will probably approve of them. If, however, your physician feels even these exercises are inappropriate for you just yet, of course, follow this advice.

Remember: When performing any exercise, you should slowly exhale as you are lifting or contracting and slowly inhale as you are lowering or releasing.

Exercises for Immediately After a Vaginal Delivery

Begin the day of delivery, while you're in bed. When you get home, perform these exercises on a thick blanket or exercise mat on the floor.

Head Curl-Up:

Begin with 5 to 10 repetitions twice daily; build up to 20.

  1. Lie on your back with your knees bent and your feet close to your buttocks. Press your back down against the bed or floor. Inhale slowly and deeply.

  2. Exhale slowly; at the same time lift just your head. Hold as you complete the outward breath.

  3. Relax.

  4. Repeat.

Note: Do this exercise as many times during the day as you can. Then progress to the "Head and Shoulders Curl-Up."

Head and Shoulders Curl-Up:

Begin with 5 repetitions twice daily; gradually increase to 20.

  1. Lie on the bed or floor, your knees bent and your feet close to your buttocks. Press your back down and inhale slowly and deeply.

  2. Exhale slowly; at the same time, lift your head then your shoulders. Hold as you complete the outward breath. Perform this exercise slowly and with control (no jerky movements). Keep your head in line with your spine; do not throw your head forward! The lift comes from the shoulders and should be straight up, about 6 inches maximum, with your face toward the ceiling.
    Diagram for postpartum exercises
    ©2006 Publications International, Ltd.

  3. Relax, return to the starting position, and repeat.

Pelvic Floor Squeeze:

Do 60 or more repetitions each day, in sets of 3 or 4.

  1. Sit or stand comfortably (you can do this exercise in most positions). To increase the challenge, move your legs farther apart.

  2. Tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of 3 (gradually work up to a count of 10). Be sure to breathe.

  3. Relax completely.

Note: Because these muscles fatigue easily, repeat in sets of 3 or 4 squeezes throughout the day anytime, anywhere. Concentrate on the sensations of tension and lifting, relaxing and lowering within the pelvis.

Pelvic Tilt:

Begin with 10 repetitions a day; gradually increase to 20.

  1. Lie on your back with your knees bent and your heels close to your buttocks.

  2. Inhale and press your back to the bed or floor. Hold for a slow count of 5 (work up to 10). Concentrate on pressing your back to the floor using your abdominal muscles -- do not push with your feet. For an extra benefit, squeeze your buttock muscles and the pelvic floor.
    Diagram for pastpartum exercises
    ©2006 Publications International, Ltd.

  3. Relax, then repeat.

Note: This is a wonderful stretch to help relieve a tired or achy back.

Bend and Straighten Legs:

Start with 10 repetitions a day; progress to 20. Start with Variation A. Using comfort as your guide, progress through Variations B and C to Variation D as quickly as possible.

Variation A

  1. Lie on your back with both legs bent, feet flat on the bed or floor.

  2. Slowly straighten your right leg then bend it back to the starting position.

  3. Repeat with the opposite leg.

Variation B

  1. Lie on your back with one leg bent and the other leg straight.

  2. Slide the bent leg out straight and then back to the bent-knee position.

  3. Repeat with the straight leg, returning to a straight-leg position.

Variation C

  1. Lie on your back with one leg bent and the other leg straight.

  2. Bend one leg as you straighten the other. (Both legs move at the same time, slowly, in opposition.)

Variation D

  1. Lie on your back with both legs bent.

  2. Straighten then bend both legs at the same time.

Exercises for Immediately After a Cesarean Delivery

Begin these exercises the day of delivery (as soon as you return from the recovery room). Perform them in bed.

Deep Breathing:

Perform 5 times every hour you are awake.

  1. Breathe slowly and deeply to expand the upper, middle, and lower portions of your chest. Count to 10 slowly as you inhale and again as you exhale.

Huffing:

Perform 2 or 3 times every hour you are awake.

  1. This exercise is especially important if you had general anesthesia. In response to the anesthetic, the lungs produce mucus, which, if not removed, can clog the small air sacs and breathing tubes of the lungs. Perform huffing instead of coughing.
  2. A huff is a quick outward breath. It is like saying "ha" -- a short, quick breath, with force, from the abdominal muscles. The outward breath must be quick, otherwise the force is not sufficient to dislodge any mucus. Spit out the mucus you bring up; don't swallow it.
  3. If huffing doesn't bring up any mucus and you still hear a rattle in your chest, try the "Deep Breathing" technique again to loosen it.
  4. With huffing, the abdominal wall is pulled in instead of out; therefore, huffing is more comfortable than "Deep Breathing." Still, you may want to support the abdominal wall with your hands or a pillow. Be reassured you will not pull the stitches out.

Foot Exercises:

Perform 5 times every hour you are awake.

  1. Without lifting your leg off the bed, do 5 ankle circles to the right and 5 to the left. Make them slow and big. Repeat with the other ankle.

  2. Slowly point and flex the foot. Repeat with the other foot.

Pelvic Floor Squeeze:

Do 20 repetitions a day, progressing to 60, in sets of 3 or 4. Begin when the catheter is removed.

  1. Lie or sit (later you will stand) comfortably with your legs apart. (To increase the challenge, move your legs farther apart. )

  2. Tighten the pelvic floor as if to lift the internal organs or to stop urination in midstream. Hold as tightly as possible for a slow count of 3 (gradually work up to a count of 10). Be sure to breathe.

  3. Relax completely.

Note: Because these muscles fatigue easily, repeat in sets of 3 or 4 squeezes throughout the day anytime, anywhere. Concentrate on the sensations of tension and lifting, relaxing and lowering within the pelvis.

Leg Squeeze:

Perform 3 times every hour you are awake.

  1. Lie on your back with one leg bent and the other leg straight, the foot flexed.

  2. Slowly press the straight leg to the bed and tighten all the muscles in that leg, gently pulling the toes toward your head.

  3. Repeat with the opposite leg.
    Diagram for postpartum exercises
    ©2006 Publications International, Ltd.

  4. With both legs straight and your ankles crossed, tighten all the muscles in your legs: Press your knees down, tighten your thigh muscles, squeeze your buttock muscles. Hold while you slowly count to 5. (Don't hold your breath!)

  5. Release, then repeat.

Hint: If needed, prop yourself up on pillows.

Pelvic Tilt:

Perform 3 to 5 times every hour you are awake.

  1. Lie on your back with your knees bent and your heels close to your buttocks.

  2. Inhale and press your back to the bed. Hold for a slow count of 5 (building up to 10). Concentrate on pressing your back to the bed using your abdominal muscles -- do not push with your feet. For an extra benefit, squeeze your buttock muscles and the pelvic floor.
    Diagram for postpartum exercises
    ©2006 Publications International, Ltd.

  3. Relax, then repeat.

Note: Slow, controlled movements are the key to success with this exercise. In the beginning, abdominal pain lets you do only a third or a half of this movement. That's fine; listen to your body. Improving pelvic circulation is important -- do the best you can with this movement. As your body heals more and more each day, hold the tilt longer and longer. Remember to breathe. Add a "Pelvic Floor Squeeze," too. On the third day after surgery, add "Bend and Straighten Legs." On the seventh day, add "Head-Up Lift."

Bend and Straighten Legs:

Add this exercise three days after surgery. Repeat Variation A 3 to 5 times, twice a day. Using comfort as your guide, progress through Variations B and C to Variation D as soon as possible.

Variation A

  1. Lie on your back with both legs bent, feet flat on the bed.

  2. Slowly straighten the right leg then bend it back to the starting position.

  3. Repeat with the opposite leg.

Variation B

  1. Lie on your back with one leg bent and the other leg straight.

  2. Slide the bent leg out straight and then back to a bent-knee position.

  3. Repeat with the straight leg, returning to a straight-leg position.

Variation C

  1. Lie on your back with one leg bent and the other leg straight.

  2. Bend one leg as you straighten the other. (Both legs move at the same time, slowly, in opposition.)

Variation D

  1. Lie on your back with both legs bent.

  2. Move both legs down and up at the same time.

Head-Up Lift:

Add this exercise seven days after surgery. Perform 3 to 5 times, twice a day. Add more repetitions as comfort guides you.

  1. Lie flat on your back with no pillows, your knees bent. Press your back down. Inhale slowly.

  2. Slowly exhale and lift just your head. Hold for a count of 3.
    Diagram for postpartum exercises
    ©2006 Publications International, Ltd.

  3. Lower your head and relax.

Note: Using comfort as your guide, progress to lifting both your head and your shoulders on exhalation. Concentrate on lifting them toward the ceiling as a unit but just an inch or two off the bed. Do not thrust your head forward on the lift. Keep your eyes on the ceiling; do not let your chin fall toward your chest.

Soon, you'll be able to return to a more intense workout. The next page gives guidelines for when to resume aerobic exercise.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.