I was 32 years old when I had my first son. Experienced enough to have spent over a decade learning and working in the health and wellness space, old enough to have had many friends go through one or multiple births, and informed enough to give a good amount of thought to the postpartum period, not just the birth itself.
And even though I was a lifelong athlete and exercised routinely up until my son was born, I had a fairly good understanding of what my body would need and felt like I was mentally prepared to give myself time to rest after the birth.
But I had no idea.
In my mind, I would take a week (basically an eternity) to stay in bed as much as possible and allow my body to initially recover, then around 2 weeks I’d resume short walks that would gradually increase in length, and after getting cleared at my 6-week appointment, I’d get back to lifting, running, and riding my Peloton almost daily. Seemed like a good and safe plan to me.
Only, I was not cleared to exercise at my 6 week appointment, and when I finally did start exercising, I felt like I was in a body that did not belong to me. It’s hard to explain, but everything just felt...off. I had lost a good bit of strength, a lot of endurance, and movements that had once felt as natural as walking, felt foreign. But slowly (albeit much more slowly than I had thought) and carefully, I did start to build on my routine and feel more like I did pre-pregnancy.
What I thought would take a few months, took over a year. In fact, I did not feel like myself again, from an exercise perspective (or really any perspective) for nearly a year and a half. They tell you to manage expectations after birth...well my expectations were clearly not managed adequately.
In an effort to shed some light on postpartum exercise expectations and perhaps help you to not have to go through the disappointment I went through, here are a few things to know.
1. There are a number of benefits to postpartum exercise
Decreases physical and mental fatigue
Although it might seem like exercise would exacerbate the nearly crippling fatigue and exhaustion we feel as new mothers, research suggests that the opposite is actually true (1). In fact, exercise routines have significantly decreased the physical and mental fatigue in postpartum women, including those with postpartum depression.
Lowers risk of postpartum depression
Postpartum depression is a serious mood disorder that affects approximately 10-15% of new mothers each year (2). And studies suggest that exercise during and after pregnancy minimizes the risk of postpartum depression and reduces the symptoms of depression (3).
Improves aerobic fitness levels
Aerobic fitness is a key factor in reducing risk of chronic conditions such as obesity, heart disease, type 2 diabetes, and stroke. Studies suggest that postpartum exercise can improve women’s exercise capacity and aerobic fitness, thereby decreasing their risk for chronic disease now and in the future (4).
May slow bone loss caused by lactation
It is well known that lactation can result in a temporary loss of bone mineral density, particularly axial bone loss ranging from 3-9%. But studies suggest that postpartum exercise can actually slow this bone loss and preserve the integrity of the tissue (5).
Promotes return to pre-pregnancy weight
Pregnancy is thought to be a contributor to and risk factor for long-term obesity. However. Studies suggest that postpartum exercise, even just walking, could lead to less weight retention and an acceleration to pre-pregnancy weight (6).
2. Everyone’s timeline for returning to exercise is different.
Studies show that an increasing number of women are active throughout their pregnancy (7), but specific guidelines and advice for returning to exercise are lacking and leaving many women feeling confused.
The common advice given is to wait until your 6 week appointment to resume strenuous exercise, but there isn’t a lot of research to back that recommendation up. And in reality, everyone’s return to postpartum exercise is different and will depend on a number of factors including how the pregnancy and delivery went, whether it was a vaginal delivery or cesarean, pre-pregnancy fitness level, and many other factors.
In addition to a lack of guidance and physical health, many other factors affect the timeline for return as well, including demands of a newborn, lack of time, and sleep deprivation.
The best advice, in my opinion, in terms of managing expectations on timing is to understand that your plans for a timeline will need to stay fluid and we, as new mothers, should take into consideration that there are a number of factors, both physical and emotional, that should be acknowledged prior to returning to strenuous exercise.
3. Good, evidence-based recommendations exist
A number of studies have been published looking into important factors and recommendations when returning to exercise in the postpartum period. Dr. James Clapp, a leading researcher in the field of exercise and pregnancy, developed guidelines for the postpartum period. He suggests the main goal in the first year after pregnancy is obtain personal time and regain a sense of control. He also recommends the following: 1) beginning slowly and increasing intensity gradually; 2) avoiding excessive fatigue and dehydration (stay hydrated); 3) supporting and compressing the abdomen and breasts; 4) stopping to evaluate if it hurts; and 5) stopping exercise and seeking medical evaluation if experiencing bright red vaginal bleeding heavier than a menstrual period (7).
The American College of Gynecology (ACOG) suggests that women should be able to start exercising again shortly after the baby is born (for women with uncomplicated deliveries). They suggest that women should 1) aim to stay active for 20-30 minutes each day; 2) Try simple postpartum exercises first (abdominal, back, and pelvic floor exercises); 3) Start slow and gradually add moderate-intensity; and 4) Stop exercising if you feel pain (8).
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