Postpartum exercise: How to get back to fitness safely

Postpartum exercise guidelines can be different for every mom, but if you're eager to get moving again, here's what you need to know about safely getting back into fitness after having a baby.

A healthy pregnancy should encourage movement, not a lack of activity, says Dr Serasheni Moodley, an obstetrician and gynaecologist at Mediclinic Sandton. She encourages her patients to start gentle movement as early as possible, often just hours after giving birth.

“Irrespective of whether they have a normal delivery or cesarean section, I want my patients to be mobile as early as possible to prevent deep vein thrombosis, because the clotting risk is extremely high post-pregnancy,” she says.

This approach to postpartum exercise speeds up physical recovery and supports mental wellbeing during a time of significant life change.

The six-week rule

Dr Moodley has one important rule for postpartum exercise that applies to all new moms: “I don’t allow abdominal exercises until six weeks after pregnancy, whether you had a normal delivery or a C-section.”

This rule is in place because of diastasis recti, a condition where the abdominal muscles stretch to make room for the growing uterus. “If you try to strengthen those muscles too soon, it won’t help bring them back together,” she explains. “This is why new moms often have that ‘preggy pooch’ that people talk about. Instead, I recommend moms use a tummy binder to help bring the muscles closer together and address the diastasis.”

Postpartum exercise timeline

Before starting any fitness routine, Dr. Moodley emphasises the importance of understanding your own journey and listening to what your body is telling you.

• Focus on how your body feels and talk to your doctor or a physiotherapist for advice that’s specific to you.
• Some pain, especially around a C-section scar, is normal but should gradually decrease. If the pain gets worse or becomes unbearable, seek medical help.
• Stay hydrated: Drink plenty of water, especially when breastfeeding and exercising, as not drinking enough can affect your milk supply.

After vaginal deliveries:

• Immediately: Begin gentle walking.
• At two weeks: Start doing glute bridges to help with abdominal healing.
• At four weeks: You can begin swimming, yoga, and walking in water.
• At six weeks: It’s an important time to start pelvic floor exercises. “Pelvic floor exercises aren’t just Kegels, because doing too many Kegels can lead to urinary problems,” warns Dr Moodley. It’s a good idea to consult a physiotherapist for advice.

After C-section deliveries:

• First two weeks: No driving, but walking is encouraged.
• At two weeks: Start doing glute bridges. As you get stronger, you can gradually make the exercise harder, like adding an extended leg to the glute bridge, says Dr Moodley.
• At four weeks: You can start yoga, walking, using a rowing machine, and doing water activities, but it’s best to wait before doing swimming strokes.
• At six weeks: You can start returning to more normal exercise routines.

Exercise when breastfeeding

Breastfeeding moms can exercise, but they should plan carefully. “When your breasts are full of milk, exercise can feel uncomfortable,” says Dr Moodley. “It’s a good idea to time your workouts, like after feeding your baby and expressing milk if needed, and make sure you wear a well-fitting bra.”

Deeper benefits of postpartum exercise

Dr Moodley says postpartum exercise is about more than just getting your body back in shape: “Having a baby changes your freedom because you're now responsible for this little person for the rest of your life, and you need to take some of that freedom back.”

She adds, “We have kids because we want to enjoy them. You want to be fit enough to do things with them as they grow.”

With regular, safe exercise, most women can slowly return to their pre-pregnancy fitness levels, helping them maintain both their physical health and sense of self throughout the journey of motherhood.