Going back to exercise after having a baby

Written by Magdalena Hawley

Mums Going Strong Fitness

 What every mum needs to know when returning to exercise post-birth

 Exercising after having a baby can improve your physical and mental wellbeing. Benefits of postnatal exercise include:

• • Improving your mood, relieving stress and preventing postpartum depression.
• • Improving energy and making you less tired.
• • Promoting weight loss and improving your sense of wellbeing
• • Firming up your body and restoring muscle strength.
• • Promoting recovery

However, you should be really careful when returning to exercise after having a baby. It is vital that your pelvic floor (PF) and abdominal muscles have regained sufficient strength before you recommence sports, aerobics, running or heavy lifting (and it doesn’t matter if you had a baby 6 weeks ago, 6 months ago, or 6 years ago). Participating in these or other high-impact activities TOO early may reduce PF muscle strength and cause long-term bladder and bowel problems or pelvic organ prolapse.

There are a few important things that you need to know before you return to exercise after having kids. You can find my top three below.

1. Your six-week check-up is not a green light to go back to your pre-pregnancy fitness program.

A six-week check-up is an important appointment you shouldn’t miss. However, even if you receive a green light to exercise, that doesn’t mean that you can just get back to what you did before you got pregnant. It’s okay to start getting back to exercise but still with some modifications, which very often is not spoken about by the doctors. 

During your six-week check-up, the doctor should check how you are healing (your perineal area or C-section wound), ask questions about your general and mental health, check your uterus, and ask questions related to the baby (regardingbreastfeeding or bottle-feeding, etc.). 

However, it’s very rare that doctors check the pelvic floor internally, and sometimes they don’t even check your abdominal separation.  And it’s really important to know what’s happening with your pelvic floor and your abdominal muscles before you commence any workout program. 

That’s why I always recommend to mums, even if they got the all-clear to exercise, to go and see a women’s health physio.  

A women’s health physio not only will check what’s happening with your pelvic floor, they will also make sure you can properly activate your pelvic floor muscles as many women do it incorrectly. They will check your abdominal separation and check your transverse abdominus muscles activation. Some also use real-time ultrasound so you can visually see how your muscles are activating.

2. Leaking is not normal.

One in three women who have had children will suffer from some form of incontinence. It can be a little leak or even complete loss of bladder or bowel control (yep, not funny). Remember, leaking is not normal…very common but not normal! It can be treated and managed, and in many cases, it can be fixed! But if you won’t do anything about it, it might get worse.

Some of the treatments include PF exercises/Kegels, bladder training, good toilet habits, and medications.

Most of the time, we talk about leaking being a sign of a weak PF; however, you can have an overactive PF that is too tight. If that is the case, doing Kegels and tightening your abdominal wall and PF can do more harm than good. PF muscles must be able to contract to maintain continence and relax to allow for urination, bowel movements, and sexual intercourse. When your PF muscles are too tight/overactive and never relax, they will often cause pelvic pain or urgency and frequency of the bladder and bowels. If this case, you will have to focus more on relaxing and letting go of your PF rather than activating it.

Sometimes, incontinence can be a sign of prolapse. Prolapse occurs when the muscles, fascia, and ligaments holding your pelvic organs (bladder, uterus, and bowel) are weakened and stretched, which allows the pelvic organs to drop. Some signs of prolapse include incontinence, heavy sensation or pressure in your PF, a lump coming out of the vagina, constipation, painful sex.  

As you see, leaking can be a sign of different issues with your pelvic floor. If something doesn’t feel right “down there,” please go see a women’s health physio. Don’t take your pelvic floor for granted.

3. Diastasis recti/abdominal separation is totally normal, but you still need to be aware of what NOT to do.

Diastasis recti (also known as abdominal muscle separation) is the stretching/weakening of the linea alba and the entire abdominal wall that occurs during pregnancy. It usually happens during the later stages of pregnancy, and it’s totally normal (your body is making more space for the growing baby). But sometimes, it doesn’t go back together afterwards, which is why you might still have that “mummy tummy.”

Diastasis recti reduces the integrity and functional strength of the abdominal wall and can aggravate lower back pain and pelvic instability. You need to understand how to help your muscles heal and decrease the intra-abdominal pressure pushing onto them. And you need to be aware of what NOT to do, as some very popular exercises (e.g., sit-ups, planks, and push-ups) will make it worse. Your abdominal wall needs a degree of loading to heal, but it requires the right kind and amount at the right time.

It’s also important to understand that it’s not only about how wide the gap is when it comes to abdominal separation. More important are the depth and how much control and tension you can create along the linea alba to manage the intra-abdominal pressure.

Separation may heal (close) in some women but not others. Closing the gap is not necessarily the goal. The goal is to have a functional core that can withstand intra-abdominal pressure. Again, the best person to assess for separation is a women’s health physio.

Returning to exercise post-birth is often a priority for mums. However, you have to remember that exercising after childbirth is not only about fat loss or trying to get your pre-baby body back; it’s also about restoring your physiological functions. So take your time, don’t rush into anything, be kind to yourself, and if you can, work with a trainer who knows how to work with mums.

Magdalena Hawley is a Women’s Health & Fitness Coach. She is a founder and head trainer of Mums Going Strong Fitness, group and personal training company specialising in postnatal fitness with a focus on core and pelvic floor recovery. And a creator of Body Confident Mama Project - online coaching program for busy mums.