Returning to exercise after delivery is important. According to the American Council of Obstetricians and Gynecologists (ACOG), with your doctor’s approval, you can start exercise as soon as you feel that you are ready. Regular exercise can increase mental well-being, decrease stress or depression, help gain back bladder control, and regain muscle tone.

Julie Rosenberg, Physical Therapist at NorthShore, urges you to protect your body after giving birth. It is important to start slow and gradually increase your exercise, tracking your progression and tolerance. Here are some common exercises to help you get moving again:

First check and correct an abdominal separation.

Perform this simple test 3-4 days after your baby is born. Lie on your back with knees bent and feet flat. Keeping your chin tucked in, reach with your arms outstretched towards your knees as if you were doing a curl-up. Feel with one hand along the midline of your abdomen (where some women get a dark line during pregnancy) just above or below your navel. You’re looking to feel for a separation between your abdominal muscles. If you feel less than two finger widths separation, it is considered normal and often will repair itself after delivery. Two finger widths or greater is considered a diastasis recti, which is where your abdominal muscles are separated.

If you have diastasis recti, the goal is to maintain abdominal strength without stressing the abdominal separation. To correct this, lie on your back with your knees bent and cross your hands over your abdomen so that you are approximating the separated muscles. This can also be accomplished with a folded sheet or beach towel. Breathe in deeply and as you slowly exhale, raise your head to your chest. Hold this position for 5 seconds - do not hold your breath! Your shoulders should barely come up from the floor. Relax and repeat 5-7 times. Do this several times a day.

Additional After Delivery Exercises:

• Kegels: Begin 3-5 days after delivery; start with 10 repetitions, 1-2 times per day and slowly build up to 6 sets of 10 per day.
• Abdominal Strengthening:  Begin abdominal exercises slowly, avoid sit ups and avoid leg lowering/raising exercises if you have a visible bulge or diastasis recti greater than 2 cm.  Begin with pelvic tilts or rocking on all fours and progress as tolerated. 
• Aerobic Exercise:  You can gradually progress aerobic exercise after delivery.  Do not perform impact aerobic exercise until vaginal bleeding has ceased there are no urine leaks when coughing, sneezing, jumping or running. For most women after a cesarean section, vigorous aerobic activity is not recommended until eight weeks after delivery.     

Every recovery period is different, so be patient when building back your strength. Please consult your OB when beginning abdominal or aerobic exercises, especially after a cesarean delivery. NorthShore Physical Therapists work with clients in the prenatal and postpartum periods to safely care for women during a time of changes in their bodies and activities when caring for their new little ones.