Getting active again after birth

After a straightforward birth, a gentle walk can be a good place to start, as soon as you feel up to it. Ask for advice before running, tough classes or heavy exercise. The NHS advises this before high-impact activity, and after a complicated birth or a caesarean.

Start gently

The NHS includes walking, gentle stretches and pelvic floor exercises among the first things you can do after a straightforward birth. ACOG’s US guidance also says you can often start exercising a few days after a vaginal birth without complications, or when you feel ready. After a caesarean or complications, ask your obstetric clinician when it’s safe to start.

Keep your first plan small. Pick an activity you can fit into your day, then build up slowly. The UK Chief Medical Officers advise a slow start if you weren’t active before, and a slow restart if you were. This applies even if you were fit before pregnancy.

If you join a class, tell the instructor you’ve recently given birth. The NHS suggests asking a midwife or health visitor about postnatal classes.

Where the weekly guidance fits

The UK Chief Medical Officers’ guidance covers birth to 12 months. It recommends building up to at least 150 minutes of moderate activity every week. It also advises building back up to muscle-strengthening activities twice a week, and starting daily pelvic floor exercises as soon as you can.

ACOG also recommends at least 150 minutes of moderate aerobic activity each week. Moderate effort raises your heart rate, but you can still talk. Singing becomes hard. Examples include brisk walking and cycling on flat ground. These are goals to work towards, along with the advice to start slowly.

Build towards the weekly target at a pace that leaves room to recover. Ask your clinician how to adapt the plan to your birth and any symptoms you have now. A short activity can be the whole plan for today.

Pelvic floor recovery before impact

Pelvic floor exercises mean squeezing, holding and relaxing the muscles. Let go fully between squeezes. If you can’t tell which muscles are working, ask a health professional to check how you’re doing them. NIDDK recommends an exercise plan made for you.

Get advice about leaking pee or a heavy feeling between the vagina and anus. The NHS says a GP or health visitor can help and refer you to a specialist. Use that chance to ask about pelvic health physiotherapy and which activities suit your symptoms.

For running or aerobics, the NHS suggests getting advice at your 6-week postnatal check before you start. Having the appointment doesn’t on its own mean you’re ready. Talk about any pelvic floor symptoms and discomfort first, and ask how to build up to impact.

A gap between the tummy muscles

During pregnancy, it’s common for the long muscles down the middle of the tummy to separate. This is called diastasis recti. The growing womb pushes the muscles apart, making them longer and weaker. The NHS says pelvic floor exercises and exercises for the deep tummy muscles can help close the gap.

NHS advice is to avoid sit-ups, planks and high-impact exercise at first, as well as heavy lifting and straining on the toilet. Contact a GP if there is still an obvious gap 8 weeks after birth. They can refer you for physiotherapy and specific exercises. Ask sooner if pain or another physical problem is bothering you.

Make movement comfortable

If you’re breastfeeding, ACOG suggests feeding or expressing before exercise so full breasts are less uncomfortable. Wear a well-fitting, supportive bra and keep water to hand. UK guidance says you can be active while breastfeeding.

When to pause and ask for advice

Stop what you’re doing and call 999 now (UK), 911 (US), or your local emergency number for new chest pain or severe difficulty breathing. Stop what you’re doing and get an urgent medical check now for new breathlessness, or pain and swelling in one leg. Contact your maternity service or GP (UK), obstetric clinician (US), or local urgent service.

Stop exercising if it hurts. Talk to your GP or health visitor in the UK, your obstetric clinician in the US, or your local doctor or midwife about muscle or joint pain that won’t go away, leaks or a heavy feeling in your pelvis. After a caesarean or a complicated birth, ask before you start anything hard.

You could ask: “Walking is comfortable, but I leak when I try to jog. Can I have my pelvic floor checked and get a plan for getting back to it?” Ask what to try next and which symptoms would mean the plan needs to change.