Ok this may be a slightly controversial topic, so I am going to start with a disclaimer. This is an opinion piece, NOT prescriptive advice, and I encourage everyone to make a decision that feels right to them and their own body on this. With that being said, I have over eight years of experience training women before, during, and after pregnancy, after vaginal births and cesarean sections, and of all different fitness backgrounds. I have trained with and collaborated with pelvic floor physical therapists and discussed this topic with them, and here’s how I feel…
First things first I’ll just say it: most women are disappointed by their six week checkup. If you don’t know what the six week checkup is, it’s what we call the one and often ONLY postpartum checkup a woman gets after one of the most intense (and often surgical) changes her body will ever go through. Oftentimes this checkup with your OB is primarily to check the incisions and any stitching that may have occurred, and you may have a cursory screening for PMADs (Perinatal Mood and Anxiety Disorders). Your provider may check your blood pressure and weight, and if your uterus is back down to normal size. After this appointment your doctor will generally “clear” you to return to exercise and sexual activity.
The question is: HOW should you return to exercise? What type of exercise is best? Can you go right back to your old workouts or do you need to do anything in particular? What about physical therapy? Typically after a surgery wouldn’t you require physical therapy? Are you ACTUALLY ready to have sex again when you still feel like your insides are falling out? What if it hurts when you do?
As you can see, this appointment often leaves women with more questions than answers. The fact is, OB’s have an incredible amount of responsibility and demand on their time, and they also don’t always get extensive training on musculoskeletal conditions related to pregnancy. Therefore, it’s really helpful for the patient to take it upon themselves to be educated about the changes that have occurred in their body, or to find a professional who can help. (Hi! I’m here for you!!)
For instance, believing that it’s unsafe to do exercises of any kind for six straight weeks, then suddenly one day you have the green light to do bootcamp, running, or anything else you want doesn’t make very much sense – does it?
But unfortunately without guidance, a lot of women jump back into exercise much too quickly after their postpartum appointments, thinking they are “safe” to do so because they are no longer bleeding, and they end up hurting themselves by doing too much too soon.
I often liken it to building a house: you can’t paint and put up shutters if you haven’t first built a strong foundation. And building the foundation is something I believe you can start before six weeks postpartum, if you feel inclined to do so.
What matters most here is listening to your body. Your body may call you to rest for those first six weeks, and really take that time to heal and recuperate. Especially if you experienced trauma to the pelvic floor, serious tearing, blood loss, or a C-section, it is normal to want that six weeks to rest. I want to reiterate that. Taking those six weeks to rest if that feels good to you is TOTALLY fine. There is no rush in this process, and in fact, the more slowly and intentionally you approach your return to movement, the better.
On the flip side, for people who were extremely active throughout pregnancy and are used to that level of activity, six weeks can feel like an eternity. Especially if you had a smooth birth with little damage, you may be feeling ready to get moving again as early as two to three weeks postpartum. That’s incredible! If this is you, my advice is to start moving, but to do so super intentionally.
What I really recommend to anyone craving movement early on postpartum is a graduated approach. See my diagram below:
Imagine climbing up that slope cautiously. Start with short five minute movement breaks. Focus on diaphragmatic breathing, mobility of the spine and ribs (cat cows, side stretches, child’s pose), maybe some gentle core and glute activation.
Walking is also an incredible way to gently wake up the pelvic floor from slumber. Make sure you start with shorter intervals of 10-15 minutes, especially if you are still feeling sore in the pelvic floor or around any incisions. As you draw closer to six weeks, you can lengthen your walks to closer to 20-25 minutes at a time.
Additionally, as you draw closer to six weeks you may want to do more in your strength workouts. You may feel pulled to jump back into arms and legs because it feels good to do, but remember – we want to build the foundation of that house. Breathwork, core work, stabilizers like the glutes, and postural muscles like the upper back are all the best places to focus on early on.
It’s also super important to pay attention to how you feel during and after your movement sessions. Watch out for pain or heaviness in the pelvic floor, pain or soreness around incisions, and general achiness or fatigue. All of these can be signs that you need to pull back slightly and ease your way in a bit more.
My last tip for those wishing to return to exercise before 6 weeks postpartum: get guidance from someone who knows their stuff. Even though I am pro movement, I also recognize that this is a precarious time, when risk of injury is slightly higher than usual. That’s why I mean it when I say START SLOW. Get help selecting exercises from a prenatal and postpartum specialized trainer, or a local yoga or pilates instructor with experience in this space. Getting back to movement quicker is not worth it if you are going to end up injured.
If you don’t know who to turn to for help, and are itching to move but want to do so safely, I’ve got you. I created a 10-week Postpartum Recovery Program that is safe to start as early as 4-6 weeks postpartum. I have education on special conditions like C-section recovery, pelvic prolapse, diastasis recti, and more, and my entire program is pelvic floor physical therapist approved. You’ll also get a one on one consultation with me! If you want to know you’re in good hands with your recovery, I hope you’ll give it a try. Two week free trial, cancel any time.
And at the end of the day, remember this: you are the expert in your own body. Listen to your intuition, it’s more powerful than you think!
Julia Neto is a prenatal and postpartum fitness expert with over eight years of experience in the space, and the founder of Her Move Wellness. She's a NASM CPT, CES Prenatal and Postpartum Corrective Exercise Specialist, NASM Certified Nutrition Coach, and Birthsmarter Pro. Julia's passion is helping women feel strong, secure, and informed in their bodies through pregnancy, postpartum recovery, and beyond. Her Move Wellness is a platform that makes safe and effective fitness affordable and accessible for women across the globe.
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