For active women, returning to pre-pregnancy fitness levels is an important milestone.
Yet despite the desire by millions of people to get back to the gym after childbirth, there are few hard and fast rules as to what constitutes a safe and gradual return to sport/exercise. A paucity of scientific studies and a surprising lack of consensus on the length of the postpartum period makes it tough to create a firm set of exercise recommendations specific to the physiological changes that occur during pregnancy and childbirth.
People with an uncomplicated delivery generally get medical clearance to work out after their six-week checkup. But the body typically takes longer to recuperate, with vaginal and cesarean births reporting distinctly different timelines for recovery. Hence the difficulty when it comes to establishing a one-size-fits-all set of return-to-exercise guidelines.
Then there’s the numerous physiological and psychological challenges related to those first few months of motherhood, including lack of sleep, weight gain, urinary incontinence and breastfeeding, any one of which can be a barrier to establishing a regular workout routine after delivery.
Studies of elite athletes who returned to rigorous training and competition early in the postpartum period suggest a predisposition to injury. But there’s little consensus — beyond the initial six weeks after delivery — about how soon is too soon and how vigorous is too vigorous. To make matters worse, most trainers, physicians and coaches have limited knowledge and experience with postpartum athletes, which makes a safe return to exercise more trial and error than informed actions.
Based on the struggles elite athletes have finding adequate support when trying to reestablish their athletic career after giving birth, it should be no surprise that the average fitness enthusiast is left largely on her own to figure out a return to exercise plan. Yet despite the lack of science-based recommendations, there’s no shortage of “experts” who feel compelled to weigh in with their opinion. Citing concerns about too much exercise hindering milk supply or adding to the already exhausting postpartum period, there’s plenty of misinformation surrounding the reintroduction of exercise after childbirth.
Science doesn’t back the common belief that intense exercise reduces milk production or its nutritional value. A 1994 study, published in the New England Journal of Medicine, monitored the milk supply of 33 women, six to eight weeks postpartum, 18 of whom participated in an aerobic fitness program five times a week for 45 minutes per session. Compared with the control group of 15 non-exercisers, there was no difference in breast milk concentration or the breast milk intake or body weight of the infants of the exercising mothers.
What was different between the two groups is that the women in the exercise groups were more fit than the postpartum mothers who didn’t exercise.
That doesn’t mean the road back to exercise is easy. A large number of women experience stretching and separation of the abdominal muscles (think of a set of six-pack abs separating lengthwise down the middle) during pregnancy. When the muscles separate, abdominal weakness and pelvic pain is common, especially during the first few months postpartum, which can make certain exercises uncomfortable or difficult to perform.
Urinary incontinence is another byproduct of pregnancy and delivery that can complicate a return to exercise. Estimates suggest over 50 percent of women suffer from some kind of weakening of the pelvic floor after a vaginal delivery, which when combined with any type of high impact or ballistic type movement can cause mild to moderate leaks that aren’t easily disguised during a fitness class or workout.
Then there are the other challenges new mothers face, like hormonal changes, lack of spousal and/or family support, sore breasts and separation anxiety/guilt, all of which add to the myriad of physiological and psychological changes that occur during and after childbirth. Yet despite a tough first few months, many women have successfully navigated the sometimes rocky road back to the gym. Several elite athletes have had greater career success after the birth of a child, which proves that pregnancy and childbirth are only a hiccup in the pursuit of fitness and exercise goals.
The key to successfully returning to the gym is a slow start, focusing on simple abdominal and pelvic-floor strengthening exercises to start and progressing back to a normal exercise routine in small, manageable steps over the course of 12 months.
In the absence of expert-driven guidelines on the do’s and don’ts of postpartum exercise, common sense is your best guide. Give yourself permission to take days off, don’t ignore fatigue and back off if you feel discomfort or pain. Above all, don’t give up. Exercise is a proven energy and mood booster, two very valuable outcomes for postpartum mothers faced with a myriad of physical and emotional ups and downs. Set small goals and build on small successes.
And while it may be too late for first-time postpartum mothers, research suggests that mothers who stay active and exercise during their pregnancy have fewer physical challenges when returning to the gym. A strong, fit body recovers faster from the rigours of childbirth.
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