Pre and Post Pregnancy / August 16, 2012

Part 1: Everything You Should Know About Post-Pregnancy Fitness and Activity

By Charles Platkin, PhD

Part 1: Everything You Should Know About Post-Pregnancy and Activity

What’s changed about my body since having a child that can affect my ability to exercise?

According to Erin O’Brien, creator of the exercise DVDs Prenatal Fitness Fix and Postnatal Rescue, “The lower back has such a strong curvature (lordosis) after birth that it really affects the rest of the body. Once the hormone relaxin has stopped after you’ve given birth, your joints start to tighten up again. This is a really dangerous time for women because they’re structurally not ready to do the things they did before getting pregnant. But the good news is, you can re-teach the body to go back to its pre-pregnancy way of moving. The funny thing is, some women have no problem putting themselves back together, while others (myself included) find it really a bit baffling.”

Can you really get back your old body, or even a better one? If so, how long should it take?

Experts agree that you can still have a great body post-pregnancy. “It’s not too much to expect to get your body back. I know many women even after multiple children who gain better bodies than they’ve ever had. You do want to give your body some time to do this. Don’t expect miracles. It took you 40 weeks to stretch that body out, so you need to give it time to bounce back,” says Lisa Druxman, M.A., the creator of Stroller Strides and author of Lean Mommy (Center Street, 2007). “Most women need to adjust their expectations, because it isn’t going to happen overnight and it takes discipline and time (both of which are in short supply for most new moms!). So, expect to see results in an average of three to 12 months,” says Jennifer Wider, M.D., author of The New Mom’s Survival Guide (Bantam, 2008). However, a recent review from Cochrane Library suggests that women who return to their pre-pregnancy weight by about six months have a lower risk of being overweight 10 years later.

What are the benefits of postnatal exercise?

“Exercising after having a baby can speed a woman’s recovery time after delivery. In addition, a recent article in the journal Birth reveals that exercise can lessen the severity of depression in new moms. Other studies have also suggested that exercising can lower a woman’s chances of postpartum depression. Postnatal exercise can also increase a woman’s energy, which can be quite beneficial when she is exhausted by all the changes in her life,” says Wider.

How long should I wait after giving birth before working out?

Most physicians recommend waiting six weeks to resume a traditional exercise program. But that doesn’t mean that you have to wait to begin any exercise, says Druxman. She suggests doing the following:

  • Begin pelvic floor rehab immediately: Kegels
    • Weeks 0-2: Focus on gentle activity; begin pelvic tilts and small abdominal crunches.
    • Weeks 2-4: Short walks, duration 5-15 minutes.
    • Weeks 4-6: Maintain routine, don’t rush progression.

She also suggests a few limitations such as avoiding strenuous exercise. Stop if the exercise causes pain, dizziness, fatigue or an increase in bleeding. Avoid wide squats and big lateral movements.

What about if I’ve had a C-section — when can I start exercising?

C-sections are major surgeries, and the body needs time to heal. But, “Due to the advances in surgical procedures, many women who have undergone C-sections are ready to resume intermittent walking or other gentle forms of exercise by two weeks postpartum,” says Druxman. “At six weeks, providing the woman feels up to it, many experts recommend isometric exercises, a form of resistance training that involves contracting muscles without moving the joints,” adds Wider.

What are Kegel exercises?

“Kegel exercises are one of the most important things a woman can do after giving birth. These are designed to strengthen the pelvic floor muscles, which have often been overstretched during delivery. To do them: Squeeze the muscles that you would use to stop the flow of urine. Hold for three to five seconds and then let go. Repeat 10-15 times at least three times per day,” says Wider.

Are there any other “get your body” back exercises? The Bridge: “You lie down on your back and articulate your spine slowly off the ground, starting at the base (your tailbone). You do this movement until your hips are completely off the floor. Then you slowly lower the pelvis back to the ground. Great for re-teaching the muscles of the lower back and abdomen to fire correctly,” says O’Brien. Keep your arms on the floor, legs together, feet on the ground, don’t use your arms to help.

What’s one of the best exercises women can do to get back in shape?

Walking. And even better, walking with a stroller. A study by the American Council on Exercise showed that using a stroller burned approximately 18-20 percent more energy at 3 mph and 3.5 mph than walking without a stroller (on average 6.2 calories per minute and 7.4 calories per minute respectively).

What should I look for when purchasing a stroller for fitness?

Make sure the stroller has a leash to avoid its escaping, hand brakes to control pace, a safety harness for the baby, inflatable tires (at least 16-inch wheels), three wheels (not four) and a light frame. You can expect to pay $300 or more. Additionally, Druxman recommends:

  • A front wheel that swivels. A static wheel is great if you’re moving in a straight line. But if not, you have to lift the back wheels to turn. Swivel wheels strain the wrists less because you can turn the stroller with one hand. A good model also has wheels that lock.
  • Adjustable canopy that will block the sun.
  • Padded harness for your baby.
  • Adjustable handles or appropriate height so you don’t hunch.
  • Room for storage.
  • Shocks. There has recently been concern that a baby can get Shaken Baby Syndrome(SBS) from bouncing in the stroller. SBS is a term that describes symptoms of brain injury that may occur from the impact of shaking a baby or small child. Choose a model with shock absorbers to keep the ride smooth.
  • Strong brakes to prevent rolling when you park. A foot brake is more dependable than a handlebar brake.
  • Tires with treads to handle all kinds of terrain. No-tread tires are better for flat, smooth roads.

Are there any good arm exercises for building up strength to tote the baby around?

“A ‘rowing’ motion is probably the best postpartum upper-body exercise out there. It strengthens the rhomboids, lats and rear delts, which helps with posture and alleviates upper-back pain. It will also tone up the biceps,” says O’Brien. If you don’t have access to a rowing machine, get some exercise bands or tubes. “They can be used for virtually any body part. Loop the tube through a stable object such as a staircase or fence. Sit and do rows for upper-back and arm strength. Stand on the tube to do bicep curls,” says Druxman.

How do I deal with a baby and try working out — it seems overwhelming?

“A new mom should schedule her workouts like she does her kid’s doctor’s appointments,” says O’Brien. You can also buy or rent fitness DVDs, take long walks, do yoga while your baby sleeps. It’s about setting priorities.

Should a new mom walk with the baby in a sling or BabyBjorn?

“It should not pose much risk to a new mom’s back, but she shouldn’t overdo it,” says Wider. However, beware of your posture, adds Druxman. She suggests that if you are using a sling you should regularly contract your shoulder blades by bringing them together as if you were squeezing a pencil. Also, keep your shoulders down and back, your neck long and relaxed.

Does exercise affect your milk production?

According to Druxman: “Research has shown that regular, sustained, moderate-to-high-intensity exercise does not impair the quality or quantity of breast milk. There are a small number of cases of exercise-induced increases in the lactic acid concentration of breast milk resulting in decreased infant suckling due to a sour taste. However, this problem was encountered only when the exercise was intense enough to result in lactic acid accumulation in the muscles. Typically, aerobic workouts have not been shown to affect infant suckling behavior. Also, feeding the baby prior to exercise should negate any potential problem, as any lactic acid that does accumulate in the breast milk should clear in 30 to 60 minutes post-exercise. As long as infant suckling behavior is normal, neither high-intensity exercise nor lactic acid accumulation pose any risk to mom or baby. Other research has examined the effect of exercise on immunoglobulin A (IgA), a major immune defense component, and found that breast milk IgA levels were slightly reduced after exercise. Whether this reduction could compromise infant is not known, but the authors of the study recommended breastfeeding before exercise to eliminate the risk of any potential adverse effects. Research investigating the effects of exercise on the mineral content of breast milk found no significant effect.”

Tags:  fitness health post pregnancy

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