Exercise After Childbirth: When to Restart and Where to Begin

Baby is six weeks old, your jeans do not close yet and a friend suggests going back to Tuesday's fitness class. The urge to move and the fear of overdoing it: exercise after childbirth brings out both at once. Good news, there is a logical order, and it starts well before the gym.

The principle fits in one sentence: first walking and the pelvic floor, then strengthening, and only after that impact sports such as running or jumping. Timelines vary with your birth, your fitness beforehand and how your body recovers. Here are the benchmarks from French, British and Quebec guidance, and the signs that say "not yet".

When can you restart exercise after childbirth?

Move gently, as soon as you feel able. The Quebec guide Mieux vivre advises resuming gradually "as soon as possible", if there is no contraindication, starting with walking and pelvic floor exercises. Exercise in the strict sense comes afterwards.

In France, the national health authority (HAS) places the return to sport, after a compulsory postnatal check-up and medical advice:

• around 4 to 6 weeks after a vaginal birth;
• around 8 to 10 weeks after a caesarean.

It adds that women who were very active before and during pregnancy can often restart sooner. Mieux vivre, for its part, places the return to moderate or vigorous activity within the first 12 weeks, once the perineum or the scar has healed well and if the bleeding does not increase with effort.

In Morocco, the right moment to ask is the postnatal check-up with your gynaecologist, at around 6 to 8 weeks. The HAS makes it compulsory before any return to sport: if yours takes place after 6 weeks, the return to sport waits for that appointment.

The stages, week by week

The physiotherapy departments of several British hospitals follow a progression drawn from the 2019 guidance on returning to running. Here it is, to adapt to your recovery:

These weeks are benchmarks, not targets. The Bath hospital leaflet insists on one point: listen to your body and do not force it at each stage. To place yourself within your overall recovery, our article on the first six weeks postpartum details what happens in your body.

Why the pelvic floor comes first

Because the pelvic floor has been stretched by pregnancy and often by the birth, and it absorbs every impact. Running or jumping with a pelvic floor that is still weak risks leaks or a feeling of something dropping.

The NHS advises working the pelvic floor every day, with long squeezes (held up to 10 seconds) and quick squeezes, up to 10 repetitions of each, at least 3 times a day. The exact movement and the debate over routine rehabilitation are explained in our guide to pelvic floor rehabilitation.

The HAS keeps floor-impact activities (running, tennis, trampoline, jumping) for when the pelvic floor has regained normal function. In France, rehabilitation is prescribed at the postnatal visit; other countries offer it only when there are symptoms. If you have leaks, do not stay alone with it: our article on urine leaks after baby explains what can be treated.

Which abs after childbirth, and which to avoid?

At the start, forget crunches. The NHS asks you to avoid sit-ups, planks and impact exercises in the first weeks, as well as lifting heavy loads and straining on the toilet. These movements raise the pressure in the belly and push downwards, onto a pelvic floor and abdominal wall that are still fragile.

Instead, begin with the deep abdominal muscles: lying on your side, breathe out while gently drawing in the lower belly, tightening the pelvic floor at the same time, then release. Core work then progresses, around 6 to 8 weeks, according to the British progression.

If your abdominal muscles stay apart in the middle of the belly (a diastasis), the next steps are done with a physiotherapist. The home test and the question of the girdle are in our article on the belly after pregnancy.

Exercise after a caesarean: what changes

The timeline is longer, because a caesarean is abdominal surgery. The HAS speaks of 8 to 10 weeks before a return to sport, against 4 to 6 after a vaginal birth. The stages stay the same, simply shifted: walking and breathing first, then pelvic floor and deep abdominals, then strengthening.

The pelvic floor matters after a caesarean too: nine months of pregnancy put it under strain, even without pushing. Scar massage can start around 6 to 8 weeks, once it is well closed, according to the British progression. Scar care and signs of infection are detailed in our article on the caesarean scar.

Walking, swimming, running: which sport and when?

Walking is the queen of the return. You can do it from the first days, it lengthens week after week and becomes brisk walking around 6 to 8 weeks. With baby it is even simpler: in the pushchair, back straight as the NHS reminds us, or in an ergonomic baby carrier for short outings. Our guide to choosing a pushchair helps you find a model that handles pavements well.

Swimming waits for the bleeding to stop and the scar to close, generally between 8 and 12 weeks according to British physiotherapists. Running is not recommended before 12 weeks, and only if the readiness tests go without symptoms. You then increase duration before intensity, with a "couch to 5K" type programme.

In the longer term, the World Health Organization recommends that women after a birth do at least 150 minutes of moderate activity a week, mixing endurance and muscle strengthening. Thirty minutes of brisk walking, five days out of seven, is enough to reach it.

Signs you are restarting too early

Your body warns you. The Bath hospital leaflet asks you to stop and talk to a professional if you have:

• leaks of urine or stool during or after effort;
• a feeling of heaviness in the vagina, as if something were dropping;
• lower back or pelvic pain;
• a belly that bulges in the middle during effort.

Mieux vivre adds a useful benchmark for the first weeks: if your bleeding increases after activity, you have done too much. Go back to the previous stage. And if your main goal is to lose weight, our article on losing weight after birth gives a realistic pace, compatible with breastfeeding.