Have you ever wondered what types of activities you can do or should avoid in the first 0-6 weeks after you deliver a baby? We often leave the hospital clueless; new baby, new body, new responsibilities.. and we don’t see our provider again for 6-8 weeks!

Let me help you. I’m a mom, a certified personal trainer, and I hold 3 certifications in pre/postnatal training, 1 in mobility training, 1 in biomechanics, and 1 in supporting labor and delivery.

Let this blog post help provide you with some guidelines.

Rest

No matter what type of delivery you had (cesarean section, vaginal birth, or some combination of both), you need rest.

It goes beyond just recovering your pelvic floor or abdominal incision. When you give birth, you also give birth to your placenta, leaving an approximately dinner plate sized open wound in your uterus that is also healing.

So what do I mean by rest?

In the first week or two, you want to accumulate some horizontal time. There is going to be a lot of swelling in your pelvic floor and abdomen. You want to give some time for the acute swelling and trauma to heal. You also want to give time for your uterus to shrink in size and your placenta wound to start to heal.

This also means catching sleep when you can. And that might mean asking your partner, family, or friends to watch the baby/kids while you take a mid-day nap. It might mean sharing night-time responsibilities of soothing the baby to sleep and diaper changes/feedings. Healing happens during sleep.

Asking for help makes you strong and helps you heal, it does not make you weak.

Monitor Your Mental Health

Monitoring your mental health in the early weeks postpartum is just as important as monitoring your physical health.

If you are concerned about your mental health, seek help from your primary care physician, OBGYN, therapist, or someone you trust right away. You deserve to feel better. Some facts from postpartum.net:

Baby blues (period of weepiness and sadness) are common after birth. As many as 80% of postpartum people experience them as hormones change after birth, but they typically resolve in 2-3 weeks.
If symptoms persist or worsen beyond 2-3 weeks, you may be experiencing a Perinatal Mood and Anxiety Disorder (PMAD).
According to PSI, as many as 1 in 7 postpartum people will experience a PMAD anytime in the first year postpartum.

Postpartum Support International 24/7 Hotline 1-800-944-4773

Breathing Exercises

I could talk all day about the importance of breathing on your postpartum recovery. It’s the first exercise you should be performing after you have a baby. It’s how you’re going to reconnect your core and pelvic floor again.

To start, you can try a 360 diaphragmatic breathing lying on your back and on your sides. Take 5-6 deep breaths, breathing in for 6-8 seconds, and then breathing out for 6-8 seconds. You want to do this 2-3 times a day.

This video helps provide some guidance on how to perform a 360 degree diaphragmatic breath:

You can take these breathing exercises up one more level to perform a “Connection Breath.” A connection breath is a 360 degree diaphragmatic breath, but with an added pelvic floor contraction on the exhale.

When you’re first starting out postpartum, you’re only going to perform about a 10-20% pelvic floor contraction. In other words, just a gentle pelvic floor lift. You’re NOT squeezing your pelvic floor muscles as hard as you possible can.

Follow the same exercise prescription for a connection breath:

Start on your back or sides. Take 5-6 deep breaths, breathing in for 6-8 seconds, and then breathing out for 6-8 seconds. On the exhale, perform the 10-20% pelvic floor contraction. Perform 2-3 times a day.

Watch this video on the Connection Breath:

Breathing is the foundation on which the rest of your recovery will build on. The breathing exercises will get more challenging as time goes on over the 0-6 weeks.

Upper Body & Thoracic Mobility

Pregnancy can actually change our spinal curvature as baby grows and our center of gravity changes. These adaptations are a natural part of pregnancy and they take time (more than 6 weeks) and practice to bring back to OUR OWN normal, but we can start to work on it in the first 6 weeks.

Having a newborn also means a lot of time in a nursing, bottle-feeding, and baby holding postures. This usually looks like rounded shoulders and curved upper back.

We want to start some exercises to counter those positions. It might help relieve some upper back pain/tension and will help your spine stay mobile as you recover.

My top thoracic and upper body exercises for those first 0-3 weeks are:

After 3 weeks, you might be able to increase the intensity of some of these exercises with things like:

Walking

Walking is one of the very first things you might feel ready to try, and it’s a great postpartum exercise! Take it easy in the first 0-2 weeks by limiting walks to 5 mins or less, unless you feel amazing after a walk. At this point, you should still be prioritizing rest.

Monitor for increased vaginal bleeding, which means you’re doing too much.

After 2 weeks and if you’re feeling good, then start with 5 minute walks a few times a week. You can gradually increase walking time or pace over the next few weeks. By the end of the 6 weeks, you could easily be walking 30 minutes or more!

After an increase in walking distance or pace, monitor for increased bleeding or increased discomfort / pelvic floor symptoms.

It’s all about taking it slow and making sure your body is prepared for the increased activity.

Strengthen Your Body for Acts of Daily Living

What I mean by strengthen your body for acts of daily living is start to practice some exercises that will support things you are going to HAVE to do in the first 6 weeks postpartum.

You’re going to have to sit down and stand up, so that means practicing squatting. You’re going to have to bend over to pick up your baby, so that means practicing hinging. You’re going to need to rebuild some strength in your core so you can support your spine, so that means gentle abdominal strengthening.

Now this step will really depend on your own personal recovery. Some people feel prepared to start this as early as 2 weeks postpartum, while others aren’t going to feel ready for 6 weeks or longer, and that is OKAY. Whatever you do, take it slowly.

Signs that you started too early are increased vaginal bleeding, pelvic heaviness or bulging feeling, or opening of your incision site.

But if you feel ready in the first 6 weeks postpartum, you could try to add some of the following moves to your thoracic rotation & upper body exercises. Strat with 3 sets of 6-10 reps, 2-3x a week:

Squat to a chair (or a higher surface)
Kneeling hinges
Bridges
Heel slides (do first for a week or two before trying next exercise)
Heel drops

Scar Tissue Massage

If you had a c-section, scar tissue massage is going to be an important part of your recovery. While you shouldn’t start direct scar tissue massage before 6 weeks or before your incision is fully healed, you can still start with scar desensitization and, after approximately 3 weeks, massaging the skin around the scar.

Scar desensitization looks like gently rubbing the skin around the scar with materials of different textures (cotton, tissue paper, a brush, wool, paper towel, silk, etc). This can help bring awareness and sensitivity back to the area around the scar.

After 3 weeks, you could start massaging the skin around the scar (1-2 inches above and below) to help bring further awareness and blood flow to the incision site.

At your 6 or 8 week clearance, you can discuss incision healing and further scar mobilization with your doctor or a pelvic PT.

Set Up an Appointment with a Pelvic Physical Therapist

Whether you had a vaginal birth or a c-section, you can benefit from seeing a pelvic physical therapist.

Pregnancy puts a lot of pressure on the pelvic floor and pelvic organs, so your pelvic floor is not spared, even if you had a c-section.

A pelvic physical therapist can assess muscle tone of your pelvic floor and help you determine what the right rehab plan for your pelvic floor is (do you need more kegels, are you doing them right, do you need more relaxation, etc).

Your body also undergoes physical adaptations during pregnancy (widening of the rib cage, change in spinal curvature, ligament laxity, and gait / postural changes). If you have any pain or discomfort from these changes, a pelvic physical therapist should be able to help provide exercises to address these changes.

You can also see a pelvic physical therapist BEFORE you are cleared! They won’t be able to do an internal exam, but they will be able to determine plenty of things externally and help you with your own personalize rehab.

What to do After 6 Weeks?

Your 6 (or 8) week clearance does not mean you’re suddenly ready to return to the activities that you did pre-pregnancy. Your body went through 40 weeks of adaptations and then child birth, so you’re not going to be 100% healed in 6-8 weeks.

You probably will still even look pregnant for a while! Here I am at 1 week postpartum:

For many women, they don’t feel fully recovered for a year or more! I personally took over a year to fully heal.

After your 6 week clearance is a time to gradually build up strength and re-build your foundation. If you’re looking for a program, I offer three options!!

Option 1 - Self-guided 12 week postpartum mobility program

This program focuses on helping you reconnect to your core and pelvic floor and build strength over 12 weeks, but it is also heavily mobility focused. It’s designed to help focus on correcting some common adaptations created during pregnancy. It’s delivered via PDF with video demonstrations of every exercise.

Find more info & purchase here.

Option 2 - Coach-guided 6 week postpartum program with Mother Loving Fitness, CNY

This program was created by Meghan Barrett (pre/postnatal certified CPT) and myself. It’s a 6 week program designed to help you reconnect your core and pelvic floor and gradually rebuild strength over 6 weeks. It’s delivered online via the TrueCoach app where you can provide videos for feedback and ask questions of us!

For more information or to purchase, click here.

Option 3 - Self-guided 6 week postpartum program with Mother Loving Fitness, CNY

This is the same as the coach-guided program, described above, but it is delivered via a PDF document with links to every exercise. You purchase, we send you the program, then you do it on your own time and own pace.

Click here for more information or to purchase.

First 0-6 Weeks Postpartum

Let’s recap what you can do in the first 6 weeks after you have a baby:

Rest - meaning horizontal time!
Monitor Mental Health
Breath Exercises - 5-6 deep breaths, as often as you want throughout the day
Upper body and Thoracic Mobility - gentle exercises to keep your spine and back mobile
Walking - start slow and build on walking times / pace each week
Strength Train for Daily Acts of Living - help prepare for real life
Scar Tissue Massage - skin & scar desensitization for c-section scar
Set up an Appointment with a Pelvic PT

I am always here for questions and to provide help. You can find me at:

@postpartumstrength on instagram

Or e-mail me at ellen@functionalempoweredfitness.com