Here’s what you need to know about exercising after having a baby

While most women aren’t quite ready for a rigorous fitness regimen soon after childbirth, for others, staying away from the gym in the postnatal period can be a tough ask—especially if they’ve been working out all through their pregnancy.
Usually, I encourage moms to wait about four to six weeks after giving birth to start a workout routine. I prefer to evaluate my patients prior to allowing strenuous exercise to ensure the safety of the activities and to warn them of potential issues that may occur. 
I’m an advocate for getting women back into a routine when able. The mental break and physical exertion for many moms is welcome and exhilarating. Exercising increases endorphins that help with your mental well-being. Plus, there are a lot of physical benefits of getting your body back in shape.
It’s smart to take thing slow when you start exercising again. Your body went through a lot of changes during pregnancy, and it isn’t typically back to normal until six to 10 weeks post delivery. Not to mention that there’s a higher-than-usual risk that you’ll injure yourself due to your relaxed postpartum ligaments.
Working out after you have a baby is usually a little more challenging than it was before you got pregnant. There are many factors at play that make this difficult, a big one being that you probably haven’t worked out for a while, and it’s tough to jump back in after a break under any circumstance – let alone after having a baby. 
If you’re breastfeeding, the nutritional support needed to make milk is double what is necessary to carry a fetus. Exercising on top of this requires additional caloric intake just to function. Also, with a significant breast size increase, working out can be difficult without the proper-fitting bra. 
As many people realize, after the baby is born, the uterus doesn’t “shrink” back to its normal size (about the size of your fist) immediately. This normally takes six to 10 weeks, depending on the size of the baby and the gestational age of delivery. When working out aggressively after delivery with a still-enlarged uterus, the ligaments can stretch and cause potential issues with prolapse. 
Many women tend to have issues with bladder leakage after giving birth and this can be embarrassing. As the muscles of the vagina need to tighten back up after giving birth vaginally, sometimes carrying a baby can cause bladder strength and vaginal strength issues. Often, this just corrects with time, but leakage could potentially happen in the middle of a workout. 
Another thing to consider is that your center of gravity has changed. During pregnancy, it slowly shifts as your belly grows, then changes again once you give birth – so don’t be shocked if your balance is off. Plus, you lose a bunch of weight at once when you have your baby. That’s a big change that your body needs to adjust to. 
When you do decide to start exercising again, the American College of Obstetrics and Gynecology recommends aiming to stay active for 20 to 30 minutes a day and doing simple exercises that strengthen major muscle groups, like your abs and back muscles, before ramping up to more intense exercises. If you went pretty hard at the gym before your pregnancy or you’re a competitive athlete, ACOG still recommends working up to more intense exercises, versus going all-in at once.
Melissa Goist is an ob/gyn at The Ohio State University Wexner Medical Center.

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