Exercise after giving birth: a complete guide to getting back to it safely and serenely

Getting active after pregnancy is not simply a matter of aesthetics or weight loss. Exercise after birth plays a fundamental role in muscle recovery, pelvic floor strengthening and the prevention of back pain. But it goes beyond the physical: it also helps combat baby blues, the risk of postnatal depression [1] and supports better sleep quality. Getting back to exercise thus becomes a true ally for the overall health of new mothers.

General medical recommendations

According to the French High Authority for Health: "Physical activity can generally resume 4 to 6 weeks after a vaginal birth; at least 8 to 10 weeks after a caesarean birth or after a birth requiring an episiotomy" [2]. 

Canadian guidelines, for their part, recommend "beginning or resuming exercise within the first 12 weeks following birth in order to support mental health" [3]. 

Finally, according to the Ministry of Sport: "After a vaginal birth, resumption generally takes place after 6 weeks. It can be prepared from the 4th week onwards with brisk walking, climbing stairs, etc." [4]. 

This time allows the body to heal and to regain a minimum level of hormonal stability. It is not, however, a universal rule, as every woman recovers at her own pace. Alongside this, taking a postpartum food supplement multivitamins also helps to support healing and sustain the body. If you have been taking a pregnancy food supplement rich in collagen beforehand, this may help your body recover more quickly. 

Differences between vaginal birth and caesarean section

After a vaginal birth vaginal birth, recovery may be quicker if the perineum has not sustained significant tears. After a caesarean section, however, the abdominal scar requires additional rest to avoid any complications. In both cases, a consultation with your doctor is essential before resuming exercise, particularly to assess the caesarean scar.

Signs that the body is ready

Certain signs may be cause for concern: persistent pain, urinary leakage, bleeding, or a feeling of pelvic heaviness. If any of these symptoms persist, it is better to delay returning to exercise. Conversely, improved energy levels, a reduction in pain, and the absence of complications are all positive signals.

Studies suggest it can improve mood, support cardiovascular fitness, help with weight management, promote weight loss, and reduce depression and anxiety [5].

Muscle strengthening and pelvic floor rehabilitation

Postnatal exercises help strengthen the abdominal and pelvic floor muscles, which are often weakened during pregnancy. 

Before resuming more intensive physical activity or sport after giving birth, it is strongly recommended to undergo pelvic floor rehabilitation to restore tone. This group of muscles, arranged in a diamond shape around the urethra, vagina and anus, needs to be strengthened to help prevent urinary leakage and prolapse (organ prolapse) in the long term [6].

Improved posture and reduced discomfort

The weight of the baby and the physical changes that come with it can cause tension in the back and shoulders. Exercise helps rebalance posture and reduce lower back pain whilst strengthening the abdominal muscle belt [7].

Mental wellbeing and emotional balance

Physical activity after birth releases endorphins, also known as "happy hormones", which play a key role in managing anxiety and postnatal depression [8]. It is also a moment for yourself, which can be beneficial for your self-confidence.

The French High Authority for Health states: "All physical activities can be undertaken — the most important thing is to choose activities you enjoy and can easily practise close to home" [9].

Gentle exercises to get started safely

Gentle physical activities such as walking, deep breathing, and stretching are excellent ways to reconnect with your body without straining the muscles. They are particularly beneficial for cardiovascular fitness, promote better blood circulation, and help to tone the body. 

Sports to prioritise for gradual progression

After pelvic floor rehabilitation, gentle activities such as postnatal yoga, swimming, or Pilates are particularly well suited. They strengthen the core and improve flexibility. Cycling can also be a good option. 

For swimming, it is the same as for bath after childbirth, this is possible 4 to 6 weeks after delivery, barring contraindications (caesarean section, tears, etc.).  

Recommendations from the ministry responsible for sport 

Here are the recommendations from the ministry responsible for sport [10].

Side plank 

• Lying on your side, rest on your elbow (directly below the shoulder)
• Lower legs bent, back straight, tummy drawn in
• Lift the hips to form a "plank", keeping the shoulders, hips, and knees aligned
• Hold the position for 10 seconds then gently release
• Repeat 10 times

Abdominals

• Kneeling on the floor, hands and knees apart, back straight, gradually contract the abdominal muscles as if "drawing the navel in", using each inhalation to gently tighten the tummy
• While maintaining the abdominal contraction, lift the knees off the floor and support yourself on your feet in a "plank" position, back straight, head level with the shoulders, remembering to breathe normally
• Hold the position for 10 seconds and gently release
• Repeat 5 times

Pelvic floor and adductors

• Lying on your back, bring your feet towards your buttocks and place a ball between your knees
• While drawing in the lower abdomen, gradually squeeze the ball with your legs. Remember to breathe deeply
• Hold the pressure for 10 seconds then release
• Repeat 10 times
• These exercises will help rehabilitate the pelvic floor and improve its tone. 

Glutes and abdominals

• Lying on your back, bring your feet towards your buttocks, then lift the hips and hold this position for 10 seconds, continuing to breathe regularly
• The abdominals should be contracted, and the support on the floor should come from the shoulders, not the neck
• To engage the adductors, you can also bring the knees together in small pulses
• Gently release
• Repeat 5 times

Activities to avoid in the first few months

High-impact activities such as running, involving jumps and vertical impacts, skipping, and intensive gym sessions should be avoided in the first few months. They place too much strain on the pelvic floor and abdominal muscles too soon.

Medical consultation and postnatal follow-up

A postnatal appointment with your healthcare professional (doctor or midwife) is essential to check healing and the condition of the pelvic floor.

The importance of pelvic floor rehabilitation

Before resuming any physical activity, pelvic floor rehabilitation is an essential step. It helps prevent urinary leakage and protect the abdominal wall.

Listening to your body and respecting your own pace

Every woman has a different pace. Trying to go too fast can lead to injury and frustration. Patience is the key to a successful recovery.

Risks associated with returning to exercise too soon

Returning to physical activity too quickly after giving birth can lead to pelvic organ prolapse, chronic pain and worsening of scars.

Situations requiring particular attention

Mothers who have experienced a severe tear, a postpartum haemorrhage or a complicated caesarean section must allow a longer recovery period and follow specific medical monitoring.

If you experience pain, bleeding, high blood pressure, excessive fatigue, etc., please take particular care. These situations are contraindications to resuming exercise — you should always seek advice from your healthcare professional. 

How to avoid injuries and complications

A proper warm-up, a gradual progression and regular check-ins with your doctor will help to avoid the majority of complications.

Regular physical activity, particularly aerobic exercise in breastfeeding women, has been shown to improve maternal cardiovascular health without affecting milk production and composition or infant growth [11].

Canadian guidelines state that if the baby does not feed well immediately after the mother's physical activity, she should feed her baby beforehand, delay breastfeeding until an hour after exercise, or express milk before exercise so it can be used after the activity [12].

Here are a few tips to support you: 

• With a newborn, time is limited. It is better to choose short, regular sessions — even 10 minutes a day — rather than long ones. Every minute counts.
• Every woman should adapt her activity to her own feelings, energy levels and lifestyle.
• Having the support of your partner, family or a specialist coach can make it easier to get back on track and avoid giving up.

Returning to exercise is an essential step towards regaining energy, strength and wellbeing. Every woman must move at her own pace, listening to her body and seeking appropriate medical guidance. With patience, perseverance and gentleness, getting back to exercise becomes a valuable ally on the path to a new kind of balance. A good post-partum nutrition is also essential.