Postpartum: Starting to Exercise Again

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Four to Six Weeks Postpartum and Beyond
After the first four to six weeks have passed, you will be feeling much stronger. Your uterus will have gone almost completely back to its prepregnancy dimensions, although it is not likely that you will fit into anything but your baggiest prepregnancy clothing. At this point, your body is almost certainly ready for more vigorous activity. Some women are raring to go by a month postpartum, and others need a full six weeks before they feel really ready to work up a sweat.

If you were highly fit before pregnancy and kept up with workouts during pregnancy, you probably will have no trouble getting back into that groove – and more power to you if that is your plan. Everyone has heard of some woman who did an hour of step aerobics days before she gave birth and who was back training for a marathon within a month postpartum. Feel free to say hooray for her, but don't feel compelled to live up to her example, especially if you were not super-fit before and during pregnancy. You will only end up sore and miserable and, perhaps, even injured. More is not better when it comes to exercise. The key to maintaining a successful exercise program is to find what works for your individual body. For one woman, climbing sheer rock walls is just the thing, while another woman may thrive on a daily slow swim in a warm pool, and yet another feels best when she practices yoga a few times a week.

Not too long ago, fitness guidelines dictated that you needed thirty to sixty minutes' worth of aerobic exercise – the kind that gets your heart pumping faster than 100 beats per minute – three times a week or more to be truly fit. On top of that, the guidelines recommended strength training two to three times a week to strengthen bones and muscles. Who has time for all of that? Certainly not a new mother. Those guidelines caused a lot of people to throw up their hands and give up on working out altogether.

Researchers then began to show that even mild physical activity, such as housework, walking around town to run errands, or gardening could offer the same long-term health benefits as more intense exercise. The notion that physical activity had to be continuous to be effective went the way of the dinosaurs when studies found that a few five- to ten-minute spells of activity throughout the day are just as health-supporting. This is true for women in the postpartum months as well as for anyone else.

Expand your notion of what exercise is. Taking your baby for a walk in a carrier or stroller is a great way to stimulate or soothe the child and improve your own fitness. Try walking to run errands whenever possible, and don't worry about getting your heart rate up to any particular level – that will happen on its own. Carrying your baby will strengthen your muscles and joints, and as your baby grows, so will your strength.

You should incorporate aerobic activity into every day in some way. One day you might do housework on and off throughout the day, walking and lifting and bending for ten minutes at a time. (Backpack baby carriers are great for toting baby while doing housework or cooking.) Another day you might go to the pool for a thirty-minute swim. Walking around in the mall with your baby and a friend or chasing older children around in the park also qualifies as exercise. Even the most irascible baby can be soothed by being gently bounced and rocked to music. Put your favorite music on the stereo, cuddle your baby in your arms, sling, or front pack – and dance!

Of course, if you like to go to the gym and lift weights and hit the treadmill, there is no reason not to do so once those first four to six weeks have passed. Moderate aerobic exercise increases the body's core temperature and makes it easier to burn fat and keep your energy levels high. Aerobic exercise also helps to burn off stress hormones. Overdoing it by allowing your heart rate to stay too high for too long (anaerobic exercise) actually triggers your body to produce more stress hormones, so balance is the key. Take the number 180 and subtract your age. The resulting number is your maximum safe heart rate. I recommend not allowing your heart rate to go above that rate for at least three months postpartum. For example, if you are thirty-five, you would subtract 35 from 180 to get 145, and you should not allow your heart rate to exceed 145 beats per minute. If you are feeling fatigued, it would be better to subtract 10 from that number and, in the case of this example, stay within a range of 125 to 135 beats per minute for the three-month period after you give birth. Work back into your prepregnancy routine gradually, and do not expect your body to be transformed rapidly back to its former state. It really does take about nine months, no matter how hard you work at it – so why deplete your body and stress yourself out needlessly?

In the following sections, we describe some more strenuous exercises you can do to help strengthen your muscles and stabilize your joints, even as you continue doing the stretching exercises described earlier. You can use these strengthening exercises in preparation for more vigorous activities, or simply stick with them over the long term to maintain strength and stability. Try to do them at least three times a week. For the last two exercises discussed, the Seated Rear Dumbbell Fly and the Seated Lat Row, you will need some light, handheld weights. Almost everyone has some of these collecting dust in some corner of the house. Start with three- to five-pounders and work up to heavier ones. These exercises will help to balance the strain of carrying your baby all day. They work the muscles across your upper back and the latissimus dorsi muscles, which run from your lower spine up to your shoulders.

Kegels with Wall Sit
Starting at four to six weeks after the baby is born, if you like, you can try substituting this more difficult version of Kegel exercise for the gentler type described earlier.

Stand with your back against a wall, then step both feet away from the wall about eighteen inches. Slide your tailbone down the wall into a partial squat. This will feel quite intense in your thigh muscles; you may be able to go down only a few inches at first. Hold the partial squat and do fast Kegels, contracting and releasing one to two times per second for fifteen to thirty seconds. Then slide back up the wall, straightening your legs.

Turned-Out Squats with Baby
If you have ever studied ballet, you might remember this as second-position pliés. It is a terrific exercise for strengthening the pelvic floor muscles, inner thighs, and lower back.

Hold your baby firmly against you or put him in a front pack or sling. Stand tall and place your feet as far apart apart as you can comfortably, letting your toes turn out slightly. Bend your knees in the same direction your toes are pointing, actively rotating your thighs out and away from each other. You should feel some effort in the muscles along the back of your hips. Keep your torso straight up and down as you lower your pelvis toward the floor. Go as far as you can comfortably, then come back up, maintaining the outward rotation in your legs. If you can, hold a Kegel gently throughout the exercise. Repeat this five to ten times. If your balance is challenged during this exercise, hold on to a chair back with both hands.

Baby Overhead Press
You probably already do this countless times a day. Hold your baby at chest level and raise her above your head, straightening your arms, then lower her back down. Repeat this ten to twenty times. An optional addition to this exercise is cooing, making funny faces, and giggling with your "airborne" baby!

Leg Slide
This is an excellent abdominal strengthener. Lie on your back with your knees bent and your feet flat on the floor. Press your lower back onto the floor, drawing your belly button down toward your tailbone. Slide your feet away from your body, straightening your knees until you can no longer keep your lower back on the floor, then return your feet to the starting position. You can do this one with your baby sitting on your hips. Do ten to fifteen repetitions per session.

Double Crunch with Baby
Lie on your back on the floor with your baby lying face down on the shins of your bent legs. Hold on to baby and lift your entire upper back off the floor, bringing your knees toward your forehead as you lift your head and shoulders. This is a good chance to start counting for your baby! Go for fifteen to twenty repetitions. When you feel strong enough, add a second set.

Push-ups with Baby
You are probably strong enough now to do "girl push-ups," in which you straighten your body but rest on your knees rather than on your feet. Put your baby down between your hands and give him a kiss with each of your ten to twenty repetitions.

Seated Rear Dumbbell Fly
Hold a weight in each hand and sit in a chair. Plant both feet firmly on the floor and lean your torso forward, so that it rests on your thighs. Hold the weights with your palms facing each other. Keeping your elbows slightly bent, lift the weights up and out to the side, as though you were flapping your wings. Keep the motion smooth, slow, and regular. Repeat ten to fifteen times, and then rest, letting the weights pull your arms down in a stretch. Add a second set when you feel strong enough.

Seated Lat Row
Hold a weight in each hand and sit in a chair. Plant both feet firmly on the floor and lean your torso forward, so that it rests on your thighs. Pull your elbows back along your sides, letting the weights hang down toward the floor. Try to touch your elbows together behind your back. You won't be able to, but if you work in this way, you will be working the right muscles. Repeat ten to fifteen times, then rest. Add a second set when it feels easy.



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excerpted from:

From A Natural Guide to Pregnancy and Postpartum Health by Dean Raffelock, Robert Rountree, and Virginia Hopkins with Melissa Block. Copyright © 2002 by Dr. Dean Raffelock. Used by arrangement with Avery, a member of Penguin Group (USA) Inc.

To order this book visit www.penguin.com. Get a 15% discount with the coupon code FENPARENT.


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