Cleared to Exercise? What New Moms Need to Know About Returning to Fitness
A leading OB/GYN offers guidance to new moms on how to pick up where they left off.
Words By Heather Irobunda, MD
When I was an obstetrician-gynecologist in the U.S. military, I cared for some incredibly strong women soldiers. It wasn’t unusual to see my patients run marathons in their 36th week of pregnancy or ask to work out two weeks after they’d given birth. That’s because I encouraged them to exercise during their pregnancy and then chill out during their postpartum period.
You might be in a similar situation: You’ve recently given birth and are ready to start exercising, like, yesterday. Maybe you’re dreaming of your Peloton Bike or lurking in Peloton mom groups. Or perhaps you’re a few months postpartum and feeling pressure to work out, but your body is telling you it’s still not ready.
No matter what your circumstances may be, I get it. In my clinical experience, I’ve seen how much stress new moms are under to “get back to normal” once they’ve given birth. This pressure is compounded by the general assumption that at the six-week postpartum checkup, your doctor will assess your overall health and ability to return to your exercise regimen, your sex life and your job.
While the six-week checkup is necessary (seriously, please don’t skip it), it can give you the impression that postpartum is over after your doctor gives you the “all clear.” But hear this: Postpartum doesn’t officially end at six weeks. Between lactation, sleep deprivation, hormonal dips and body changes, you’re still very much postpartum at six weeks. What’s more, medical clearance doesn’t automatically mean you’re back to “normal.”
So how do you know when (and how) it’s OK to start exercising again? First, talk to your doctor so you have the information you need to make the decision that’s right for you. However, if you’re looking for a bit of insider information, I’m here to help. Below, you’ll find some factors to consider as you think about resuming your workouts after creating a human.
When Can Most New Moms Return To Fitness?
Provided that you’ve had an uncomplicated pregnancy and delivery, the American Association of Obstetrics and Gynecology (ACOG) gives the green light to start doing some light stretches, walking and other gentle movements as soon as you feel ready, which can occur as early as a few days after delivery. The ACOG recommends that you get at least 150 minutes of moderate exercise a week during the postpartum period. Yes, this can include an easy workout on the Peloton Bike or Peloton Tread (with no incline to avoid added pressure on your pelvic floor). Keep in mind that the intention here is to move enough to get your heart rate up, but not so much that you can’t comfortably speak while getting your glazed donut look.
But before you run toward your home gym, there’s a major caveat to this recommendation: Listen to your body, check with your doctor and give yourself lots of grace.
Many people think they’re ready to jump back into their pre-pregnancy fitness routine because they had a vaginal delivery and didn’t experience significant tearing. But during pregnancy, your body goes through some extensive changes. For example, your abdominal and oblique muscles stretch to accommodate the baby. You produce hormones, such as relaxin and progesterone, which soften your muscles and joints. This increased laxity not only helps your pelvis expand during labor and delivery, but it also means your core muscles might be a bit looser than they were before you had a baby.
In short: Things might feel different, and that’s all right.
Another area of your body that might need extra love and patience is your core. As I mentioned above, your abdominal muscles stretch during pregnancy to accommodate your little one, right? Normally, our rectus abdominis muscles (aka your abs) meet at your midsection, but in two-thirds of women, these muscles separate slightly during pregnancy and postpartum, causing a condition called diastasis recti.
What does that mean? It means your abdomen might bulge a little and you may experience lower back pain and a weakening of the core muscles. This can make it harder to lift heavy objects or even to do gentle yoga. Diastasis recti is relatively common, and if you’re over the age of 35 or carried multiples (or one large baby) to full term, you’re more likely to develop the condition. Still, this isn’t something that exercise can overcome. In some cases, your gynecologist may recommend surgery to repair the separation.
So, even if your pregnancy wasn’t particularly complicated, you still might not feel like yourself physically for quite some time.
If You Had a C-Section, You May Need to Wait a Bit Longer
If you’ve had a cesarean or any birth trauma or complications, it’s best to talk to your provider about when you can resume exercises. As 31 percent of U.S. moms who gave birth by cesarean, or C-section, will tell you, the procedure is no walk in the park. During a C-section, your doctor makes three incisions: through your skin, the wall of your abdomen and through your uterus. In short, a C-section is major surgery, so you’ll need to take the full six weeks—and maybe more—to recover.
At your six-week postpartum checkup, your doctor will probably do an internal exam to ensure that you’re healing. They’ll check your incision and feel your belly to assess any tenderness or pain. At this point, you can ask questions about restarting your fitness routine and what, if any, precautions you should take.
If you’re looking for a few gentle exercises to try while you wait for official medical clearance, talk to your doctor about breathing exercises that involve drawing your belly in toward your spine, which can help strengthen your abdominal walls. I highly recommend checking out Robin Arzón’s 20-Minute Prenatal Basics class on the Peloton App, which shows you how to engage in diaphragmatic breathing, which is when you breathe by contracting your diaphragm.
You can also talk to your doctor about doing Kegel exercises, which help strengthen your pelvic floor muscles, increase bladder control and boost sexual arousal by improving blood flow to the pelvic area.
Postpartum Pain Does Not Equal Gain
I know this advice can seem counterintuitive. We live in a society that says pain is progress but trust me: Pain is your body’s way of telling you to take things slow. In fact, if you’re noticing any discomfort, call your gynecologist. In my experience, an examination and conversation might reveal vaginal tearing that hasn’t quite healed or C-section scarring that needs to be addressed. You’re not overreacting if you chat with your doctor about it.
Also, remember this: Now is not the time to set overly ambitious fitness goals. If you were an elite athlete before your pregnancy, you may ease back into your pre-pregnancy fitness routine more quickly (with clearance from your doctor, of course), but if pre-motherhood, you were a casual indoor cyclist or a champion Netflix binge-watcher, this isn’t the time to start training for the Olympics. Instead, you should begin with gentle exercises like yoga, walking and other non-stressful activities that can help ease you back into your regular routine. And before you resume doing any vigorous activity, be sure to consult with your doctor.
In the Meantime, Consider Revamping Your Fitness Goals
I always say that labor is the work, while parenting...well, that’s the sport. Don’t discount the amount of baby-lifting, rocking, walking and bouncing you do daily. Fitness is more than just PRs and #goals.
That said, there are some solid reasons to make time for physical exercise. The postpartum period is fraught for so many people. Between hormonal fluctuations, new baby challenges and sleep deprivation, your mental and emotional health can take a hit.
The American Psychiatric Association says up to 70 percent of new moms experience “baby blues” (those short-term spells of seemingly inexplicable crying, restlessness and anxiety). One in seven women will show symptoms of postpartum depression, which can be debilitating and last for months. These two conditions are very different, but physical activity can help reduce the severity or risk of depression.
I regularly remind my patients that being active helps you sleep better, boosts your mood and improves your response to stress, even if you’re not dealing with postpartum mood symptoms.
Reconnecting with your fitness community—be it online or in your neighborhood—can help make some of the challenges many new moms face a little easier.
Still, it’s important not to get bogged down with “shoulds” when you’re trying to keep a tiny human (and yourself) safe and healthy. So, if there’s anything you take away from this post, I hope it’s this: Listen to your body as you begin to work out again and give yourself loads of grace as your body adjusts.
Heather Irobunda, MD is a board-certified obstetrician-gynecologist practicing at NYC Health and Hospitals and a paid consultant of the Peloton Health and Wellness Advisory Council. She is invested in sharing her learnings with her online community to improve access to reliable, relatable healthcare information for women. Follow her on Instagram and Tiktok.
This content is for informational and educational purposes only and does not constitute individualized advice. It is not intended to replace professional medical evaluation, diagnosis, or treatment. Seek the advice of your physician for questions you may have regarding your health or a medical condition. If you are having a medical emergency, call your physician or 911 immediately.
Heather Irobunda, MD