A Guide to Safe Exercise During Pregnancy and Postpartum - Erin's Inside Job

A Guide to Safe Exercise During Pregnancy and Postpartum

A few weeks ago I finished getting my postpartum corrective exercise specialization, which is something I decided to pursue on top of my personal training certification after I had Miles. I thought that the misinformation about exercise and pregnancy was bad when I was still pregnant, but I soon realized that after I had him there was virtually nothing available and postpartum is actually a much more important time for you to have the correct information about exercise.

I sourced for your questions on Instagram and I’ve covered as many as I could below. I combined repeats or similar themes, but if you still have any questions after this, feel free to send me a DM on Instagram or an email at erinsinsidejob@gmail.com.

None of this information is meant to scare or dissuade you from exercising before, during, or after pregnancy. It’s simply to provide you with the correct information and empower you to take care of yourself during those times. I tried to get as detailed as I could, but some of these could be entire posts in themselves, in which case I provided links and resources for you to learn more.

Even if you’re pregnant and haven’t had a baby yet, read the entire post because I go into some more detail about topics discussed in the pregnancy section such as diastasis recti and breathing techniques. Plus, it will help you understand about what to do in the postpartum phase of life. If you find this post helpful, please share it to help educate others and correct misinformation. I hope it helps! ๐Ÿ™‚

Pregnant

A good rule of thumb for exercising while pregnant is that you can continue to do what you were doing before you got pregnant (with some modifications as discussed below), but it’s not the best idea to start something completely new. If you were spinning for exercise prior to getting pregnant, for example, you can continue that, but if you were doing nothing, it’s best to start slow and not jump into something like circuit or high-intensity interval training. Make sense?

I wrote this post about pregnancy myths when I was pregnant, so make sure to read that one as well because I cover a couple things not in this post.

It’s actually easy to continue exercise throughout pregnancy because as the baby grows, he/she stabilizes everything. The harder part is postpartum because that stabilizing force is gone and you have to teach your body to reactivate muscles that have been stretched and weakened for 10 months.

I discuss some modifications below, but at any time if something doesn’t feel good or correct, stop it.

How much core work during pregnancy is ok?

I got a lot of variations of this question, so I’m going to address it here in one answer. The recommendation is to stop isolated core work (planks, crunches, etc.) after 16 weeks. Now this is a general recommendation and helpful if followed. That being said, every body is different and you may be able to continue longer than that, HOWEVER, you have to ask yourself why you want to. There are many exercises that indirectly work the core as you do them – squats, deadlifts, overhead presses, etc. — which are more beneficial to you anyway in preparing for birth.

It’s also recommended that front loading exercises (pushups, planks, bent over rows, etc.) are stopped as your belly gets larger because they put all the pressure on the linea alba (the connective tissue that runs down the midline of the abdomen and separates as the baby grows). Weakening of this tissue by frequently putting undue pressure on it can lead to diastasis recti (discussed in postpartum section below) and potential hernias postpartum. It’s also important to avoid things like pullups/chinups/exercises where you are hanging because it puts a TON of stress on that same area. Even if I had wanted to, I wasn’t able to hang from a bar pretty early on because it felt like my stomach was ripping apart.

How to reintegrate in the second trimester when you’re too tired or sick in the first?

First of all, don’t beat yourself up if you need to rest during the first trimester due to morning sickness, fatigue, etc. Your body is acclimating to growing another human and you need to listen to it. Generally, the second trimester is when people start feeling like themselves again, and it’s fine to pick up where you left off. You may need to get back into things a little slower due to an extended rest period, but muscle memory is a great thing and you’ll be back to yourself in no time.

Best exercises while pregnant/Number one to prepare for birth

Some of the most important are breathing, squats, and deadlifts.

Strength training helps you prepare for the physical toll that birth takes on your body. In my own experience, after laboring for 16 hours (one of those hours being constantly pushing as hard as I could) I was taken in for an emergency c-section and had to transfer my own body weight from one stretcher to another after they had completely numbed my lower body to prepare for surgery. Obviously if you don’t have the strength to do it, someone will help you, but I remember thinking how grateful I was to have built up my strength before and during my pregnancy.

Haven’t started exercising is it too late?

It’s never too late! As I mentioned above though, don’t jump into anything well beyond what your current activity level is. Walking, swimming, and other low impact exercises are great starting points. As I would suggest with any one, strength work is so important. Start with bodyweight exercises and then start adding weight or resistance to make things a little harder.

Need to change workouts in first trimester vs rest of pregnancy?

As I mentioned in my first trimester recap, my body told me when I needed to change things. During the first trimester, it became really hard for me to catch my breath, which caused me to slow things down and cut back on the number of workouts I was typically doing in a week. Everyone is different in how they respond to pregnancy, but there’s no need to change your routine in the first trimester unless things like morning sickness, fatigue, or other symptoms cause you to.

You should start feeling more like yourself in the second and third trimesters, but a growing stomach and changes in body positioning will require you to make modifications based on what you’ve been doing.

How to make sure not pushing too hard when pregnant when you feel good

If you feel good, it’s probably ok to keep doing what you’re doing (keep in mind the modifications and recommendations above). As you near the end of your pregnancy, you may want to back off just a bit depending on your activity level. Just because you can sprint at 10.0 on a treadmill in class doesn’t mean you should. Running puts a lot of pressure on the pelvic floor and over time can weaken it even more.

Anything to do while pregnant to help postpartum

Work on your strength and breathing techniques. Understanding how to properly breathe to connect with and activate your abdominal muscles is key to being able to get everything working together again. Pilates is really great for learning the proper breathwork before and after baby. You can also see a pelvic floor therapist while you’re pregnant to learn things to do to ensure an easier transition postpartum.

Postpartum

I got a bunch of questions about postpartum exercise, which is great. My number one recommendation to you after having a baby is to see a pelvic floor therapist. In case you’re not familiar, I wrote a detailed post about what it is and what to expect which you can find here. Pelvic floor therapists are trained and specialized in diagnosing and treating issues related to pregnancy (and non-pregnancy related ones such as sexual dysfunction and anatomical issues). Your OB is not. I repeat — YOUR OB IS NOT. OBs are great at knowing how to deliver a baby, but not in how to deal with the trauma that your body goes through and how to heal it.

Every woman should wait more than six weeks to start exercising again. I guarantee most women will ignore this advice, but a more practical amount of time to wait is around 3-4 months. This doesn’t mean that you can’t do low impact movements such as walking, yoga, Pilates, or moving in general, but don’t jump right back into running or other high-intensity/high-impact exercises until you’ve waited at least that long.

Your body also produces a hormone called relaxin during pregnancy, which causes ligaments and joints to loosen as you prepare for labor. This remains postpartum as well and continues being produced as long as you breastfeed. If you don’t breastfeed, your body eventually stops producing this hormone, but as long as it remains, your body remains more susceptible to injury and change as you return to exercise.

The test by your OB to see if you are able to exercise again is having you do one kegel at your six week checkup. That’s it. I was also cleared for exercise at my two week checkup (which I had because I had had a c-section), and it wasn’t until I asked for clarification that she mentioned “oh, low impact walking and things.” I was still struggling to get off the couch at that point, so I knew I was in no shape to exercise. This also explains why I have seen women throughout my teaching career back in the gym so soon after giving birth.

Your doctor does not know your exercise routine — you do — so don’t expect them to know what you can and can’t handle. Be smart about returning to exercise. Women itching to get back to things will ignore common sense and get right back to the gym after that two or six week clearance, but I’m telling you that your body needs more time to heal than that. Even if you feel fine in returning, issues can arise up to a year or more postpartum if you’re doing things with weights your body isn’t ready for or with improper breathing that puts too much pressure on your pelvic floor.

My main tips about getting back into exercise postpartum would be:

  • learn proper breathing techniques (Pilates is amazing for this)
  • see a pelvic floor therapist even if you aren’t having issues
  • wait 3-4 months
  • start back slow and modified
  • manage your expectations
    • if you previously exercised at a high level, understand that coming back will be difficult mentally. Postpartum fitness is different than before you were pregnant. It will take time to work back to where you were, and you may not get to that place at all, which you need to be prepared for. It’s understandable to be frustrated, but don’t give up.

If pelvic floor therapy isn’t covered by your insurance or you don’t have insurance, my suggestion would be to at least go to an initial evaluation and pay out of pocket. This way you can figure out what’s going on, learn exercises to do, and get answers to any questions you may have (think of any before the appointment). Ideally, it’s best to continue to go, but if you have financial limitations, at least go once and learn as much as you can.

When can I push myself w cardio after a c-section?

Recovery from a c-section takes longer than recovery from a vaginal delivery. I recommend waiting those 3-4 months as I mentioned above before easing back into things. Start slow with the cardio and see how your body tolerates things. If running is your cardio, it can be especially hard to jump back into because many things have changed during pregnancy — your structural alignment, ligament laxity, and even gait — so you want to make sure you’re strong enough to handle a return to running. I recommend listening to the podcast I list below to see if you’re able to handle it.

Is it ever too late?

It’s never too late, but the greater the amount of time that passes, the longer it may take to correct any issues. You can always make improvement on things, which is great news, but the earlier you start working on things, the better.

How to know when itโ€™s ok to do planks, push ups, etc.

This is going to be different for everyone based on your fitness level and how much your body has healed. I asked my pelvic floor therapist to test for me, which I understand may not be an option for everyone. It also depends on whether you have diastasis recti postpartum and if so, how severe.

When attempting again, always start in a modified position to test. That means push ups and planks on your knees to get a feel for how your core is feeling. As you get stronger, you can decrease the incline until eventually you’re back to doing them the proper way. If you have diastasis recti, try and work with either a pelvic floor therapist or personal trainer who specializes in postpartum care because even those cases are unique in how to approach treatment.

What are some postpartum recovery/pelvic floor resources?

I earned my specialization from Dr. Sarah Duvall, who is a physical therapist, personal trainer, and extremely passionate about this subject. The course contained SO MUCH information and tons of videos and case studies. There are a variety of free resources on her website and YouTube channel, and I would highly recommend them over random google searches. Here are some links (everything is free):

Here is a link to her articles that also answer a ton of questions.

Instagram accounts that are very helpful:

Podcast about how to safely return to running:

Had baby 3 months ago cant get back into exercise/How to get energy to exercise

Three months feels like a long time — I know — but I promise you it isn’t. Take this time to enjoy being with your baby and letting your body heal. It’s also a huge mental shift to become a mother, so take the time you need to acclimate to that. Start small and do what you can – walks, carrying your baby around, etc.

RE: energy – I think this is a question that can apply to anyone — pregnant or not. It depends on where you are postpartum — are you three months, six, nine, or more than a year? I’d say that if you’re still within the six month range, give yourself a break. You’re learning how to deal with keeping another human alive, your sleep is interrupted, and when you look back on it, these are the times where you can really work on connecting with your child.

If you have the mental desire to get back into exercise and are past that six month mark, yet unable to find the motivation to do so, ask yourself why. Is motherhood still a little chaotic and you’re still adjusting to that? Are you getting enough sleep? Are you eating foods that help your energy levels or hurt them? As with any person who is struggling with finding the energy to exercise, ask yourself those questions. Sometimes it takes a mental push to get yourself there and back into a habit. Start with what you can because any movement is better than zero.

Where to begin for postpartum strength/if you weren’t before baby/limited time

Begin with your breath. I know I sound like a broken record, but you need to get back in touch with muscles that have been stretched and weakened for 10 months. If you start adding weight or stress to those muscles before they’re ready, you can cause further complications. If you’re not able to work with a postpartum trainer or Pilates class, watch some of these videos on proper breathing technique.

From there, ease into bodyweight movements or resistance training. If you’re unable to get to a gym or class, buy some resistance bands on Amazon (I have these) and work on slowly rebuilding strength at home.

My stomach is bigger, will planking help?

Planking can actually be worse for you in this situation because anything that puts pressure on the rectus (front) abdominal muscle can actually make your stomach stick out more if you don’t have proper core control. Learning proper breathing technique and activating those transverse abdominal muscles helps draw things back together like a corset.

How to check yourself and deal with diastasis recti

Diastasis recti (DR) is the separation of the abdominals at the linea alba. One of the most common questions women have is how to prevent this. It should be noted that DR is UNAVOIDABLE in pregnancy because the abdominals NEED to separate to accommodate a growing baby. What women are typically referring to is when this separation remains postpartum. There are different types of DR as you can see from the image below:

(source)

Depending on the type and severity of the separation, different protocols are recommended. Here is an important video about what DR is and how you may be able to fix it:

WHAT HELPS THE PEE

First, it’s important to note that leakage is very common among postpartum women, but that does not mean that it’s normal. Every case of leakage can be fixed through the appropriate treatment.

There can be several different reasons why you’re experiencing leakage, and those are best determined by seeing a pelvic floor therapist. Leakage can be caused by a pelvic floor that is too loose OR too tight, so it’s important to figure out why it’s happening for you. If your pelvic floor is too tight and you try to do a ton of kegels to stop the leakage, you’re actually doing the complete opposite of what needs to be done and will make the problem worse.

Basics immediately postpartum

You can start learning and using breathing techniques immediately postpartum, and they’re really the most important thing to help reactivate your core muscles. The transverse abdominal muscles are super important in bringing everything back together again and these are a set of muscles that really require breathing to activate and control. Crunches, planks, and other core movements work different muscle groups in your core, and while all of them are important, the TA muscles are what you want to focus on postpartum.

No leaking during movements at 6 mos, any reason to still go slow?

It depends on how long you’ve already been exercising postpartum and what kinds of movements you’re doing. For instance, I never had any leaking issues, but ended up with a minor bladder prolapse around 6 months postpartum because I was using weights that my pelvic floor wasn’t quite ready for. I know not everyone does Crossfit workouts with heavy weights, but that was my experience.

I would still go easy on things and work your way back up. If you’ve been working at a certain level for awhile and feel like you are ready to try a little more, try it out and see how your body responds. If you feel like you need to, back off again. It’s important to test the body by progressively loading more, but always back off if you feel like it’s too much. Stay at that level for a couple more weeks, then try again.


I hope this helps and again, please feel free to reach out with any more questions!

3 comments on “A Guide to Safe Exercise During Pregnancy and Postpartum

  1. Thanks for this amazing and informative post. So much info! I’ll need to bookmark it and come back a few times. thank you!

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