Oct 21, 2011 6:56 PM
After you have a baby, what's realistic for getting back in shape? How soon can you exercise and how much can you do to safely lose the weight before junior starts pre-school? The answer: One size does not fit all.
Determining when a woman can resume exercising after giving birth is highly individual, says Robert O. Atlas, MD, OB/GYN, chair of the department of obstetrics and gynecology at Mercy Medical Center in Baltimore. "Some women take a month to walk normally while others are back on the hiking trail with their baby within two weeks," he says.
In general, the healthier you are entering the pregnancy, the quicker the recovery time.
The type of delivery you've had also determines when you can resume exercising. "A cesarean delivery requires more time to recover than a vaginal delivery," Atlas says. Traditional teaching says to wait six weeks after delivery before exercising, but some women can safely return to exercising before this time.
"It also depends on the type of exercise," Atlas says. For example, returning to high-impact routines such as running or sports requires more caution than resuming or starting a yoga or Pilates class.
What you can do postpartum depends on what you did prenatal, says Bonnie Berk, MS, RN, HNB-BC, author of The Motherwell Eternity Fitness Plan (published by Human Kinetics in 2005). "If a woman was fit before she got pregnant, she can start exercising earlier than a woman who did not."
Pregnancy affects every system of the body, so it can take four to six months to heal completely, Berk says. "Complicated births involving lacerations and bigger episiotomies, for example, may delay a woman's ability to exercise safely."
Once your doctor gives the OK to start exercising, take into consideration the number of hours you need for sleep, care for your family, and everyday activities before pushing yourself too hard. "Exercise should not be another stressor," Berk says.
Start with simple walking 10 to 15 minutes, three times a day, Berk says. The American College of Obstetricians and Gynecologists (ACOG) recommends starting with easy exercises and slowly building up to more challenging moves.
Focus on core strength and balance training as well, says Fabio Comana, MS, exercise physiologist with the National Academy of Sports Medicine (NASM). "Use caution, however, as joints (particularly knees) may be lax due to changing hormonal levels." If your knees feel unstable when exercising, dial it down until your muscles become stronger.
Traditional programming for cardio and resistance should follow later, Comana says.
Starting a regimen that you're likely and able to keep up is more important than starting right away after delivery, says Sara Morelli, MD, board certified OB/GYN at University Reproductive Associates in Hasbrouck Heights, N.J. "Walking is a great way to start getting back in shape and prepare for more vigorous exercise later on," Morelli says.
Breastfeeding should not affect a mother's exercise regimen, and moderate exercise in lactating women does not affect the quantity or composition of breast milk, Morelli says.
And, according to the ACOG, moderate weight reduction during breastfeeding is safe and does not compromise infant weight gain, Morelli says. "Women should also wear a bra that fits well and gives plenty of support."
For women who engage in intense exercise, the lactic acid levels (a byproduct of exercise) may not be palatable to the baby, Morelli says. "If baby doesn't feed as well right after exercising, consider feeding the baby right before exercising. This also likely makes the breasts more comfortable during exercise."
Also keep in mind it may take awhile for you to see the results of your weight loss efforts if you're breast feeding. Your body holds on to your weight if you're breastfeeding, Berk says. "It may take six to seven months before you see the results of your weight loss efforts."
If you're just starting out, you may want to consider programs such as StrollerStrides and BabyBootCamp, which allow moms to exercise with their babies.
They're good for two reasons, Atlas says. "They get you out of the house for adult interaction and allow you to spend time with other women in your same situation." Many programs are available on DVD as well.
If you're home with the baby, try doing your own thing. Wii, Dance Revolution, and fitness DVDs burn calories in fun ways. "Have fun. Dance around the living room with your baby," Berk says.
Starting a vigorous resistance training exercise program too soon may result in complications, including prolapse, where the uterus drops, Atlas says. Increased abdominal pressure during heavy lifting increases the risk. "Typically, this occurs most often in thin women who smoke and have poor nutrition," Atlas says. If you've had a laceration or episiotomy and you do too much too soon, the episiotomy could break down. Fortunately, if that happens, it won't likely turn into a long-term problem, he says.
When abdominal muscles are cut during cesareans, they remain very tender postpartum. If you exercise too vigorously and disrupt this area, it could lead to a hernia, Atlas says. "If you're doing abdominal exercises and this area feels tender, wait another few days or a week and try again."
If you were on bedrest for a long time prior to delivery or had twins or other multiples, this may also impact your body's ability to exercise. Do it slowly, adding intensity over a long period of time. Always consult with your doctor first if you had these special circumstances.
Call your doctor if you experience bleeding of more than one pad an hour or if you feel dizzy or weak, Atlas says. "It could indicate dehydration or anemia. Plus, if you lost a lot of blood from the delivery you may be fatigued more than usual for up to six weeks."
If you developed preeclampsia (symptoms of which include high blood pressure) during your pregnancy, your doctor may also recommend delaying exercise for awhile, Atlas says.
Overall, when you can begin exercising and how much you can do depends on the birth experience and complications that may have occurred, Atlas says. "Keep in mind, too, the importance of rest. When the baby's sleeping, you should be sleeping."
You may be concerned about fitting back into your clothes, but it's important to find a balance. "It's not just about the physical but also the emotional," Berk says.