Postpartum
Dec 12, 2024
Asumi Ohgushi PT, DPT
5 min
During pregnancy, you were probably far too in awe of the growing baby in your belly to worry about what was happening to your poor abdominal muscles. After birth, it can be hard to ignore how weak they feel. From months of strain and pressure to labor and delivery or a Cesarean surgery, your abs have been through the wringer and need both TLC and rehabilitation.
Regaining strength and functionality in your postpartum belly muscles can be key to avoiding persistent diastasis recti abdominis (DRA) as well as low back or pelvic pain. Restoring your abs can also help protect your pelvic floor and prevent common postpartum pelvic floor symptoms like bladder leaks or pain with sex.
To help you get started, our expert PTs recommend the following 5 gentle and generally safe exercises that most birthing people can try as soon as they feel up for it after birth — yes, even if you're still in the hospital or birthing center.
In general, the very early postpartum is a time to prioritize rest and recovery. No matter how you gave birth — vaginal or cesarean — your body needs to prioritize healing and reserve what little energy you have left to help you care for your family. Going back to exercise too soon can disrupt your body’s natural healing process and can increase your risk for further injury and a prolonged recovery, which is why you should hold off on most exercises until your obstetric healthcare provider ensures you have fully healed.
That said, there are a handful of safe and specific exercises that will gently re-activate your abdominal muscles and pelvic floor, encourage healing, and set a perfect foundation for you to return to exercise, once you have been cleared to do so by your OBGYN (usually at your 6-week checkup).
While it can feel really good to get moving, if you notice any of the following, it may indicate that you are still doing too much and your body needs you to slow down:
The following postpartum exercises may not seem like much, but they are powerful rehabilitation exercises that you won't want to skip as you slowly return to movement and exercise after birth.
This exercise can almost feel too gentle and basic to be doing something, but we promise diaphragmatic breathing is the one exercise everyone should be doing, and it is the first step you should safely take when re-establishing a connection with your abdominals in the early postpartum.
During this exercise, your focus should be on properly releasing and expanding your lower ribs and abdominals with every inhale, to reduce a common postpartum breathing habit of expanding your upper chest with every inhale. This breathing pattern is not only a sneaky way to use up your precious energy, but it’s taking your abdominals on a free ride, instead of encouraging them to be an active part of the breathing process, like they are supposed to be.
Lie flat on your back in a comfortable position.
Tip: Try to keep your chest still- place a hand on your chest to help you see how much movement is happening there throughout this exercise.
Walking can feel intimidating right after giving birth, but it’s a great activity for a number of reasons:
As soon as you are safely able, start some gentle walking. This can be around your room at first, or you can even sneak down to the cafeteria to snag a well deserved latte. If you need support, take the hospital bassinet cart or your partner with you. Focus on standing tall as you walk, particularly if you have had a belly birth.
Pregnancy will stretch your abdominal muscles to their very max, and contribute to diastasis rectus abdominis, and core muscle weakness. After birth, these muscles can feel difficult to connect with and activate when you need them to, but conscious isometric transversus abdominis activation exercises are the perfect place to start.
The following two deep core exercises will not only help you reconnect this part of your body with your brain, but will help reduce swelling, and gently mobilize new scar tissue if you have had a cesarean. Do one or both.
Start by lying on your back while in bed or on the floor, with your knees bent and feet flat. Your hands can gently rest on your lower belly for a gentle reminder to your muscles who are about to do some work.
Tip: Practice isometrically contracting your deep abdominals and then relaxing them while coordinating the movement with your normal breathing pattern.
Where you'll feel it: Deep in your core and lower belly— the transversus abdominis muscle.
Start on your hands and knees with your hands under your shoulders and knees under your hips.
Tip: Keep your back flat and unmoving for the duration of the movement. Your belly is the only thing that moves, to draw in the deep abdominals.
Where you'll feel it: In your back and deep in your core - the transversus abdominus muscle.
Your pelvic floor will also endure a lot of change and strain during pregnancy and birth, so conscious activation of these muscles is keep as part of your core muscle system, for supporting your spine as well as all of your pelvic functions. But, this multitasking exercise does more than just activate your pelvic floor muscles. Research shows that contraction of the pelvic floor muscles encourages a co-activation of the deep abdominal muscles (without any additional effort!) So by attending to your pelvic floor health, you are also gently exercising your abdominal muscles.
Lie flat on your back or on your side.
Tip: Once this feels easy, try to contract and relax your pelvic floor muscles while breathing normally.
The goal of this move isn't to work up a sweat by burning out your thighs and buns. In early postpartum, the aim is to slow down a super functional movement pattern — one you will undoubtedly do 100 times a day without consciously exercising — in order to consciously engage and properly use your abdominals muscles to support your spine, pelvis (and likely your newborn) as you move.
Sit upright in a chair with your knees hip-width apart and your ankles directly under your knees.
For a more extensive and personalized workout that will help restore your pelvic floor and abdominals — and help you feel good in your body throughout and beyond postpartum — consider seeing a physical therapist who specializes in birth recovery.