Exercise After Birth: A Gentle, Safe Guide to Getting Active in Your First Postpartum Year

In short: After a vaginal birth you can start walking and gentle stretching as soon as you feel able; high-impact exercise such as running is delayed until after the six-week check, as it is after a caesarean. The later aim is at least 120 minutes a week of moderate to vigorous activity, spread over 4 days or more. Stop if you have dizziness, severe abdominal pain, heavy bleeding or pain in the wound.

Getting back to movement after having a baby is a journey — not a race. Whether you’re recovering from a vaginal birth or a Caesarean section, gentle, well-timed physical activity can support your body and mind through the first year postpartum. Below is a patient-friendly guide covering moderate-to-vigorous activity, lifestyle changes, warning signs, and sleep — and how Dr. Najeeb Layyous and his team can support you along the way.

Moderate to Vigorous Intensity Physical Activity

• Many women find that easing back into activity — even more vigorous activity — within the first 12 weeks after childbirth can genuinely help support mental well-being.

• Start with early, light-intensity movement, and progress to moderate activity gradually, once any surgical incisions or perineal tears have healed and vaginal bleeding doesn’t increase with activity.

• Good nutrition and staying well-hydrated help prevent low energy levels during this demanding time.

• If you’re breastfeeding, try nursing or expressing milk before your exercise session — this reduces breast fullness and can make movement more comfortable.

• A healthy sleep routine goes a long way in supporting your mental health during the postpartum period.

• Try to limit sedentary time to 8 hours or less per day, including no more than 3 hours of recreational screen time, and break up long periods of sitting when you can.

• Daily pelvic floor exercises are recommended to help reduce the risk of urinary incontinence and support pelvic floor recovery.

Key Factors Your Doctor May Discuss With You

Before increasing activity intensity, it helps to consider these common barriers:

o mental health status (including eating disorders)

o musculoskeletal pain

o lactation status

o perineal tears and surgical incisions

o relative energy deficiency in sport

o sleep quality

o fear of movement or injury (kinesiophobia)

o pelvic floor and abdominal wall function

o availability of social/emotional support

When to Pause: Contraindications to Heavy Exercise

• If you have any conditions that may make exercise risky, please speak with your doctor before beginning or continuing physical activity after childbirth.

• In most cases, vigorous activity can still be part of your routine, though some modifications may be needed until a medical condition or symptom resolves.

• Please be aware of these relative contraindications in the first year postpartum, which may call for a medical check-in:

o dizziness or light-headedness during exercise

o severe abdominal pain

o Caesarean section with worsening symptoms (for example, surgical incision pain)

o unstable high blood pressure (>140/90 mmHg)

o kidney disease

o eating disorders or malnutrition

o postpartum cardiomyopathy

o fractures or other significant musculoskeletal injuries

o vaginal bleeding not associated with menses

o haemodynamic instability

o acute systemic infection accompanied by fever, body aches, or swollen lymph glands

o calf pain or swelling indicative of DVT

o breathing difficulties at rest that are not resolved with medications

o excessive fatigue suggesting anaemia or low energy availability

o new onset of chest pain, discomfort, and other angina-like symptoms with exertion

o loss of consciousness for any reason

o neurological symptoms (for example, ataxia or muscle weakness that affects balance)

o other medical or physical conditions that may affect your ability to be physically active

• Try to avoid rushing back into vigorous activity, especially if you’re experiencing musculoskeletal pain, incisional pain, heavy vaginal bleeding, pelvic floor dysfunction, or mental health concerns.

Lifestyle Changes

Exercise

• If there are no contraindications, staying physically active offers meaningful benefits, including helping to prevent and reduce depressive symptoms.

• Aim for an individualized, gradual progression toward at least 120 minutes of moderate-to-vigorous physical activity per week — this can include brisk walking or cycling, along with a mix of aerobic exercise and resistance training — spread across 4 or more days a week.

• Begin with early mobilisation through light activity, such as gentle walking, and progress to more vigorous exercise once surgical incisions or perineal tears have healed sufficiently and vaginal bleeding doesn’t increase with activity.

• Make sure you’re getting enough calories and fluids (your needs are higher while breastfeeding) to avoid low energy availability, which can affect recovery, bone health, menstrual cycles, sleep, and energy levels.

• Your breasts will change size quickly during breastfeeding, so a well-supportive bra is important to minimize movement during exercise. Avoid tight or binding bras, as these can affect your milk supply.

Advice [2]

• Regular activity can help you relax, stay fit, and feel more energetic.

• It can also support your body’s recovery after childbirth and may help prevent postnatal depression.

• If you had a straightforward birth, you can start gentle exercise as soon as you feel ready — this could include walking, gentle stretches, and pelvic floor and tummy exercises.

• It’s usually best to wait until after your 6-week postnatal check before starting any high-impact exercise, such as aerobics or running.

• Your lower back and core abdominal muscles may be weaker than before, and your ligaments and joints stay more flexible for a few months after birth — so there’s a higher risk of injury during this time.

• Listen to your body, pace yourself, and make sure you’re also getting plenty of rest.

Sleep

• Prioritizing quality sleep supports your mental health, physical and cognitive recovery, and helps reduce the risk of injury.

• A healthy sleep hygiene routine — such as avoiding screens before bed and keeping your bedroom dark, cool, and quiet — can help support your mental well-being as a new mother.

Every recovery journey is different, and it’s always a good idea to check in with your doctor before increasing your activity level after birth. If you have questions about your recovery, exercise, or overall postpartum wellness, Dr. Najeeb Layyous and his clinical team are here to support you at every stage of your journey.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist