Between 6-8 weeks you are likely to have a postnatal check-up with your GP. At this appointment, you can be medically cleared to return to more strenuous physical activity. If any ongoing symptoms are affecting your ability to be physically active, please discuss these with your healthcare provider and seek onward referral if appropriate.
You should be aiming now – as able – to increase your physical activity levels towards the guidelines set by the U.K.’s Chief Medical Officer and the World Health Organisation.
By 8 weeks it is usual to be passing less and less lochia and any ooze from scars should also be reducing. If you have stopped passing lochia, and your scar is dry, you can now start swimming or water-aerobics as well.
C-Section scar mobilization via massage techniques can be commenced at this stage and is best done under the guidance of a pelvic/women’s health physiotherapist.
i. Continue pelvic floor muscle exercises, progressing core and pelvic stability exercises and walking.
ii. Continue gradual increase in the intensity of low-impact aerobic activities e.g. power-walking, using a cross-trainer or static-bike.
iii. Start adding resistance to strengthening exercises
Start with light weights and progress gradually, aiming for a maximum effort intensity of 7-8/10 during activity. If you don’t know how many repetitions of an exercise to do, consider stopping when you think you could only do three more repetitions in a set, and repeat for 3 sets according to that rule. It doesn’t matter if the number of repetitions you can do per set reduces.
If you are doing something like yoga or barre, start increasing the range of motion through which your joints move, add resistance and take care not to overload your core or pelvic floor.
There are particular postnatal group-exercise classes during which you can where your baby in a sling. Make sure you have no increased vaginal heaviness, abdominal pain or “doming”/ “coning” whilst baby-wearing, or during the activities. If you do, wait a few weeks and continue your rehabilitation before trying again, or seek the guidance of a pelvic/women’s health physiotherapist.
It is currently advised that you should not be returning to impact-based activity at this stage in your postpartum recovery. [1] As such, continuing to increase strength and power through strength-based exercises is your best bet before returning to activities such as running and jumping beyond the 12-week mark.
As a general rule, if any exercise brings on discomfort within the low back, abdomen or pelvis, reduce the resistance/weight used, or the range of motion moved through, by half and try again. If you are unsure where to start with postnatal resistance or weight training, consider working with a level 3 qualified pre/postnatal qualified personal trainer, and ensure they are aware of modifications required for healing tummy gaps and pelvic floor dysfunction.
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