Exercise After Childbirth- How, What, Why and When

1. Exercise After Childbirth: How, What, Why and When? Can you imagine growing a human for nine months — your organs squeezed, your posture shifted, and your pelvic floor doing overtime like it’s supporting a basketball — then birthing that basketball (either vaginally or via surgery) and asking yourself, “When can I go back to running?” It sounds ambitious, but it’s one of the most common questions new mums ask. Unfortunately, clear, evidence-based answers are hard to find. So, let’s explore what the research actually says about returning to exercise and sport after childbirth. The Postnatal Reality: Challenges Beyond the Obvious After giving birth, women face an incredible range of physical and emotional challenges — far beyond what most imagine. These can include: ● Musculoskeletal injuries such as perineal tears, pelvic floor dysfunction or caesarean incisions ● Sleep deprivation, which increases injury risk ● Breastfeeding demands, which can sap energy needed for recovery ● Mental health changes, from baby blues to postnatal depression ● Financial and time pressures, as 24/7 caregiving takes over daily life And of course, these come on top of the usual barriers to exercise, like motivation and weather.

2. That’s why a woman’s return to exercise after birth must be guided professionally, sensitively, and based on evidence. Should Mothers Return to Sport After Having a Baby? The short answer? Yes — but with care. A recent scoping review identified 33 different international guidelines on postnatal return to sport (RTS). While the advice was inconsistent, one thing was clear: exercise has enormous physical and psychological benefits for new mums. The challenge is making sure that return is safe and individualised. When Is It Safe to Return to Exercise? Most guidelines suggest returning to sport “when medically safe”, often around 6–8 weeks postpartum following a medical review. But what does “medically safe” actually mean? Every woman’s recovery is different. For instance: ● A mum with an uncomplicated vaginal birth may recover faster than ● A mum who’s had a Grade 3 perineal tear or a caesarean (a major abdominal surgery). That’s why physiotherapists and other clinicians must work alongside obstetric teams, using a biopsychosocial approach — addressing both the physical and mental aspects of recovery.

3. Screening Before Returning to Sport Before giving the all-clear, a thorough screening should take place. Only a small number of the reviewed guidelines mentioned this, but it’s crucial. Screening should cover: ● Musculoskeletal health ● Pelvic floor function ● Mental health ● Sleep and fatigue ● Nutrition and breastfeeding Some validated tools include: ● RED-S Clinical Assessment Tool ● Edinburgh Postnatal Depression Scale ● Tampa Scale for Kinesiophobia ● Pelvic Floor Disability Inventory (Short Form) A GP or obstetricianshould always provide medical clearance before returning to sport. Common Barriers and Misconceptions Even after clearance, many new mums hesitate. They might fear: ● Re-injury or aggravating existing issues ● Leaking or pelvic heaviness ● Fatigue and lack of confidence

4. Breastfeeding can also alter energy balance, and without adequate nutrition, mums risk Relative Energy Deficiency in Sport (RED-S) — which can lead to fatigue, poor recovery, and injury. Understanding these barriers helps clinicians tailor recovery plans that are realistic and empowering. General Guidelines for Returning to Exercise When ready, new mums should start gently and progress gradually. Early recommendations: ● Begin pelvic floor exercises as soon as possible ● Include light walking or mobility work As recovery progresses: ● Aim for 150 minutes of cardiovascular exercise per week ● Add two strength sessions weekly (start with body weight, then progress to weights) The goal is consistency, not intensity. A slow and steady build ensures a safer and more sustainable return to fitness. The truth is, postnatal return-to-sport guidelines are often vague. Every mum’s experience is unique — shaped by her body, her birth, her mental health, and her goals. That’s why the most important step isn’t following a rigid plan — it’s working with a clinician who understands postnatal recovery and can guide the process safely and compassionately.

5. Ready to Return to Running or Sport? If you’re unsure how to begin exercising after childbirth, you don’t have to figure it out alone. Book a telehealth appointment with Dr Brea Kunstler, physiotherapist and run coach at Performance Medicine. Dr Kunstler specialises in helping new mums rebuild strength, confidence, and fitness safely — whether your goal is walking the pram around the block or getting back to running.