Fitness Focus
Copy-and-Share by Brad A. Roy, Ph.D., FACSM, FACHE
Postpartum Exercise
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D
uring the past 25 years, numerous research studies
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have demonstrated significant benefits associated with
physical activity during and after pregnancy for both
mother and baby. Pregnancy triggers numerous physical changes
in a woman’s body, including water retention and weight gain.
After delivery, many women have difficulty returning to their
prepregnancy weight, with an average weight retention of 0.5 to
3.8 kg (1.1 to 8.4 lbs) noted per pregnancy. Nearly 20% of women
are more than 5 kg (11 lbs) heavier 6 to 18 months after delivery.
Postpartum weight retention is related to inadequate physical
activity, poor nutrition, and, in some cases, excessive weight gain
during pregnancy. Across time, weight retention, physical
inactivity, and poor nutritional choices can lead to a myriad of
chronic health conditions, including obesity.
POSTPARTUM EXERCISE CHALLENGES
Whereas the postpartum period is a critical transition time,
return to a physically active lifestyle, balanced diet, and a
gradual shedding of extra weight can be challenging. For some
women, the challenges of motherhood manifest themselves in
physical and mental symptoms. Fatigue, frequently
compounded by sleep disturbance, is common and present in
nearly two thirds of women 12 months after delivery. The lack
of vigor associated with fatigue, newborn sleep and feeding
schedules, and the strain of balancing other family duties and
work schedules can be overwhelming and can negatively affect
mom’s ability/desire to exercise consistently. In some women,
these factors lead to significant levels of depression.
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VOL. 18/ NO. 6
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BENEFITS OF POSTPARTUM EXERCISE
Although conventional wisdom might suggest that exercise will
accentuate fatigue, the opposite is generally true. Prolonged
rest/physical inactivity actually contributes to fatigue, promotes
increased body weight and decreased vigor and mental acuity,
and increases the risk of developing future chronic health
conditions. An emerging body of evidence indicates that
exercise in the postpartum period:
) Reduces fatigue and increases vigor
) Improves mood states and mental acuity
) Improves fitness
) Promotes return to prepregnancy weight
) Decreases the risk for developing future chronic health
conditions
) Provides important mom time and social interactions
RETURNING TO PHYSICAL ACTIVITY
After delivery, women are encouraged to increase their physical
activity gradually. Because the delivery course varies and many
of the physiological changes of pregnancy persist for 4 to
6 weeks, the process should be individualized. Generally,
moms experiencing an uncomplicated delivery will receive a
green light to exercise at 4 to 6 weeks after delivery, whereas
those healing from a cesarean delivery may need additional
time. Women who consistently exercised before pregnancy and
remained physically active throughout pregnancy often can
return to their prepregnancy routines fairly quickly once given
medical clearance. Those who were inactive previously and
those who adopted a sedentary lifestyle during pregnancy will
need to start and progress more gradually. Following are some
tips to consider when restarting your exercise routine:
) Obtain medical clearance from your provider before beginning.
) Begin with low-intensity activity and gradually increase to
moderate efforts.
) Women who are competitive athletes and those doing
higher-intensity training before pregnancy usually can return
to those levels fairly quickly.
) Consider using an accelerometer or pedometer, with an initial
focus on gradually increasing daily steps rather than focusing
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 on weekly time accumulation (150 minutes or more of
moderate-intensity exercise each week generally is recommended).
Start where you are and add 500 to 1,000 steps each week,
with a goal of building to 10,000 steps per day.
) Light to moderate exercise does not seem to affect breast
milk, whereas high-intensity exercise can increase lactate
levels in milk. Consider breast feeding or pumping just
before exercising to both feel more comfortable when you
are exercising and avoid the increase in lactate associated
with high-intensity workouts.
) Gradually introduce various resistance training and/or
functional training activities. A personal trainer can provide
guidance on appropriate activities, form, and intensity.
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Copyright © 2014 American College of Sports Medicine. Unauthorized reproduction of this article is prohibited.
There are numerous benefits to being physically active after
pregnancy, including a reduction in fat mass, increased lean
mass, improved lipid profiles, and enhanced mental outlook
and acuity. All women are encouraged to begin exercising as
soon as medically appropriate and to remain physically active
throughout their lifetimes.
Brad A. Roy, Ph.D., FACSM, FACHE, is an administrator/executive director
at Kalispell Regional Medical Center. He is responsible for The Summit
Medical Fitness Center, a 114,800 sq ft medical fitness center located in
Kalispell, Montana, and a number of other hospital departments.
VOL. 18/ NO. 6