Your postpartum workout plan, week by week

After an uncomplicated vaginal birth, you can usually start walking, gentle stretching and pelvic floor exercises within days, as soon as you feel ready. Then build up slowly over about three months, adding strength work and low-impact cardio before anything high-impact like running. After a cesarean or a complicated birth, recovery takes longer, so ask your doctor or midwife when to begin and follow this plan only once they've said it's OK.

Start with your clinician's go-ahead

ACOG, the American College of Obstetricians and Gynecologists, says that after a healthy pregnancy and a normal vaginal delivery it's usually safe to start exercising a few days after birth, or whenever you feel ready. After a cesarean or complications, ask your ob-gyn first. The NHS agrees on gentle exercise, and suggests getting advice at your postnatal check, around 6 to 8 weeks after birth, before high-impact exercise such as running.

Neither says "wait six weeks, then do everything." A 2019 UK guideline on running after birth, written by physiotherapists, argues both ways: six weeks is too long to wait for walking and pelvic floor work, and too early to run.

Why recovery takes longer than six weeks

Each part of your body heals on its own timeline.

• The pelvic floor. These muscles support your bladder, bowel and uterus. The running guideline notes they're weak and injured in most women after birth, and that recovery of the main pelvic floor muscle generally peaks by 4 to 6 months. A 2020 Cochrane review says about one in three women leak urine after childbirth.
• The abdominal wall. In a Norwegian study of 300 first-time mothers, 60% had a gap of at least two finger widths between their long belly muscles 6 weeks after birth, about 45% at 6 months and about 33% at 12 months. Most gaps were mild, and women with and without one reported the same amount of lower back and pelvic pain.
• A cesarean scar. The running guideline cites estimates that the abdominal fascia, the tough layer closed during surgery, has regained only 51% to 59% of its strength 6 weeks after a cesarean, and 73% to 93% by 6 to 7 months.
• Joints. The NHS says ligaments and joints stay more supple for a few months after birth, so stretching or twisting too far carries more risk of injury.

None of this means you're fragile. It means the early weeks are for rebuilding, not testing yourself.

A week-by-week postpartum workout plan

This timeline follows the example progression in the UK running guideline. It's expert consensus, not a tested program. Read each week as the earliest point for that step, not a deadline, and expect steps to come later after a cesarean, a significant tear or stitches.

A few rules hold through every week:

• Short sessions count. ACOG suggests 20 to 30 minutes of activity a day, and says even 10 minutes helps.
• Breathe out on the effort, as you stand up from a squat or lift the car seat, instead of holding your breath.
• Change one thing at a time. Add a few minutes or reps, then hold for a week.
• Stop if it hurts. That's ACOG's advice too.

Pelvic floor exercises: how to do them

The NHS describes the movement as squeezing and drawing in around your anus, as if holding in gas, and around your vagina and bladder, as if stopping the flow of urine. You can do this sitting, standing or lying down, in two ways:

1. Long squeezes: hold for as long as you can, up to 10 seconds, then fully relax.
2. Quick squeezes: squeeze and let go straight away.

Keep breathing normally, and don't pull in your stomach as you squeeze. Build up to 10 of each, at least three times a day.

Here's the honest part. The 2020 Cochrane review, which pooled 46 trials with 10,832 women, found that structured training started early in pregnancy may help prevent leaking. Training started after birth is less clear: a general program for everyone probably doesn't lower leaking rates much, and it's uncertain how well it works for women who already leak. The WHO still recommends daily pelvic floor training after birth, and in the trials it rarely caused problems.

So do them. If after a few weeks you're still leaking, feel heaviness or aren't sure you're doing them right, ask for a referral to a pelvic health physical therapist. The UK guideline says every new mother should be offered a pelvic health assessment from 6 weeks.

The tummy gap (diastasis recti)

To check yourself the NHS way, lie on your back with knees bent, lift your head and shoulders slightly, and feel along the midline above and below your belly button. Count how many fingers fit in the gap, and recheck now and then. The NHS says the gap usually closes by about 8 weeks, and to see your doctor if it's still obvious after that.

What to do about it is where advice genuinely differs:

• The NHS suggests avoiding sit-ups, planks, high-impact exercise and heavy lifting to start with.
• ACOG says abdominal exercises, including crunches and drawing in the belly, have been shown to reduce the gap.
• A 2021 systematic review of 7 trials with 381 women found only very low-quality evidence for any specific exercise program.

Our read: no exercise has been proven to close the gap, and none has been proven off-limits for good. Start with gentle deep core work, like the NHS's side-lying exercise: lie on your side with knees bent, breathe in, then as you breathe out gently draw in your lower belly and squeeze your pelvic floor. Hold for a count of 10, up to 10 times. Progress when moves feel controlled. If your belly domes or sinks along the midline during a move, the running guideline reads that as your abdominal wall not yet handling the load, so go back a step and tell your doctor or physical therapist.

Adding strength training

The WHO's 2020 guidelines were the first to include advice specific to the postpartum period: at least 150 minutes of moderate activity a week, a mix of aerobic and muscle-strengthening work, and starting small if you're not there yet. ACOG suggests strength work on at least two days a week.

Life with a baby already means lifting, carrying and bending over a car seat many times a day, so train those patterns on purpose. From around week 6, a simple session could be sit-to-stands, glute bridges, wall push-ups, band or light dumbbell rows and a few light deadlifts, 1 or 2 sets of 8 to 12 each. Once that feels easy and symptom-free, our home workout plan has full weeks with easier and harder versions of each move.

Running and other high-impact exercise

The UK guideline advises against running before 3 months after birth, or later if you have pelvic floor symptoms. First, check you can do all of these without pain, heaviness, dragging or leaking:

• Walk for 30 minutes
• Balance on one leg for 10 seconds
• Do 10 single-leg squats on each side
• Jog in place for 1 minute
• Do 10 forward bounds
• Hop in place 10 times on each leg
• Do 10 "running man" reps on each side: on one leg, swing the other knee forward and back with the opposite arm, as if running

It also suggests aiming for 20 reps each of single-leg calf raises, single-leg bridges, single-leg sit-to-stands and side-lying leg raises. Falling short doesn't rule out running, it just shows where to focus. When you start, use a walk-run program and build time before speed.

Exercise and breastfeeding

According to ACOG, regular aerobic exercise while breastfeeding improves fitness without affecting how much milk you make, what's in it or how your baby grows. Feed or pump before you exercise, drink water before you start, and wear a supportive bra that fits well.

Eat enough to fuel you both. Our article on how much protein women need covers the general numbers, but breastfeeding changes your needs, so check yours with your doctor or a registered dietitian.

When your period comes back

The bleeding after birth, called lochia, isn't a period. The NHS says it lasts a few weeks, fading until it stops. If you're not breastfeeding, your first period could come as soon as 5 to 6 weeks after birth. If you're fully breastfeeding, including at night, it may not return until you cut back. You can also get pregnant again from 3 weeks after birth, so don't wait for your period to think about contraception.

Your first cycles may be unpredictable. Until they settle, plan by how you feel each day, as in our guide to cycle syncing with irregular periods. Once they're steady, our cycle syncing workouts guide explains how to shape training around each phase. If you'd like help with that, HerShape builds a weekly workout plan around your goal, equipment and schedule, and adapts it to your cycle phase, with irregular cycles accounted for.

Warning signs: when to stop and get help

Stop exercising and talk to your doctor, midwife or a pelvic health physical therapist if you notice:

• Heaviness, pressure, a bulge or a dragging feeling in your pelvis
• Leaking urine or stool, or an urge to go that you can't hold off
• Pelvic or lower back pain, or pain during sex
• A gap or bulge along the middle of your belly that isn't getting smaller
• Bleeding that continues or increases beyond 8 weeks and isn't your period

The NHS says to contact your midwife or doctor straight away about any of these after birth, and if they're sudden or severe, call 911:

• Pain, swelling or redness in the calf of one leg
• Chest pain or difficulty breathing
• Sudden or very heavy bleeding, feeling faint or a racing heart
• A high temperature with a sore, tender belly
• A headache with changes in your vision or vomiting

Your mood matters too. The WHO links activity after birth with a lower risk of postpartum depression, but exercise isn't a substitute for care. If you're struggling, tell your doctor or midwife.

The bottom line

A good postpartum workout plan starts smaller than you expect: walking, breathing and pelvic floor work first, everyday strength and low-impact cardio through months two and three, and impact only once you pass the checks. Expect it to take longer after a cesarean or a difficult birth. Get your clinician's go-ahead first, and treat leaking, heaviness or pain as reasons to get checked, not things to push through.

Sources

• ACOG: Exercise After Pregnancy
• Obstetrics & Gynecology (2020): ACOG Committee Opinion No. 804, Physical Activity and Exercise During Pregnancy and the Postpartum Period
• NHS: Keeping fit and healthy with a baby
• NHS: Your post-pregnancy body
• NHS: Your body after the birth
• NHS: Caesarean section recovery
• NHS: When will my periods start again after pregnancy?
• British Journal of Sports Medicine (2020): World Health Organization 2020 guidelines on physical activity and sedentary behaviour
• Athletics Northern Ireland (2019): Returning to running postnatal, guidelines for medical, health and fitness professionals managing this population
• Cochrane Database of Systematic Reviews (2020): Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women
• British Journal of Sports Medicine (2016): Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain
• Brazilian Journal of Physical Therapy (2021): What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis