Postpartum Exercises

You should begin exercising as soon as possible after childbirth, even within 24 hours. In fact, if your perineum is not numb from anesthesia, begin doing Kegels within the first 2 hours.

The muscle work involved in immediate postpartum exercise is not strenuous or harmful. It will help restore tone to your pelvic floor and abdominal muscles, as well as encourage good circulation in your legs. Your caregiver may give you a list of exercises to begin after delivery. If not, show him the following exercises and get his approval, as well as any modifications that he feels may be necessary in your particular case. Start gradually, and add exercises and repetitions as your strength and comfort permit. Do not overdo!

Unless otherwise noted, do each exercise twice a day, beginning with 2 to 3 repetitions and gradually working up to the number of repetitions listed. Consistency is much more important than the length of the session.

If you have a cesarean delivery, get your doctor’s permission before starting a vigorous exercise program. For a suggested exercise program, see “Exercise After a Cesarean”.

First Day

Do the following exercises while still in the birthing room or as soon as you can in your regular room.

Super Kegel Exercise

Benefits: Tones the pelvic floor muscles. Improves circulation. Promotes healing of the perineum.

Directions: While lying down, sitting, or standing, contract the muscles of the pelvic floor and hold for 20 seconds. Continue to breathe normally.

Frequency: 1 rep every 2 hours, for a total of 10 reps a day. Do the first rep in the birthing room and 1 rep after every urination.

Abdominal Tightening

Benefits: Decreases abdominal flabbiness and helps restore muscle tone to the abdominal wall.

Directions: While sitting or standing, pull in the abdominal muscles and hold tightly for 5 seconds. Continue to breathe normally. Gradually increase the holding time to 10 seconds.

Frequency: As often as possible.

Ankle Rotating

Benefits: Aids blood circulation and prevents blood clots.

Directions: In bed, lie down or sit with your legs stretched out in front of you. Rotate your foot at the ankle three times in one direction, then three times in the other direction. Repeat with the other foot.

Frequency: 5 to 10 reps with each ankle per exercise session.

Foot Flexing and Stretching

Benefits: Aids blood circulation and prevents blood clots.

Directions: In bed, lie down or sit with your legs stretched out in front of you. Flex your foot, slowly bringing your toes toward your body. You will feel stretching in the calf muscle. Then release your foot, slowly pointing your toes away from you. Repeat with the other foot.

Frequency: 5 to 10 reps with each foot per exercise session.

Second Day

Continue the super Kegel exercise and abdominal tightening from the first day and add the following two exercises.

Pelvic Tilt

Benefit: Tones the abdominal muscles.

Directions: Lie on your back with your knees bent and your feet flat on the floor. Arch your back and press your buttocks against the floor. Then release your buttocks and press the small of your back against the floor, contracting your abdominal muscles. Continue to breathe normally.

Frequency: 5 to 10 reps per exercise session.

Prone Resting Position

Prone resting position.

Benefit: Helps the uterus return to its normal position.
Directions: Lie on your stomach with a folded blanket or pillow under your abdomen and upper thighs, and another one under your ankles. Turn your face to one side, eyes opened or closed, and rest for as long as you wish.

Frequency: As often as possible.

Third Day

On the third day, check for separation of the recti muscles before you do any further abdominal exercising. The recti muscles are a band of muscles that runs vertically through the center of the abdomen. The band is divided into two halves, which are joined by connective tissue.

Checking for separation of the recti muscles.

Many pregnant women experience separation of the recti muscles, especially if they did not use good body mechanics while lifting.

To check for separation, lie on your back with your legs bent and your feet flat on the floor. Press the fingers of one hand in a horizontal line into the area below your navel, then slowly raise your head and shoulders about 8 inches off the floor. You should feel the bands of muscles on both sides of your abdomen pull toward the center and move your fingers out of the way. If three or more fingers slide into a gap between the muscle bands, you have separated recti muscles.

To correct the problem, do head lifting (see below) to close the gap before continuing with your regular exercises. The gap should close to the normal 1/2 inch within 7 to 10 days. Until the gap is closed, do not rotate or bend your trunk from side to side, or twist your hips. These movements could pull your recti muscles further apart.

If your recti muscles are fine, continue doing the super Kegel exercise, abdominal tightening, pelvic tilt, and prone resting position from the first 2 days.

Head Lifting

Benefit: Restores the recti muscles to their proper position.

Head lifting to correct separated recti muscles.

Directions: Lie on your back with your knees bent and your feet flat on the floor. Cross your arms over your abdomen and take a deep breath. Slowly exhale and raise your head off the floor, pulling your abdominal muscles together with your hands. Inhale and slowly lower your head.

Frequency: 10 reps per set, 5 sets per day.

Second Week

Continue the super Kegel exercise from the first week. Replace the remainder of the exercises with the following exercises, which are more advanced versions of the earlier ones.

Modified Sit-Up

Modified sit-up.

Benefit: Tones the abdominal muscles.

Directions: Lie on your back with your knees bent and your feet flat on the floor. Inhale, then exhale, raising your head and shoulders off the floor and reaching both your hands toward your knees. Inhale, lying back down.

Variation of modified sit-up.

Variation: As you exhale and raise your head and shoulders off the floor, reach both your hands to the outside of your right knee. Inhale and lie back down, then exhale, raise your head and shoulders, and reach both hands to the outside of your left knee. Inhale and lie back down.

Caution: If the recti muscles are still separated, support them as you do this advanced version of the head lifting exercise. Do not do the variation of this exercise until the recti muscles are restored.

Frequency: 5 to 10 reps per exercise session.

Pelvic Rock

Benefit: Tones the abdominal muscles.

Directions: Kneel on the floor on your hands and knees. Align your head with your spine, tuck in your bottom, pull up your abdominal muscles, and press up your spine at the lower back. Hold this position for a few seconds, then return to the starting position. Repeat the exercise with a constant rhythm and a rocking motion.

Frequency: 5 to 10 reps per set, 3 sets per day.

Knee-Chest Position

Knee-chest position.

Benefit: Helps the uterus return to its proper position.

Directions: Get down on your knees, spacing them about 12 to 18 inches apart. Bend forward at the hips, lowering your chest to the floor and placing the side of your face on top of your folded hands, your elbows pointing out to the sides. If desired, position a pillow under your face and chest. Contract and relax your abdominal muscles as many times as you wish, then rest for at least 5 minutes.

Frequency: 2 sets per day.

Third Week

Continue the super Kegel exercise, pelvic rock, and knee-chest position from the first 2 weeks and add the following five exercises. In addition, to strengthen your cardiovascular system and tone your body in general, begin walking briskly around your neighborhood every day.

Side Kicks

Side kicks.

Benefit: Helps restore the waistline.

Directions: Lie on the floor on your right side wife your arms over your head and your head resting your right arm. Keeping your right leg slightly bent, raise your left arm and leg toward the ceiling and touch your hand to your knee. Return your arm and leg to the starting position, stretching the arm over your head and elongating your waist and rib cage. Repeat 5 to 10 times on that side. Relax. Turn to your left side and repeat with the other arm and leg.

Frequency: 5 to 10 reps with each arm and leg per exercise session.

Modified Sit-Up II

Modified sit-up II

Benefit: Tones the abdominal muscles.

Directions: Lie on your back with your knees bent, your feet flat on the floor, and your hands clasped behind your head. Inhale, then exhale, raising your head and shoulders off the floor and reaching your elbows toward your knees; do not touch the knees. Inhale, lying back down.

Frequency: 5 to 10 reps per exercise session.

Modified Sit-Up III

Modified sit-Up III.

Benefit: Tones the abdominal muscles.

Directions: Lie on your back with your knees bent, your feet flat on the floor, and your hands clasped behind your head. Inhale, then exhale, raising your head and shoulders off the floor and reaching both your elbows to the outside of your right knee; do not touch the knee. Inhale and lie back down, then exhale, raise your head and shoulders, and reach both elbows to the outside of your left knee.
Inhale and lie back down.

Frequency: 5 to 10 reps per exercise session.

Single Leg Raises

Benefits: Tones the leg and abdominal muscles. Improves the blood circulation.

Directions: Lie on your back with your knees bent, your feet flat on the floor, and your hands clasped behind your head. Draw your right knee toward your chest, then inhale, point your toes, and continue raising the leg toward the ceiling until the knee is straight. Exhale, flex the foot, and slowly lower the straightened leg to the floor. Return the leg to the starting position and repeat the movement with the left leg.

Frequency: 5 to 10 reps with each leg per exercise session.


Single leg raises: Draw your knee toward your chest …



… raise your leg with the toes pointed …



… then flex your foot and slowly lower your leg.


Single Leg Sliding

Single leg sliding.

Benefits: Tones the leg and abdominal muscles. Improves the blood circulation.

Directions: Lie on your back with your knees bent, your feet flat on the floor, and your hands clasped behind your head. Inhaling through your nose, draw your right knee U toward your chest, flexing your foot. Then exhaling through your mouth, slowly return the foot to the floor and slide the leg downward, pressing the small of your back to the floor and contracting your abdominal muscles. Return the leg to the starting position and repeat the movement with the left leg.

Frequency: 5 to 10 reps with each leg per exercise session.

Fourth Through Sixth Weeks

Continue doing the super Kegel exercise, side kicks, single leg raises, and single leg sliding from the first 3 weeks and add the following two exercises. In addition, increase the length of time you spend walking around your neighborhood.

Hip Rolls

Hip rolls.

Benefit: Helps restore the waistline.

Directions: Lie on your back with your arms stretched out sideways like a T. Draw your knees toward your chest, then roll your hips to the right, lowering your knees and legs to the floor on your right side; keep your back and arms flat on the floor. Return your hips and knees to the center position, then roll your hips to the left, and lower your knees and legs to the floor on your left. Return to the center position.

Frequency: 5 to 10 reps to both sides per exercise session.

Modified Sit-Up IV

Modified sit-up IV.

Benefit: Strengthens the abdominal muscles.

Directions: Lie on your back with your knees bent, your feet flat on the floor, and your arms folded across your chest. Inhale, then exhale, raising your head and shoulders to a 30-degree angle. Inhale, lying back down.

Frequency: 5 to 10 reps per exercise session.

After the 6-Week Checkup

Continue practicing all the exercises from the fourth through sixth weeks—side kicks, single leg raises, single leg sliding, hip rolls, and modified sit-up IV—for at least the next 2 months. In addition, continue walking briskly around your neighborhood and add an aerobic exercise such as jogging, swimming, or bicycle riding. Continue doing your super Kegels, which are an exercise that you should do for the rest of your life.

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