Returning to exercise after birth: A postnatal guide

Returning to exercise after birth? A step-by-step guide to pelvic floor recovery, safe timing and rebuilding strength postpartum. Read Blackmores' guide.

The months after birth reshape how the body moves, recovers and generates energy. Returning to exercise is a gradual process built around tissue healing, pelvic floor recovery and rebuilding functional strength over time. This article covers safe timing, first steps, warning signs and when to bring in specialist support.

Movement in the postpartum period may influence long-term pelvic health, functional strength and confidence with everyday activity.

Why postpartum exercise should be gradual

Pregnancy and birth change the body in ways that continue evolving well beyond the six week check. The abdominal wall has stretched, the pelvic floor has borne significant load, and some hormonal changes from pregnancy may persist for months after birth, particularly while breastfeeding.

Better Health Channel notes that most changes that occur during pregnancy will have returned toward normal by around six weeks after birth. Women who had a caesarean, difficult birth or complications may need more time before starting group exercise, gym sessions or personal training. Waiting until the six week postnatal check with a doctor or midwife before stepping up from gentle walking and pelvic floor work is commonly recommended.

Working with the body's healing timeline sets up a more sustainable progression: a step by step build up from gentle activity to higher load, longer duration or more challenging movement, guided by how the body is responding rather than a fixed calendar. Individual timelines vary based on delivery mode, sleep, energy levels, breastfeeding demands and any pelvic health considerations.

Pelvic floor recovery: why it matters before high impact movement

The pelvic floor is a group of muscles that supports the bladder, bowel and uterus. Continence Health Australia describes pregnancy and childbirth as significant events for these muscles, noting that around one in three women who have had a baby experience some bladder leakage at some point.

Rebuilding pelvic floor function is a foundation for safe return to movement, particularly higher impact activities like running, jumping or repeated lifting. According to Healthdirect Australia, gentle pelvic floor exercises can generally be re-started from around 48 hours after birth, even after perineal trauma (tearing or stitches in the area between the vagina and anus), though this should be checked with the treating doctor or midwife.

Early pelvic floor training focuses on gentle activation rather than heavy contraction. Continence Health Australia guidance suggests finding a comfortable position (sitting, standing or lying down), lifting and squeezing the pelvic floor muscles, then fully relaxing. The suggested starting point is holding each contraction for three to eight seconds, aiming for eight to ten contractions, three times a day.

First steps: breathing, walking and gentle activation

The first phase of return to movement centres on three simple building blocks:

• Diaphragmatic breathing. Slow, connected breaths that coordinate the diaphragm with the pelvic floor. This can begin in the first days after birth.

• Walking. Short walks, gradually increasing in duration as energy allows. Walking is the most commonly recommended low impact activity for the early postnatal period.

• Gentle activation. Basic pelvic floor squeezes, deep abdominal engagement and posture based movements.

Pelvic Floor First, a national initiative of Continence Health Australia, recommends aiming to steadily increase back to higher impact exercise over a three to four month window after birth, with low impact activity such as walking as the mainstay during this time.

Rebuilding strength after pregnancy and birth

Rebuilding functional strength supports posture, load carrying (a newborn is a lot of load), and long-term joint health. Early strength work centres on the deep core and hip stabilisers, before progressing to broader compound movements.

According to Pelvic Floor First, sit ups, curl ups, planks, hovers and mountain climbers are often delayed during the early recovery phase until pelvic floor and abdominal wall function have been assessed, as they can place pressure on the lower abdominal wall and the recovering pelvic floor. A pelvic floor and abdominal check is recommended before adding these movements back in.

Useful early strengthening options include:

• Bridges
• Bodyweight squats within a comfortable range
• Wall or incline push variations
• Split stance work such as gentle lunges
• Bird dog and modified four point kneeling movements

Progression is guided by symptoms and comfort, not calendar dates. Adding load, tempo or complexity too quickly can be counterproductive.

Energy, sleep and nutrition considerations

Broken sleep, shifting hormones, breastfeeding demands and the nutritional cost of pregnancy all shape available energy in the early postpartum period. Recovery, milk production and everyday movement place real demands on nutrition.

Iron status may warrant attention in some women following pregnancy and birth, particularly where dietary intake is limited or there has been significant blood loss. Blood loss at birth, combined with the increased iron demand across pregnancy, can leave iron stores lower than usual. The NHMRC Nutrient Reference Values set the Recommended Dietary Intake for iron during lactation (women 19 to 50) at 9 mg per day, compared with 18 mg per day for non-pregnant, non-lactating women in the same age group. Everyday food sources include lean red meat, poultry, fish, legumes, tofu, wholegrains and dark leafy greens. Pairing plant iron sources with vitamin C rich foods can support absorption.

Hydration matters, particularly for those who are breastfeeding. Fluid needs across the day are higher than usual. Water first, alongside a balanced diet, is the practical starting point.

Sleep is trickier to control. Where possible, layering in short daytime rests, sharing overnight care where circumstances allow, and going to bed earlier can help offset broken nights. Consistent, moderate movement, even a short walk, can support sleep quality over time.

Signs you may be doing too much too soon

Postnatal training progress is guided by how the body responds during and after movement. Pelvic Floor First advises that return to previous activity levels depends on the pelvic floor muscles having recovered, with no back pain, vaginal heaviness, or bladder leakage during or after exercise.

Continence Health Australia lists a range of changes that suggest the pelvic floor may need more support, including:

• Bladder leakage when coughing, sneezing, laughing, lifting or exercising
• A feeling of heaviness in the pelvic area
• Difficulty controlling wind or bowel motions
• Pelvic pain

If any of these appear during or after exercise, scale back the intensity, drop the impact, or step back to gentler movement patterns and speak with a doctor, midwife or pelvic health physiotherapist.

When to speak to a pelvic floor physiotherapist

A pelvic floor physiotherapist assesses the strength, endurance and coordination of the pelvic floor, along with the abdominal wall and broader movement patterns. Their input can be valuable in the postpartum period whether or not symptoms are present, and particularly for women experiencing symptoms or preparing to return to higher-impact activity.

Healthdirect Australia suggests seeing a pelvic floor physiotherapist or continence nurse if pelvic floor muscles are difficult to feel or activate voluntarily.

Common reasons to book an assessment include:

• Persistent bladder or bowel leakage
• A sensation of heaviness or dragging in the pelvic area
• Ongoing pelvic, lower back or hip pain
• Preparing to return to running or higher impact activity
• Feeling uncertain about how to correctly activate the pelvic floor

Returning to running or higher impact exercise safely

Running sends repeated impact loading through the pelvic floor and abdominal wall. Returning too soon can push tissues that are still recovering.

Better Health Channel sets out a widely referenced Australian progression. From six weeks postnatal, low impact options such as walking, swimming, yoga, pilates and low impact aerobic workouts can be considered after the doctor or midwife check. Higher impact exercise such as running and sport is typically considered from 12 to 16 weeks postnatal, provided load and volume align with pelvic floor recovery. Assessment by a women's or pelvic health physiotherapist is recommended before making this shift.

A consensus statement published in the British Journal of Sports Medicine, emphasises that return-to-running readiness is best judged against a set of recovery markers across physical, mental and lifestyle factors, rather than the calendar alone. Their consensus recommends screening for pelvic floor strength, endurance and coordination, sleep and fatigue, pre-existing musculoskeletal or pelvic health considerations, energy availability, and, for those breastfeeding, hydration and lactation demands.

Practical readiness signs include comfortable extended walking, symptom free strength and balance work, and progressive impact tolerance without leakage, heaviness or pain. If any of these signals appear during progression, pause and seek advice rather than push through. A pelvic floor physiotherapist can map out a graded return-to-running plan that fits how recovery is going.

Key takeaways for sustainable postpartum movement

• Postpartum recovery follows no fixed timeline. It's shaped by delivery mode, sleep, feeding demands and individual healing.
• Early weeks favour gentle breathing, walking and pelvic floor activation over structured workouts.
• Traditional core exercises like sit ups, planks and crunches sit later in the progression, after pelvic floor and abdominal wall recovery.
• A pelvic floor physiotherapy assessment is a valuable step before returning to running or higher impact sport.
• 12 to 16 weeks postpartum is a widely recognised window for reintroducing higher impact activity, with readiness milestones mattering more than the calendar.
• Nutrition, hydration and rest sit alongside movement as part of training in this stage of life.

Frequently asked questions

When can you start exercising after giving birth?

Gentle pelvic floor exercises and short walks can often start in the days after birth, subject to clearance from a doctor or midwife. Structured or higher intensity exercise is generally guided by the six week postnatal check, with higher impact activity such as running typically considered from 12 to 16 weeks.

What exercises are safe postpartum?

Diaphragmatic breathing, pelvic floor squeezes, walking, gentle bridges, wall push variations and modified squats are common starting points. Sit ups, crunches, planks and other higher-pressure core exercises are often delayed until pelvic floor and abdominal wall recovery has been assessed.

Why is pelvic floor recovery important after birth?

The pelvic floor supports the bladder, bowel and uterus. Rebuilding its function helps with bladder and bowel control, everyday movement and safe return to higher impact activity.

Can low iron affect postpartum exercise energy?

Iron contributes to oxygen transport throughout the body and adequate iron intake supports normal energy production. Women concerned about their iron status should speak with their GP, who can arrange appropriate testing if needed.

What are signs you are doing too much too soon?

Bladder leakage, pelvic heaviness, pain, or increased vaginal bleeding during or after exercise are signals to step back and seek advice.

How does breastfeeding affect exercise and hydration?

Breastfeeding raises fluid and energy needs. Drinking water regularly, eating consistently and pacing intensity are practical adjustments.

When should you see a pelvic floor physiotherapist?

For any persistent bladder or bowel leakage, sensations of heaviness, ongoing pelvic pain, or before returning to running or high impact sport. Assessment can be helpful even without symptoms.

How do you return to running after birth?

Follow a criteria based progression: pain free walking, then strength and balance work, then low impact activity, then a graded return to running. 12 to 16 weeks postpartum is the window suggested in current Australian guidance, with pelvic floor readiness as the key factor rather than the calendar alone.

What postpartum symptoms should not be ignored?

Heavy bleeding, severe pain, signs of infection, ongoing bladder or bowel changes, or persistent low mood are reasons to speak with a healthcare professional promptly.

Disclaimer: This article provides general information only and is not intended to diagnose, treat, cure, or prevent any disease. The information presented is not a substitute for professional medical advice. If you have concerns about your health, please consult your GP or healthcare provider for a personalised assessment and recommendations. Supplements should not replace a balanced diet.