II. Indications
- Exercise is recommended for all women in first 12 weeks after delivery (unless contraindicated)
III. Contraindications
- See Get Active Questionnaire for Postpartum (below)
- Significant Abdominal Pain or Vaginal Bleeding
- Post-cesarean delivery with symptoms worsening with Exercise
- Non-healed surgical incisions or perineal tears
- Postpartum Cardiomyopathy
- Unstable Hypertension
- Unstable Eating Disorder
- Relative Energy Deficiency or Malnutrition
IV. History: Barriers to Exercise
- Mental health symptoms
- Insomnia
- Abdominal wall and pelvic floor symptoms
- Wound Healing
- Musculoskeletal pain
- Anemia
- Eating Disorders
- Lack of social and emotional support
-
Lactation status
- Requires an additional 450 to 500 kcal/day of intake
V. Associated Conditions: Postpartum Medical Conditions Mitigated by Exercise
- Mood Disorders
- Weight Retention
- Sleep Disorders
- Diabetes Mellitus
- Cardiovascular Disease
- Stress Incontinence
- Low Back Pain
VI. Management
- Start
- Begin with early mobilization and light activity
- Initially prioritize nutrition, hydration and sleep
- Plan for progression of activity individualized to the patient (and with contraindications in mind)
- After surgical wounds have healed
- After lochia has decreased to manageable leve;
- Goal Activity
- Exercise for 120 minutes per week
- Moderate to vigorous Exercise for at least 4 days per week
- Exercise should be a combination or aerobic (e.g. brisk walk, Bicycling) and Resistance Training
- Additional Recommendations
- Ensure adequate nutritional intake per day (esp. in Lactation)
- Pelvic Floor Exercise (e.g. Kegel Exercise) daily
- Sleep Hygiene
- Limit recreational Screen Time to 3 hours per day
- Limit sedentary activities to 8 hours per day
VII. Resources
- Get Active Questionnaire for Postpartum (CSEP)