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Rebuilding Your Core after Pregnancy

Lose the Pooch with These Exercises
  -- By Sara Hambidge, Physical Therapist

A common concern among new mothers is how to get rid of their jelly bellies and regain flatter, more toned stomachs. For some women, re-strengthening their core seems an easy task, but for most it is an uphill battle that takes many months, even years. With proper exercise and diet the process is not as hard as many think. In fact, depending on your delivery method, there are specific exercises you can do to speed up your body’s recovery.

How Early Is Too Early?
Many women want to resume intense exercise as soon after birth as possible, before their abdominal muscles or pelvic floor are ready. This may lead to incontinence problems and prolonged back pain, sometimes due to diastisis recti (a stretching of the midline of the abdominal muscles) that was not corrected. With proper training, and beginning as early as 24-48 hours after birth, you can avoid many problems and work toward rebuilding and toning your body the right way. If you’ve done a good deal of abdominal work and exercised throughout your pregnancy, this process will be easier, but if you were sedentary, you can still achieve good results.

Proper nutrition and a gradual return to other forms of exercise (walking, jogging, weight lifting) are just as important in restoring the body to its pre-pregnancy state. You’ll never see a “six pack” if a layer of fat is overlays it. Weight loss and fitness take patience, time, and discipline; if things are pushed too soon, other problems can arise. It can take 6-12 weeks to return to a pre-pregnancy state – sometimes longer – so don’t give up!

Always check with your doctor before beginning this routine, since all mothers and all deliveries are different. Restrictions may apply to you that prevent your doing these exercises immediately. Begin only when your doctor clears you, and always remember that patience and time will help - so don’t get discouraged!

The Importance of Breathing
Once the baby is born, your body undergoes a dramatic change in a very short period of time. The skin and muscles that were so taut over the belly are now loose and jelly-like and can lack the neuromuscular awareness to work properly. This is why it is so important to use breathing techniques that shorten the abdominal wall to its previous length. As you inhale, your chest and abdomen should expand; as you exhale, your chest and abdominal wall should flatten. This concept is important when retraining your core after birth. The muscles in your belly must shorten before they can be strengthened. Exhaling while pulling your abs in shortens and strengthens with each outward breath.<pagebreak>

What About Diastisis Recti?

A spreading of the midline of the abdominal wall, it is usually detected in later pregnancy, and is present if you can feel a separation of greater than three fingers. The extent of diastisis should be checked three days postpartum by lying on your back with knees bent, placing fingers in midline of abdominal wall and lifting your head up. Feel for the separation below your fingertips; if it's greater than three fingers, make the exercise modifications outlined below until the diastisis is corrected.
 

EXERCISES TO STRENGTHEN YOUR CORE

Below is a list of exercises to begin within 24 hours postpartum (from Essential Postpartum Exercises by Elizabeth Noble, Physical Therapist).

VAGINAL BIRTH
Begin with only a few repetitions of each and increase as tolerated.
Phase 1

Phase 2

Phase 3
If diastisis is present after day 3 postpartum, do not move on to phase 3.

CESAREAN DELIVERY
*See instructions above


BOTH VAGINAL AND CESAREAN DELIVERIES
Move on to exercises listed below as tolerated.