Patient Education Guide
Returning to Exercise After Having a Baby
What the evidence says — and why the 6-week clearance isn't what you think
The most common misconception about postpartum recovery
The 6-week postnatal check from your midwife or OB confirms that you have healed normally from birth. It is not a return-to-exercise clearance. It does not assess your pelvic floor strength, abdominal function, or readiness to run, lift, or return to sport. Those require a separate, specific assessment.
What Actually Happens to Your Body During and After Birth
The pelvic floor
The pelvic floor muscles support your bladder, bowel, and uterus. During pregnancy they are under increased load for nine months. During vaginal birth they are significantly stretched. During caesarean section the abdominal muscles and fascia are cut through multiple layers. Either way, these structures need time and guided rehabilitation to restore full function.
The abdominal wall
Diastasis recti — the separation of the abdominal muscles at the midline — is present to some degree in most pregnancies. It does not always resolve on its own, and the severity varies widely. A physiotherapy assessment determines the degree of separation and what exercises are appropriate.
Connective tissue
The hormone relaxin — which loosens ligaments and joints to allow birth — remains elevated in the body for several months postpartum (and longer in breastfeeding mothers). This means joints are more mobile and potentially less stable during this period, which affects what loading is appropriate.
The Evidence-Based Return-to-Exercise Timeline
Weeks 1–6
Rest and gentle recoveryWalking, breathing exercises, gentle pelvic floor activation. No impact exercise. No heavy lifting beyond baby care.
6 weeks
Postnatal checkConfirms healing. Not a return-to-exercise clearance. Ideal time to book a physiotherapy assessment.
Weeks 6–12
Progressive rehabilitationBegin specific pelvic floor and abdominal strengthening based on your physiotherapy assessment. Walking, swimming, low-impact activity as tolerated without symptoms.
12 weeks+
Criteria-based return to running and impactCurrent guidelines recommend waiting until at least 12 weeks postpartum before returning to running — and only once specific pelvic floor and strength criteria are met. Earlier return increases the risk of prolapse, stress incontinence, and pelvic pain.
Months 4–6+
Return to sport and higher-intensity trainingDependent on individual assessment findings, symptoms, and how the body has responded to progressive loading. Some women return earlier; some need longer. Both are normal.
Signals to Watch For
Generally OK to continue
- Mild fatigue after exercise that resolves with rest
- Light muscle soreness 24–48 hours after activity
- No pelvic or abdominal symptoms during or after
Stop and get assessed
- Leaking urine or faeces during or after activity
- Heaviness or pressure in the pelvis
- Pelvic or lower back pain during or after exercise
- A bulge at the midline of the abdomen during exertion
- Pain during intercourse
What a Postpartum Physiotherapy Assessment Covers
- Pelvic floor strength, coordination, and relaxation
- Degree of diastasis recti and abdominal wall function
- Scar assessment (for caesarean or perineal tears)
- Movement assessment relevant to your goals
- A graded return-to-exercise programme built around your assessment findings
Common Questions
"I feel fine — do I still need an assessment?"
Feeling fine is a good sign — but the pelvic floor and abdominal wall can have significant deficits without causing obvious symptoms at low activity levels. Symptoms often emerge only when loading increases (running, heavy lifting, jumping). An assessment at 6–8 weeks prevents problems from developing rather than treating them after they've appeared.
"It's been years since I had my baby — is it too late?"
No. Pelvic floor rehabilitation is effective regardless of how long ago you gave birth. If you've had ongoing symptoms — or symptoms that return when you train harder — it is worth addressing now.
"I had a caesarean, so my pelvic floor is fine?"
Not necessarily. The pelvic floor is affected by the weight of pregnancy regardless of how the baby was delivered. Caesarean section also involves significant abdominal surgery — the scar tissue and abdominal wall recovery has its own rehabilitation requirements.