This pamphlet will tell you about:

The benefits of exercise Good exercises to get you started Programs to keep you going

Exercising after you have your baby can improve your physical and mental well-being.

Benefits of Exercise

Daily exercise can help restore muscle strength and firm up your body. Exercise can make you less tired because it raises your energy level and improves your sense of well-being.

During pregnancy the muscles in your abdomen stretch. It takes time for good muscle tone to return. You can do some simple exercises to help tighten the muscles.

When Can I Start?

Check with your doctor before starting an exercise program. You should start when you feel up to it and know you will keep it up. Follow the same guidelines as you did when you were pregnant. If you had a cesarean birth, a difficult birth, or complications, it may take a little while longer to feel ready to start exercising.

If you didn't exercise during pregnancy, start with easy exercises and slowly build up to harder ones. If you exercised regularly throughout pregnancy, you have a head start. You should not try to resume your former pace right away, though.

Getting Started

Walking is a good way to get back in shape. Brisk walks will prepare you for more vigorous exercise when you feel up to it. Walking is a good choice for exercise because the only thing you need is a pair of comfortable shoes. It's also free, and you can do it almost any place or time.

Walking also is good because your baby can come along. The two of you can get out of the house for exercise and fresh air without needing to find child care. Seeing other people and being outside can help relieve stress and tension.

Try the exercises here (see reverse side) to get you started. They'll help you get in shape safely.

As you feel stronger, think about trying more vigorous exercise. You will want to decide on exercises that meet your needs. A good program will make your heart and lungs stronger and tone your muscles.

There are special postpartum exercise classes that you can join. Your doctor or nurse can help you find some good classes.

Resources that may be helpful are local health and fitness clubs, community centers, local colleges, hospitals, and adult education programs. With any program you get involved in, make sure it's one you will keep doing. Exercise over time is more important than starting right away after birth.

Your Exercise Program

Your workout should always include time for you to warm up and cool down. This will help reduce the risk of injury or sore muscles.

Warm Up

Before you begin each exercise session, always warm up for 5–10 minutes. This is light activity, such as slow walking, that prepares your muscles for exercise. As you warm up, stretch your muscles to avoid injury. Hold each stretch for 10–20 seconds—do not bounce.

Target Heart Rate

You should exercise so that your heart beats at the level that gives you the best workout. This is called your target heart rate. To check your heart rate, count the beats by feeling the pulse on the inside of your wrist. Count for 10 seconds. Multiply this count by 6 to get the number of beats per minute.

The box gives guidelines for finding your target heart rate. It is about 60–80% of your maximum heart rate (the fastest your heart can beat). Exercise that results in a heart rate above 80% of your maximum heart rate may be too much unless you're in top physical shape. Exercise that results in a heart rate below 60% gives too little conditioning.

When you begin your exercise program, aim for the lower range of your target heart rate (60%). As you get into better shape, slowly build up to the higher end of your target heart rate (80%). You should aim to exercise about 20–30 minutes while in your target heart rate.

Target Heart Rate for Women
To find your target heart rate, look for the age category closest to your age and read the line across. Your maximum heart rate is usually 220 minus your age. Your target heart rate is 60–80% of the maximum. These figures are averages to be used as general guidelines.
Age	Target heart rate (beats per minute)	Average max- imum heart rate (beats per minute)
20 25 30 35 40 45 50 55 60 65 70	120–160 117–156 114–152 111–148 108–144 105–140 102–136 99–132 96–128 93–124 90–120	200 195 190 185 180 175 170 165 160 155 150
(U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Heart, Lung, and Blood Institute. Exercise and your heart. Washington, DC: U.S. Government Printing Office, 1981; NIH publication no. 81-1677)

Cool Down

After exercising, cool down by slowing your activity. This allows your heart rate to return to normal levels. Cooling down is like warming up. Cooling down for 5–10 minutes and stretching again also helps prevent sore muscles. Hold each stretch for 20–30 seconds—do not bounce.

Keep in mind:

Wear comfortable clothing that will help keep you cool. Wear a bra that fits well and gives plenty of support to help protect your breasts. Drink plenty of water.

Finally...

Exercising after you have your baby can help you get back in shape. It can improve your physical and mental well-being. Before you begin your exercise program, talk to your doctor. Then follow the guidelines given here to start a safe and effective exercise program.

Postpartum Exercises

Leg Slides

This simple exercise tones abdominal and leg muscles. If you had a cesarean birth, it doesn't put much strain on your incision. Try to do leg slides a few times a day.

• Lie flat on your back and bend your knees slightly.
• Inhale, and slide your right leg from a bent to a straight position.
• Exhale, and bend it back again.
• Be sure to keep both feet on the floor and keep them relaxed.
• Repeat with your left leg.

Shoulder Lifts

Start this exercise the same way you would head lifts. When you can do 10 shoulder lifts with ease, move on to curl-ups.

• Inhale and relax your belly.
• Exhale slowly and lift your head and shoulders off the floor. Reach with your arms so you don't use them for support. If this bothers your neck, place both hands behind your head.
• Inhale as you lower your shoulders to the floor.

Head Lifts

Head lifts can progress to shoulder lifts and curl-ups. These all strengthen the abdominal muscles. When you can do 10 head lifts with ease, move on to shoulder lifts.

• Lie on your back with your arms along your sides.
• Keep your lower back flat on the floor.
• Bend your knees so that your feet are flat on the floor.
• Inhale and relax your belly.
• Exhale slowly as you lift your head off the floor.
• Inhale as you lower your head again.

Curl-Ups

Start this exercise the same way you would head lifts.

• Inhale and relax your belly.
• Exhale. Reach with your arms, and slowly raise your torso until it's halfway between your knees and the floor (about a 45º angle). If you need more support for your neck and head, place your hands behind your head.
• Inhale as you lower your torso to the floor.

Kneeling Pelvic Tilt

Tilting your pelvis back toward your spine helps strengthen your abdominal muscles.

• Get on your hands and knees. Your back should be relaxed, not curved or arched.
• Inhale.
• Exhale and pull your buttocks forward, rotating the pubic bone upward.
• Hold for a count of three.
• Inhale and relax.
• Repeat five times. Add one or two repetitions a day if you can.

Kegel Exercises

Kegel exercises tone your pelvic-floor muscles. This, in turn, controls bladder leaks, helps the perineum heal, and tightens a vagina stretched from birth.

• Squeeze the muscles that you use to stop the flow of urine.
• Hold for up to 10 seconds, then release.
• Do this 10–20 times in a row at least three times a day.