This pamphlet explains

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. Exercising helps tighten these 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 did not 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 is 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.

Another way to get started is to try the exercises shown on the reverse side. 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 health care provider 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 is one you will keep doing. Exercise over time is more important than starting right away after birth.

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 usually is 220 minus your age. Your target heart rate is 50–85% of the maximum. When you first start exercising, aim for the lower end of the range. As you become more fit, increase your target heart rate.
Age	Target heart rate (beats per minute)	Average maximum heart rate (beats per minute)
20	100-170	200
25	98-165	195
30	95-162	190
35	93-157	185
40	90-153	180
45	88-149	175
50	85-145	170
55	83-140	165
60	80-136	160
65	78-132	155
70	75-128	150

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 light activity, such as slow walking, 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 50–85% of your maximum heart rate (the fastest your heart can beat).

When you begin your exercise program, aim for the lower range of your target heart rate (50%). As you get into better shape, slowly build up to the higher end of your target heart rate. After 6 months of exercise, you should be able to exercise at up to 85% of your target heart rate. But you do not need to exercise at 85% of your target heart rate to stay fit. You should aim to exercise about 20–30 minutes while in your target heart rate.

Cool Down

After exercising, cool down by slowing your activity. Cooling down allows your heart rate to return to normal levels. Cooling down for 5–10 minutes, followed by stretching, also helps prevent sore muscles.

Keep the following 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.

Postpartum Exercises
Leg Slides This simple exercise tones abdominal and leg muscles. It is safe to do after a cesarean birth, because it does not 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.	Head Lifts Head lifts can progress to shoulder lifts and curl-ups. These exercises 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.	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.
Shoulder Lifts When you can do 10 shoulder lifts with ease, move on to curl-ups. Lie on your back with your knees bent, your feet flat on the floor, and your arms along your sides. Inhale and relax your belly. Exhale slowly and lift your head and shoulders off the floor. Reach with your arms so you do not use them for support. If this bothers your neck, place both hands behind your head. Inhale as you lower your shoulders to the floor.	Curl-Ups Lie on your back with your knees bent, your feet flat on the floor, and your arms along your sides. Inhale and relax your belly. Exhale. Reach with your arms, and slowly raise your torso until it is halfway between your knees and the floor (about a 45-degree 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.	Kegel Exercises Kegel exercises tone your pelvic-floor muscles. This, in turn, controls bladder leaks, helps the perineum heal, and tightens vaginal muscles 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.

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. Follow the guidelines given here to start a safe and effective exercise program.

This Patient Education Pamphlet was developed by the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women’s health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as “superior.” To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright © July 2009 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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