You must wait six weeks after birth to return to exercise.
"I've been cleared to exercise!" are often the elated words of a new mom who is an athlete. This statement always stumps me: Is someone besides you in charge of what you do with your body? What good does abdicating responsibility for your own health do for you or your baby? Further, what does 'cleared' actually mean?
Oftentimes, new moms, following the word of their well-intentioned medical practitioner, remain relatively sedentary throughout pregnancy until six weeks postpartum when they get the magickal approval to return to training. Then they re-immerse in their training as though no time had passed since the last time they trained in earnest resulting in prolapse, exacerbated abdominal and pelvic floor weakness, general frustration, and a loss of confidence in their athletic ability postpartum.
According to a 2014 peer-reviewed article:
Despite this motivating statement about the importance of exercise soon after giving birth, most women wait until their six-week postpartum checkup to discuss exercise with their doctors. According to the ACOG, about 40% of women decline a postpartum visit at all leaving them to wonder about when they might be ready to return to exercise. Additionally, the ACOG advises that women seek their postpartum visit between four and six weeks which means that many if not most women under the current model would be "cleared" for exercise much sooner than six weeks if they heeded these new guidelines.
Curiously, the ACOG cites no scientific evidence to support the timing of that postpartum visit instead relying on "cultural traditions" which, in my opinion, are a sorry means by which to govern health care.
Let's put aside the current model of care for a moment and think through empowering ourselves to make decisions about our bodies. Whether your care provider deems you ready for exercise or not, you are the ultimate authority on your body. Depending on your birth, your level of fitness throughout pregnancy, and how you feel your recovery is going, you might not feel ready to start training again until ten or twelve weeks postpartum or as early as the day after giving birth. I went into labor while climbing and returned to take lead falls a couple days after birthing my daughter which sped rather than hindered my recovery.
When I coach athletes through pregnancy and postpartum, they all perform differently but they all return to training much sooner than six weeks postpartum. They do this of their own accord, not at my urging. They learn through our coaching engagement to listen to the subtle cues their bodies give them about wellness and readiness to train which is a vital skill for endurance athlete whether pregnant or not. Most new moms I work with return to the gym within two weeks postpartum. They first test their bodies by doing brief, light, low-commitment sessions before progressing on to more intense or longer sessions. Precisely zero of my postpartum clients has experienced a negative outcome to their health or their breastfeeding status by returning to training this soon after giving birth. The key here is a phased reentry into training, not being sedentary for six weeks then overtraining.
So often women are conditioned by the medical system and other women (mom shaming much?) to adhere to a socially-accepted range of normal. The reality is that pregnancy, birth, and postpartum are likely to go differently for a professional athlete than they are for a weekend warrior, different as well for a mindful mover versus a dissociative athlete. The point is that the range of normal is huge spanning the luxuriously slow pregnancy some women dream of to the ultra-endurance pregnancy I had - and they are all correct and healthy ways to conduct pregnancy.
What women deserve is evidence and options so that they can make their own informed decisions about what is right for them. So before you wait to return to exercise until some doctor tells you it is 'safe', check in with your own body and ask it what is appropriate. A gradual return to training might make the difference between positive mental health and a dive into postpartum depression.