Clinically reviewed by What is postnatal exercises
Postnatal exercise is the staged return to activity after having a baby. The order matters more than the effort. Breathing and pelvic floor work come first, then walking, then the deep abdominal muscles, then strength, and impact last of all.
In Urdu it is delivery ke baad warzish. Done in that order it reduces back pain, settles leaking and gets you back to normal activity. Done in the wrong order, starting with sit ups and running, it commonly makes leaking, heaviness and tummy doming worse.
Get your doctor's clearance before you start, and especially after a caesarean, where the abdominal wall is still healing for weeks.
Symptoms you might have
- Leaking urine when you cough, sneeze, laugh or lift the baby
- A heaviness or dragging feeling low down, worse by the end of the day
- A gap or soft dip down the middle of the tummy, and a ridge that domes up when you sit up
- Lower back pain that started after delivery and is worse lifting and feeding
- Any of these getting worse after exercise, which is the sign the step was too big
Why it happens
- The abdominal muscles stretched over nine months and the midline tissue is still soft
- The pelvic floor carried the baby's weight for months, whether delivery was vaginal or by caesarean
- A vaginal delivery can stretch or tear the pelvic floor, and that tissue takes weeks to heal
- Hormones keep the joints softer for months, and longer while you are breastfeeding
- Restarting heavy housework within days of delivery, which is common here and sets many women back
When you should see a physiotherapist
Come in from around six weeks after delivery, once your postnatal check is done, or earlier if you want to be sure the gentle work is correct. There is no cut off: women come years later and still improve.
Get your doctor's clearance first. After a caesarean this is not optional, because the abdominal wall is still healing and loading it early risks the wound.
Go to a hospital the same day for heavy or bright red bleeding that returns, fever, a wound that is red, opening or leaking, a painful swollen calf, chest pain or breathlessness, or a severe headache with blurred vision, which can still mean preeclampsia in the weeks after delivery.
See a doctor if you cannot control your bowels, if you feel a bulge that will not go back, or if your mood is very low. All three are treatable.
Al-Shama Physiotherapy Clinic
Ask about an appointment
اپائنٹمنٹ کے بارے میں پوچھیںAppointment ke liye poochein
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یہ فارم پُر کریں؛ واٹس ایپ پر آپ کی تفصیلات کے ساتھ پیغام تیار ہو جائے گا۔Yeh form bharein, WhatsApp aap ki tafseel ke saath khul jaye ga.
How it is treated
The assessment checks the pelvic floor, the abdominal wall, the scar if there is one, and the back and hips. It tells you which stage you are at, rather than guessing from how many weeks have passed.
- Exercise therapy in stages: breathing, then pelvic floor, then deep abdominals, then glutes and legs, then loaded strength, then impact
- Pelvic floor training with feedback, so you know the right muscles are working. This is the most important part
- Manual therapy for the lower back, hips, neck and upper back, which take a beating from feeding and lifting
- Caesarean scar work once the wound is fully healed and your doctor is happy, to free a scar that has become tight or numb
- Electrotherapy, ultrasound, TENS, dry needling and hijama for muscular pain, available again after delivery and after clearance, applied away from a fresh scar
Almost no one needs surgery. A hernia repair or a prolapse repair is a surgeon's decision, considered only after a genuine trial of supervised training.
Exercises, and what to avoid
What helps
- Weeks one and two: slow breathing with the ribs and belly expanding, gentle pelvic floor squeezes, short walks around the house
- Weeks two to six: longer walks, pelvic floor holds and quick squeezes, gentle deep abdominal connection while breathing out
- After clearance at six weeks: glute and leg strengthening, upper back work, sit to stand, and gradually heavier lifting
- From around three months, and only once the pelvic floor has been checked: jogging, jumping and anything with impact
What to avoid
- Sit ups, crunches, planks and twisting abdominal work in the early weeks. They push down on the pelvic floor and widen a separation
- Running, skipping and jumping before the pelvic floor has been assessed, however good you feel
- Carrying water containers, gas cylinders and furniture in the first six weeks
- Holding your breath to lift. Breathe out through the effort, every time
What you can do at home
Attach the pelvic floor work to feeding. Eight feeds a day is eight reminders, and nothing else needs to be scheduled.
Treat constipation early. Water, fruit, vegetables, a stool under your feet, and no straining, which undoes pelvic floor work faster than exercise builds it.
Use the next day as your test. Leaking, heaviness, scar pain or back pain worse the next morning means the last step was too big. Go back one stage for a week.
Heat helps a sore back and neck, fifteen minutes at a time. Nothing hot goes on a caesarean scar until it is fully healed and your doctor is satisfied.
How long it takes
The first six weeks are healing, not training. Breathing, gentle pelvic floor squeezes and walking are all that belongs in them.
From six weeks, with clearance, most women notice real strength returning within six to eight weeks of consistent work. Pelvic floor recovery needs a minimum of three months before it is judged.
Running and impact are usually reasonable from around three months, and only once the pelvic floor has been checked and you are not leaking or feeling heaviness. After a caesarean, allow longer for the abdominal wall.
Full recovery of strength takes six to twelve months, and it does not expire: starting two or five years later still works, with consistency for three months rather than three weeks.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
زچگی کے بعد ورزش کی ترتیب سب سے اہم ہے۔ پہلے سانس کی ورزش اور پیڑو کے پٹھے، پھر چلنا، پھر پیٹ کے اندر کے پٹھے، اور سب سے آخر میں دوڑنا۔
شروع کرنے سے پہلے ڈاکٹر سے اجازت لینا ضروری ہے، خاص طور پر آپریشن (سی-سیکشن) کے بعد، کیونکہ پیٹ کا زخم چھ ہفتے تک بھر رہا ہوتا ہے۔
پہلے چھ ہفتے صرف ہلکی سانس کی ورزش، پیڑو کے پٹھے کے نرم دبائیں، اور گھر میں تھوڑی چہل قدمی۔ بیٹھنا اپس اور بھاری وزن بالکل نہیں۔ دوڑنا یا کودنا تین مہینے سے پہلے نہیں، اور پیڑو کے پٹھے کا معائنہ کروانے سے پہلے ہرگز نہیں۔
فوراً ہسپتال جائیں اگر تیز خون آئے، بخار ہو، زخم لال یا کھلا ہو، یا ایک پنڈلی سوجن جائے۔
Roman Urdu
Delivery ke baad warzish ki tarteeb sab se ahem hai. Pehle saans ki warzish aur pelvic floor, phir chalna, phir pait ke andar ke pathay, aur sab se aakhir mein daudna.
Shuru karne se pehle doctor se ijazat lena zaroori hai, khaas tor par operation (C-section) ke baad, kyunke pait ka zakham chhe hafte tak bhar raha hota hai.
Pehle chhe hafte sirf halki saans ki warzish, pelvic floor ke narm squeeze, aur ghar mein thori chehal qadmi. Sit ups aur bhari wazan bilkul nahi. Daudna ya koodna teen mahine se pehle nahi, aur pelvic floor ka checkup karwane se pehle hargiz nahi.
Foran hospital jayen agar tez khoon aaye, bukhar ho, zakham laal ya khula ho, ya ek pindli sooj jaye.
Treatment at the clinic, and online
INFORMATION → INDIVIDUAL CARE
A plan built around you.
Talk with Dr. Zahra Fatima, DPT. Understand your next steps, with guidance for your own symptoms and daily routine.
Talk it through
Discuss your symptoms, what you find difficult and what you want to get back to.
Understand your next steps
Use the consultation to discuss which care and exercises fit your situation.
Take your plan with you
Your online consultation includes a written plan you can refer to afterwards.
Questions people ask
When can I start exercising after delivery?
When can I start exercising after a caesarean?
When can I start running after having a baby?
Are sit ups good for losing the belly after delivery?
Can I exercise while breastfeeding?
Related conditions
- Pelvic floor weakness and exercises
- Back pain in pregnancy
- Diastasis recti treatment
- Lower back pain in women
- Recovery after a C-section