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The 4th Trimester

Hello new Mamas! If you’re reading this you are probably in your 4th Trimester. 4th Trimester? What is that? This is the 3 months (12 weeks) after you’ve given birth. Unfortunately, not enough significance is given to this phase, however, this phase is VERY important and there should be much more awareness on this stage. During this time both the mother and the newborn baby are adjusting to their new life. They both go through huge physical and emotional changes. The baby is adjusting to the new life out of the womb while the mother is trying to get a grip of the new life as a mum. 

I won’t go into much detail about the 4th trimester, since it is not the purpose of today’s blog, although it does come hand in hand with today’s subject. 

Postpartum Exercise

Whether we are used to exercising before or not, the majority of mothers look forward to getting back to their pre pregnancy level of fitness. Don’t get me wrong, we are ok with our post partum bodies especially knowing it built a whole new human from scratch whom we love so dearly, but it would be nice if we could fit at least in SOME of the pre pregnancy clothes some time in the near future. Nonetheless, getting back to exercise is more than just about clothes and looks. 

Exercise is an essential tool for a healthy mental well being. Many mothers struggle in this aspect; either because of post traumatic stress following childbirth, and/or because of the change in lifestyle and stress of taking care of a newborn. Exercise is an excellent healthy drug-free tool to alleviate stress, improve memory, improve quality of sleep (which we REALLY need), and boost overall mood. One does not have to be a fitness maniac to gain these benefits. A few minutes a few times a week can do the trick. 

Apart from looking better and improving mental health, specific exercise is crucial for the repair and reconstruction of muscles that have been affected during pregnancy and/ or childbirth, mainly core muscles and pelvic floor. 

Throughout the pregnancy our body goes through drastic changes due to hormonal fluctuations and physical changes (increase in weight). Some muscles become more lax while others become much tighter causing imbalance and increased risk of injuries and body pains. Following natural childbirth many experience muscle tears or prolapse. With a Cesarean surgery (C-section) the abdominal muscles go through major trauma as these are cut wide open to bring out the baby. Exercise is the key for a healthy recovery of these muscles.

When can I start to exercise after giving birth?

Many are confused on when to start or what type of exercise one can do post partum. In both types of childbirths it is important to move and avoid prolonged periods in the same position (unless advised otherwise  by the medical team). Needless to say, the body has been through a lot and also needs a considerable amount of rest and healthy eating. 

As a general rule one can start walking once given the go ahead at the hospital. As soon as you pass your first urine you can also start activating the pelvic floor by IMAGINING that you are stopping urine flow or wind from passing (never stop urine flow as this might lead to incorrect emptying of the bladder). If you are not in pain you can also start reactivating your core by drawing in the belly button while breathing normally. Another option is to try diaphragmatic breathing. 

Here’s the technique:

Breathe in- relax your belly

Breathe out- draw your belly button in and engage the pelvic floor (kegel).

During pregnancy we also like to call this the Hug Your Baby Breathing Technique. There is also a video available on my YouTube channel through this link

Exercise After Vaginal Birth

If there is not any major trauma, those who went through natural birth can start exercise immediately. This does not mean starting a full on workout or starting jogging straight away. But starting mild to moderate intensity exercises and gradually increasing duration and intensity.

Exercise After C-Section

In the case of a C-section, being that it is a major abdominal surgery, it is recommended to wait 6 weeks before starting to exercise. Additionally, the mother should not lift anything except the baby, when needed and with caution, for the safety of the baby and mother. From 6 weeks onwards it is safe to start exercise slowly and gradually progress.

Diastasis Recti

Post partum, it is advisable for every mother to check for diastasis recti. This is the partial or complete separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach. Diastasis recti is very common during and following pregnancy since the growing uterus stretches the muscles in the abdomen to accommodate your growing baby.

In the case of Diastasis Recti you must avoid crunches, sit ups, double leg lifts and certain other exercises. It is best to seek workouts that are safe and ideal for diastasis recti, usually these are pilates based and it is best to look for workouts by trained individuals such as physiotherapists. In this link I discuss some of these exercises which one can start with

Postnatal Pilates

Postnatal Pilates promotes alignment, postural care and improves awareness of your “new” post-birth body. This is also important to help in the prevention of low back pain and shoulder and neck tension mostly related to the regular lifting of the baby. The deep breathing exercises used during Pilates oxygenate both the muscles and the brain which also improves psychological well being.

Here’s a link for a free video sample of postnatal Pilates

We offer a package of 5 online classes for €12 or 11 classes for  €24 adapted for postnatal/ postpartum recovery . These are guided by a fully qualified physiotherapist and APPI trained in prenatal/postnatal Pilates.

For more info send an email on or go on our FB Page Prenatal-Postnatal Physio by Pippa


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