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Foundations of postnatal exercise: Where do I start with this post-baby belly?

I’m both a maternity physiotherapist and a Pilates Instructor. I taught my last class 3 weeks before birth. I looked and felt great while pregnant. But after the birth I found it hard to get my body to recover and change too. Five months after the birth of my son, my tummy still looked like jelly, felt flabby, protruded out, felt disconnected. I remember clearly the day I just stood and stared at my belly and cried.

Thoughts ran through my head: ‘But I'm a Pilates instructor. I'm a pelvic health physio. I teach postnatal exercise classes. I know exactly what to do - and I have been doing it. My pelvic floor exercises, my pilates routines, walking, posture. Surely it should look better than this by now?’  

I captured that disheartening, dispiriting moment. I wanted to remember the disappointment, the self-realisation of my vanity, my honest fear that it might never look any better, my guilty feelings that I blamed my baby. My frustration with the s-l-o-w process of muscle rehab. Why? Because I wanted to be able to be truly empathetic in the future.

I also wanted to then notice how much longer till it felt better. What made the difference? Had I done the right thing and taken the right approach or should I have been bootcamping and planking much sooner, despite knowing the science against that approach? How could I confidently reassure my future clients and mum friends that it would get better?

And actually it really wasn’t very long after this that I felt like I turned a corner.

One day, my tummy felt like it belonged to me again, even though it wasn’t exactly the same. The underlay felt firmer and the skin less sallow and crinkly. I wore my New Year’s eve party dress with confidence. In fact, I had my best bottom ever from walking so much with the pram and my abs felt good enough to flash a hint of flesh in a tankini again.

I support the idea that we are proud of our ‘new’ mummy bodies. This body has worked and created and produced a child.

So what did I do to achieve a better, stronger core after pregnancy?

Sorry, no. No magic programme. I didn’t do anything other than keep plugging away at the classic Pilates foundation exercises, progressing steadily up the levels and then branching out into more mainstream cardiovascular exercise and higher level core workouts.

I wasn’t trying to be clever. I was just trying to find 10-15 ‘good’ minutes every day to feel I had done something a bit harder and more challenging than my body really fancied. It made my brain practice the muscle patterns and sequences that make up the foundation of movement and encouraged the changes that I wanted.

There was also lots and lots of putting that brain and muscle training into real life by being very aware of my posture and encouraging the right muscles to work when walking the pram, when winding my baby, when sitting to feed, even when sitting at playgroup. I also went back to teaching Pilates one night a week.

I am a fan, if you possibly can, of signing up to a proper postnatal exercise class one evening a week. It doesn’t have to be Pilates. Whatever is your thing, or just plain most convenient to get to. Choose something aimed at postnatal mothers and led by an experienced and interested instructor. Get your partner or family to commit to babysitting for you for that one hour class (and time to get there and back). Pay your money upfront because it will make you go. Having someone professional hold you accountable, check your technique and make you do it properly is so worthwhile.  

So there’s no magic and no “quick fix”. But the long term, sustainable results that we all want, to have a strong, lean, pain-free, high-performance body again, are attainable.

Why a post-baby body is a bit different to just being ‘unfit’

The muscles stretched by pregnancy need more time and attention to retract. It’s not the same as having become deconditioned through lack of exercise.

You have been working very hard, just being pregnant. Your cardiovascular system is often at its prime when you give birth, which is how athletes return to full fitness again, sometimes achieving even better race times after having children.

Some people say that since it takes 9 months to stretch your belly out to accommodate your full term baby, we should allow the same amount of time for the tissues to retract and become shorter again. This seems to make sense.

One of the common errors is to think that your body returning to ‘normal’ will be a quick process. Realistically, can take 2 weeks for the uterus alone to shrink down from full-term baby size back to the 5cm organ that it usually is.

I still adore the Duchess of Cambridge for showing us her post-baby belly as she left the hospital after the birth of George, normalising the amazing process that the body is going through.

How your abdominal muscles change during pregnancy

The abdominal muscles have to adapt to accommodate your baby while you are pregnant. If you held a tape measure between your sternum and your pubic bone when pregnant, you would be able to measure their changing length. During pregnancy, the muscles of the abdomen stretch to lengthen.

At the same time, the linea alba, a tough supporting ‘seam’ where the rectus abdominus muscles meet in your body’s midline, also stretches out, creating a greater separation between the muscles of your abdomen.

The linea alba is not a muscle itself, but a fibrous structure. When it stretches, it becomes thinner and more vulnerable with less inherent strength, much like the way that pastry becomes thinner as you roll it out.

This all looks appears fine when the baby is inside you, really quite beautiful, but once the baby is out, the muscles and fibres don’t have the same shape or strength that they did before.

How good posture encourages your muscles to remodel after having a baby

If you stand around totally relaxed, your belly hanging over the top of your jeans, your back swayed, your bottom muscles relaxed, there is very little reason for your brain to undertake any process of change. It thinks that you need and want this posture and allows the muscle to remain long like this.

Since it is very difficult for the muscle to contract in this lengthened position, it’s easy to get caught up in a vicious circle of not using the muscle correctly.

However, if we regularly hold the muscle in a slightly ‘shortened position’ - for example, by trying not to let your tummy hang out over the top of your jeans, using the Pilates-style drawing in of the lower abdominals to improve your posture and stay even just 1/2 inch less protruded (‘shorter’) - your body will learn to adapt.

Little by little, the muscle shortens itself. One day, when you release the belly to your most relaxed position, you’ll notice is isn’t hanging out nearly so far as it used to. With regular practise, your muscles will have learnt to contract properly again and they will have shortened to their original length. Plus, you’ll have regained some strength there too.

By combining this muscle shortening and strengthening process with reducing the layer of fat in the abdominal wall through good nutrition, you will start to see the shape and “tone” of the abdominal muscles return.

How pilates-based exercises create a good foundation for a baby-stretched body?

In most traditional styles of exercise, such as aerobics, you copy the teacher with the goal to look as if you are doing the same pattern of arm and leg movements and keeping up with the pace they are going at. There isn’t that much attention on how you achieve that pattern. You will look good if someone comes in the room, like you are making lots of effort and doing exciting exercises, but what is actually happening in your abdomen and pelvic floor?

My guess is not an awful lot.

I think you will find that these muscles are either just hanging about in that long over-stretched post-baby position, or gripping like mad in a counter-productive, over-tense, couldn’t-keep-this-up-in-real-life kind of way, which means as soon as you stop exercising it will all collapse back to the ‘stretched position’ and nothing really changes for the long term.

With a pilates-style approach, the emphasis is always first on what have you done with your pelvic position, abdominals, pelvic floor and breath (the core muscles) before you add the arm or leg pattern.

You make yourself ‘be’ how you want to be in real life, flatter tummy, firmer pelvic floor, spine in a neutral position (not bum stuck out or bizarrely tucked under, just your normal self) and then you think, ‘how can I stay like this no matter what my arm or my leg does’.  

Oh my, it is tricky at first. But I love the quote, “if it feels easy, it is probably not pilates”.

The starter exercises are designed to be in the right order to create change without bulging

I usually suggest you start in side lying so that you can see your tummy hang out in front of you. I know that’s not a nice look but it is much easier to see the abs and check on them than when you lie on your back and they fall on top of you. The correct action is to draw your lower abdominals (below the belly button) in, just a half an inch to an inch more than it wants to hang, and then you make sure you can breathe. Yes, just breathe. Don’t knock it till you try it!

Only then, you try to lift your arm up in the air without your tummy falling out. Your brain will not like this. It will think, ‘hey, I can breathe, OR I can hold in, OR I can lift your arm - but I cannot do all 3 at once’. This is exactly the problem that you need to overcome. If every time you lift the baby to have a cuddle your abdomen bulges out, any other exercise session you may have done is completely wasted.

Formal exercise is going to be max 1/2 hour of your day. Baby lifting and carrying more like 17 hours of your day.  

The foundation exercises practice coordinating that brain and muscle pattern over and over again, until it feels quite normal and not very difficult to combine any 3 activities.

First, arms. Then we try moving a leg while holding in and breathing. Then an arm and a leg. Then we move to learning to do this on your back. Here, we can practice moving alternate legs without losing the abdominals (which mimics what we want to happen when we walk) or folding legs in and out (which mimics climbing the stairs).  

It may take you several sessions to be able to coordinate these tasks again, but then you will be able to add some hand weights or use your legs in more challenging patterns and find that you can control the abdominal wall in a shorter position for a wider variety of tasks. We practice upright, too, where you have to fight against gravitational pull.    

The benefit of postnatal exercise lasts all day

It’s not just what happens in the time you are formally exercising that makes the difference.

The really wonderful thing about taking 20 minutes out to train your brain to coordinate all these elements, is that when you stand up and move off to change the baby or walk to the shops you will find that you are still executing those patterns because they have become ingrained in your head.

Hold-and-breathe-and-move…

And so as you move about, you will be reinforcing the patterns that you want, the shape that you want, the posture that you want. Sure, after an hour of distraction, these patterns will fade again and you will be a bit floppy and back in the long, stretched muscle position, but then you will think about sitting and eating your lunch with good posture and your lower abdominals gently engaged to support your back, and your brain will practice again this coordinated sequence.

Soon it becomes a habit. You will be surprised to find that when you aren’t actively thinking about your posture and how you are standing, you feel unsupported, floppy and tired by the lack of external support. In contrast, holding yourself purposely in symmetrical alignment starts to feel much nicer and far less effortful.

What’s not to like about postnatal exercises?

The exercises don’t hurt. They feel brain-taxing but equally rather pleasant. They feel right. The tasks may seem almost too simple when you start out. That is because I have chosen to put them in the order that incrementally moves you from level to level so that you hardly notice how quickly you are progressing. Anyone walking into the room might say to  you, ‘come on, is that really exercising?’ But they can’t see what is going on inside your body and in your brain. Make them try it!

Initially, the emphasis on the breath and the detail rather than the activity itself feels weird, but in our Foundation Pilates videos I will talk you through every step of when to move, when to hold your muscles and when to relax. People often say that their sleep-deprived brain loves that I even tell you when to breathe!  

Why don’t you just try one postnatal exercise session?

Try one of the short starter videos (birth to 6 weeks, or caesarean to 6 weeks as appropriate) every day for 5 days and I know you will be pleased with the results.   

If you are already well past 6 weeks but feel that your present exercise plan (or lack of) hasn’t got you to where you want to be yet, then think about taking one step back in order to go 3 steps forward later.

Start with the birth to 6 weeks video (ignoring my chat at the beginning about your newborn baby) and establish these careful foundations and building blocks for the brain.

As soon as you feel it is getting easy, move on to  Mind the Gap 1 postnatal exercise video. I won’t need to tell you when to move on - you will just know when you're ready for Mind the Gap 2.

We are going to teach you about your body so that you can make good choices when presented with any other exercise task at a class or in another video.

Once you learn how to move this way it becomes so intuitive that you can’t forget it. Any other exercise programme that you follow - HIIT with my friends Clio and Caroline at &Breathe postnatal, ballet with the beautiful girls at Sleek Technique, or some yoga - you will use these core foundation skills as a sound springboard to these other great postnatal exercise routines.  

Enjoy! And don’t hesitate to contact me if you have questions, discussion points or need a bit of help. You can find me at supportedmums.com.

Amanda x