First things first: rest is just as important as movement. Your body has done something incredible, and healing takes time. Always check in with your doctor or midwife before starting any kind of exercise.
In the beginning, it’s not about “working out” in the way you might think. Instead, the focus should be on:
- Breathing properly to support your core
- Posture and alignment to avoid unnecessary strain
- Reconnecting with your core and pelvic floor before jumping into anything intense
Slow and steady is the way to go. Be patient with yourself, listen to your body, and know that every little step (or breath!) counts toward feeling stronger.
What exercises would you recommend to women in the first few weeks after they have given birth if they are experiencing incontinence?
If you are experiencing bladder or bowel leakage after giving birth (and this can happen after a Caesarean too), it is highly likely that this is because the pelvic floor muscles have been stretched and weakened from carrying the weight of your baby through your pregnancy. They may also have experienced some further injury during the delivery.
The pelvic floor muscles need to be exercised to rebuild their strength and tone. This helps keep the bladder and bowel tubes properly closed, preventing leakage when you cough, sneeze or move fast, and helps you ‘hold on’ when you need to delay a bathroom visit! Your abdominal muscles will have been stretched too, and they need exercise to go back to full strength so that you can use them to help lift the weight of the baby without pressure on your back or bladder.
However, in the very early days, while your body is healing after birth, you don't have to do hundreds of pelvic floor exercises every day. The priority in the first few weeks is to get the swelling down so you’re more comfortable, encourage blood flow to the area and start reminding the muscles what to do.
Simply stop every couple of hours, relax completely in a chair (or lying down), focus on the area around the bladder and bowel openings. Release any tension, especially if you have felt sore or vulnerable. You can’t work muscles that are tense. Next, try to slowly ‘pulse’ the pelvic floor muscles, as best you can, thinking of promoting blood flow, loosening stiffness and making a brain-floor connection again. Make this a part of your ritual of feeding the baby and you won’t forget!
As you are less sore, you can now move to the ‘exercise’ stage. You will find a video as well as free downloadable leaflets including essential advice and exercises following childbirth written by physiotherapists from the charity POGP. These have pictures of rest, changing and feeding positions, getting in and out of bed, and bowel emptying as well as specific advice for after a Caesarean. There is also lots of information on how to do pelvic floor exercises as well as starting and progressing with abdominal exercises.
Aim to do your “fast" and “slow holding” pelvic floor exercises for 10 repetitions each, properly, three times a day. After each feed, MOVE your body, especially your spine, with stretches like leaning sideways and arching backwards to counteract all the forward-ness of caring for little ones. Once a day, find just 10 minutes to really focus on connecting to your abdominals.
Recap: Weeks 1 to 6 Postpartum
The first six weeks after birth are all about healing and recovery. Your body has been through a lot. Your pelvic floor is stretched, your core is weaker, and your tissues are still healing. That’s why this phase is more about reconnecting with your body rather than jumping into intense workouts.
Here are some gentle, safe movements to start with (if cleared by your doctor or midwife) 2:
- Diaphragmatic breathing: Deep belly breathing helps engage your core and support your pelvic floor.2
- Pelvic tilts: A simple way to wake up your core and relieve tension in your lower back.3
- Gentle pelvic floor contractions (Kegels): Light contractions (without overdoing it) help rebuild strength. 3
- Glute bridges: If cleared, these can activate your glutes and core without putting too much pressure on healing tissues.
Consistency over intensity is key. Instead of setting aside long workout sessions, try fitting these exercises into your daily routine:
- Do a few pelvic tilts while lying in bed
- Try gentle Kegels while feeding your baby
- Squeeze in some deep breathing while rocking your little one to sleep
Small, mindful movements add up over time. Be patient with your body, as it’s already doing an incredible job.
What light exercises would you recommend that women could do at home? Could you give us a simple example exercise plan that someone could follow?
Foundation Pilates and yoga moves are perfect for getting started on reviving your core. There are lots of postnatal resources for moms online to get you started. Ideally, also find a local postnatal class to keep you accountable and make sure someone is checking your technique.
Watch out for abdominal ‘doming’ – if an exercise makes your tummy pooch, bulge or ‘peak’ it is too challenging for you at the moment. Make that exercise the goal but use the level before to train to get there.
Great exercises to do at home are:
Bridging: Start lying on your back with your knees bent, feet flat. Draw in your abdominals and pelvic floor muscles, then lift your bottom in the air. Try to hold steady, using your abdominals and bottom muscles (not your neck and shoulders) to keep the lifted position for 2-3 slow breaths. Lower slowly. Repeat 10 times.
Knee folds: Same start position. Draw in your abdominals and pelvic floor muscles, keep them working gently, now imagine balancing a glass of water on your tummy. Keep the water absolutely still as you fold one knee up, over your hip.
Then slowly put that foot back down where it came from, and without letting the imaginary glass move, change feet. Imagine climbing a giant set of stairs - you need to move from one leg to the other keeping good abdominal and pelvic floor control. In real life, think of this exercise every time you go up the stairs!
Double knee folds: When single leg folds get easy, increase the challenge by first bringing one leg up, keeping it there, and then bring the second leg up. This is surprisingly much harder! Any sign of abdominal pooching stick with single knee folds a bit longer.
Squats: Fabulous for bottoms and if you “think core” as you do them you will activate your abdominal and pelvic floor muscles too. Don’t worry too much about ‘form’ at this stage. Put your feet wherever is comfortable. Deep or shallow to start. Just get yourself moving, building up stamina and strength. You can stretch your arms out ahead of you as you squat down for extra challenge. Work for one minute without stopping.
Sit to stand: Up and down from a chair, but slowly so that you can feel the effort in your legs. Again, think abs and pelvic floor as you reach the top and control the lowering down. Once you have good control you could hold your baby while you do them. But same warning – tummy pooching, or pressure down on the bladder area is a sign you need to spend longer on the basic version first.
Recap: Weeks 6 to 12 Postpartum
At this stage, you’re moving from early recovery to slightly more active movement, but the focus is still on building strength safely. Your core and pelvic floor are getting stronger, and you can start incorporating more functional exercises into your routine.
Here are some great exercises to try:
- Standing Kegels: Engaging the pelvic floor while upright helps with real-world strength (think lifting your baby, walking, etc.).
- Modified squats: A great way to strengthen your legs and glutes while keeping pressure off your pelvic floor.
- Transverse abdominis activation: Gentle core engagement to help rebuild deep core strength.
- Supported planks: A modified plank (on knees or with hands elevated) to gradually reintroduce core stability.
- You might also find that light walking or gentle yoga feels good at this point. Just keep listening to your body and avoiding anything that causes discomfort or pressure in your pelvic area.
Sample Weekly Schedule:
- Monday – Standing Kegels + light walk
- Tuesday – Transverse abdominis activation + supported plank
- Wednesday – Rest day or gentle yoga
- Thursday – Modified squats + light walk
- Friday – Standing Kegels + supported plank
- Saturday – Light yoga or stretching
- Sunday – Rest day
Remember, pelvic floor engagement is key. These movements should feel controlled and intentional. Keep focusing on form over intensity, and don’t rush the process. Slow, steady progress leads to long-term strength.
Recap: From Week 12 Onwards
By now, you might be feeling a little more like yourself again. But recovery is a long game, and your body is still adjusting. Even at 12 weeks postpartum (and beyond), it’s totally normal to be working on strength, stability, and bladder control.
If you’re ready to step things up a little, here are some great ways to ease back into regular movement:
- Postnatal Pilates or yoga: Moves like the happy baby yoga pose are fantastic for improving flexibility after childbirth.3
- Light strength training: Focus on glutes, core, and overall stability before adding heavier weights.
- Pelvic floor exercises: Keep these in your routine! They’re key for long-term recovery.
The most important thing? Take it at your own pace. Healing doesn’t stop at 12 weeks. Many women continue to see improvements months (or even years) later. If you’re still struggling with incontinence, pain, or other symptoms, don’t hesitate to reach out to a women’s health physiotherapist or your healthcare provider for expert support.
What clothes would you recommend for women with incontinence who are exercising in the first few months after they have given birth?
While you are waiting for your diligent exercising to pay off it can also help to add more support layers from the outside by choosing the right clothes. Wear proper supportive underwear with low/wide waist bands, or a feeding ‘vest’ with a tummy support panel. If it is winter, wear thick tights. Choose firm material: close-fitting pants, leggings or track suit that help make you conscious of your posture and holding your tummy in.
If you are feeling vulnerable to bladder leaks, don’t be put off getting out and about with your baby. It is really important that you have company, form friendships and are active outdoors.
You can use women's incontinence pads to give you confidence (but still work on your pelvic floor for a long-term solution). Choose a liner designed for the purpose of catching and containing liquid, not the ones designed for periods.
Liners for bladder leakage use the technology developed for baby diapers, such as little gel beads that swell with liquid, and fabrics that can wick fluid away from the surface. This means liners can be much slimmer than they used to be, keep dampness away from your skin and have good odor control too.
Having gained a little more confidence a few months down the line, what exercise would you recommend that women with incontinence do?
When you are ready to pick up the pace, most women want to focus on getting flatter firmer abdominals. But we need to be mindful of not putting too much pressure on the vulnerable bladder and pelvic floor area.
Always aim for slow, intense, controlled repetitions of abdominal exercises. At the beginning of an exercise session, focus on core exercises where your goal is to keep your body still (using your transversus abdominis, obliques and pelvic floor muscles). Then move your legs or arms as the challenge; in Pilates/core work this would be leg stretches, hip twists, table top; at the gym use the free weights (start 1-2 kg each hand), lat pulls, ab and adduction, leg presses and anything squat/step-up related.
Put upper abdominal and sit-up type exercises for rectus abdomens (like headlifts, mini-crunches and roll-ups) in the middle of the session (when the core is awake and working well but not yet tired) with a maximum of 20 slow, focused repetitions (watching like a hawk that there is no abdominal bulge). You only need to lift your head and shoulders a few inches to feel the ‘six pack’ muscles working.
Be careful on rowing machines — you need excellent technique to avoid bearing down on the pelvic floor. Remember abdominal muscles need stretching too. Finish your session with a Pilates/yoga cobra, lying on your front pushing up through your hands.
Remember that real life is full of opportunities for camouflaged exercise: nothing is as good for your bottom (gluteals) as stairs, stroller pushing or chasing after a toddler on a scooter. Use any excuse to play ball, run around and swim with children. Use any glimpse in a mirror or window to think POSTURE!
