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Postpartum Guide to Exercise You can begin some exercises as early as the first postpartum day. Early walking is especially important. You should be assisted the first few times you are up. Due to blood loss and changes in circulation during delivery, some women experience dizziness and light-headedness. If you have had a Cesarean birth, you will be encouraged to walk in the hall with assistance within 24 hours after delivery. Gradually, as you regain your strength, you will be on your own. It’s important not to rush, and to take your time. The following Postpartum Exercise Program is designed to help you achieve a speedy and comfortable recovery from childbirth. Talk to your healthcare provider if you have any questions. The exercises outlined here will help you return gradually to your normal level of activity. **The Postpartum Exercise Program is designed:** To improve circulation. To help with posture and promote good body mechanics. To help restore muscle tone and strength. To help you feel well and have more energy. **For your comfort and safety, it is important that you follow the following guidelines:** Gradually increase your activity day by day. Find a balance between rest and activity. Do not become overtired or engage in sudden and/or severe exertion. Avoid heavy lifting, straining, pulling, or pushing. Do not exercise to the point of pain. Increased bleeding or bright red discharge is a sign that you are doing too much. Discontinue the activity and contact your physician or midwife. Never do double leg lifts or full sit-ups. Do not hold your breath during exercises. Breathe out as you contract or move your muscles while exercising. Work consistently and regularly on the postpartum exercises for several weeks. After doing the exercises for several weeks, you may be ready to ease into a more rigorous program of exercise. Check with your doctor of midwife before resuming or beginning a formal exercise program. **Avoiding Injury** The term “good body mechanics” is used to describe how to protect your back from injury while you move. It is important to maintain good body mechanics after delivery to avoid undue strain or pain, especially in the stomach or back areas. Also, due to the hormonal effects of pregnancy, your joints are at risk for injury for several weeks to months after childbirth. Good body mechanics are essential to protect your joints until former strength is regained. It is always important to support and maintain the natural curves in your spine. It is especially important to maintain these natural curves as your body returns to normal after childbirth. **Lying Down** Remember to roll to your side and use your arms to come to a sitting position from lying down. **Lifting** When lifting, keep your back straight, with normal posture curves supported. When lifting, bend your hips and knees. Do not bend at the waist. Never twist your back while lifting. Hold the load you are lifting close to your body. Practice good lifting techniques whether lifting something light or heavy. The following exercises can be started immediately. Remember to go slowly at first and gradually increase to prevent muscle soreness. Start with five repetitions of each exercise and increase slowly as you are able. **Kegel or Perineal Squeezes** This exercise should be done whether you gave birth vaginally or by Cesarean. Performing this exercise may take some time to master. These exercises will help support and maintain pelvic organs, improve circulation in the pelvic area, reduce stitch discomfort, speed healing of the tear or episiotomy, and strengthen the pelvic floor. Begin in any position - standing, lying down, etc. Start by tightening the muscles you use to hold back urine. Try to hold the contraction for a count of 10 and then relax. Relax buttocks, abdominal, and thigh muscles as much as possible in order to emphasize your pelvic muscles. Perform ten repetitions, three times a day. Because urinary incontinence can become a problem for any woman, it is recommended that you continue to do this exercise on a regular basis for the rest of your life. **Pelvic Tilt** This exercise will help strengthen stomach and pelvic muscles and stretch lower back muscles. Start the exercise lying on your back with your knees bent and feet flat. Try to contract your stomach muscles and flatten the small of your back into the floor or bed. If you can, try to tighten your pelvic floor muscles at the same time and hold for a count of five. Relax, and then repeat five times. **Ankle Circles** This exercise will help to decrease swelling and promote good circulation in your legs and ankles. It is preferable to be lying down but you may do them while sitting with your feet propped up as high as possible. Be sure to make BIG circles with your feet, bending and straightening your toes as you go. Repeat five times. **Chin Lifts** This exercise should be done before any curl-ups or partial sit-ups. Start by lying on your back with knees bent and feet flat. While doing a pelvic tilt, bring your chin up to your chest while leaving your shoulders and back on the floor or bed. Try to hold for a count of five. Relax, and then repeat five times. **Walking** Start walking as soon as possible after childbirth to increase general strength, endurance, and circulation. You may begin in the hospital by walking in the halls. Remember to start slowly and gradually increase distance and speed. Continue your walking program at home.