Postpartum exercise might be the last thing on your mind after giving birth, and that’s OK! But moving your body and picking up a gentle fitness routine after your baby is born can be healthy, energizing, and even mood-boosting—especially if you exercised regularly before pregnancy.

Whatever your level of experience, interest, or postpartum goals, you may be wondering when you will be able to start, how to ease back in safely, and how to manage any challenges that come with postpartum exercise.

When you can start exercising after pregnancy

Previously, the guidelines were to wait for your six week postpartum check-up to get clearance from your doctor to resume exercise.

However, the American College of Obstetricians and Gynecologists (ACOG) now says that after a healthy vaginal delivery, most postpartum moms can begin exercise as soon as they feel ready, even within a few days after giving birth.¹

However, ACOG cautions that if you had a C-section or any kind of complication during birth, you should ask your doctor or midwife about when you can safely resume exercise.

Samantha Spencer, PT, DPT, postpartum rehabilitation specialist and medical advisor at Aeroflow Breastpumps, says whenever you begin exercising postpartum, you should do so gradually.

“You’ll want to focus on bodyweight and lower impact exercise for at least the first 12 weeks after birth to give your body time to recover from pregnancy,” she advises.

Spencer says there are certain clues that might indicate you have moved into postpartum exercise too soon, or that you should do less intense workouts.

“If you’re noticing increased bleeding (not associated with a menstrual cycle), pelvic pressure, heaviness, incontinence, or pain, those are all signs you could be doing too much, too soon,” says Spencer. “Slow your pace and reach out to your provider or a physical therapist to help you figure out what’s up and how to adjust.”

The bottom line? Always listen to your body, and definitely pull back if exercise doesn't feel right. If exercise is causing increased bleeding or any other concerning symptoms, make sure to contact your healthcare provider.

How to ease back into exercise

It’s best to exercise mindfully and gently in the first few weeks after giving birth. There is no need to rush.

ACOG recommends starting with abdominal and back exercises, gradually building up to moderate aerobic exercise, and to stop exercising if you feel any pain or discomfort. For aerobic exercise, ACOG suggests starting with three 10 minute walks a week, and going from there.¹

Helene Darmanin, PT, DPT, CSCS, founder of Mama Bear Physical Therapy, recommends reframing what exercise looks like in those early postpartum weeks.

“A ‘workout’ may be something as simple as standing up and down a few times to ease back to squats and pulling on a resistance band in a few different directions,” says Darmanin. “If this gentle return feels OK and any incisions or tears are healing well, then you can start to progress to your preferred method of physical activity.”

Besides light walking and gentle strength training, many postpartum moms focus on abdominal exercises. It’s important to choose exercises that are postpartum-friendly, especially if you are dealing with a diastasis recti (separation of the abdominal muscles).

Consider searching for exercises classes geared specifically toward those in the postpartum period, or consider working with a pelvic therapist who specializes in postpartum exercise and rehabilitation.

Challenges of postpartum exercise

While picking up an exercise routine should hopefully make you feel better after having a baby, there are some unique challenges of this postpartum period to prepare for.

Managing postpartum conditions

Darmanin recommends pulling back on your postpartum exercise routine if you experience pain or any other issues, such as leaking urine.

If you have diastasis recti—a very common postpartum condition characterized by widening of the abdominal muscles—you should exercise caution and seek expert help so that you perform exercise in a way that won’t exacerbate your condition.

“Urinary incontinence, or leaking of urine, pelvic organ prolapse, back, wrist, pelvic, or upper back/neck pain are also common,” says Darmanin. “These are all things that physical therapists can help with, even virtually if you can’t make it to a clinic.”

Again, if you have any concerning physical symptoms while exercising, especially increased bleeding, pressure, or pain, contact your doctor or midwife.

Choosing what to wear

In general, wearing breathable, comfortable workout clothing can help immensely.

“Make sure that you have comfortable clothes that are not going to pinch, especially in areas that will be tender after giving birth (the abdomen, the pelvis, and the breasts),” Darmanin advises.

Spencer recommends investing in some workout gear to give you some extra support, as well as a supportive bra. “High-rise or postpartum compression leggings and a well-fitting sports bra can be super helpful for staying comfortable during postpartum exercise,” she says. “They’ll keep your core supported while you gradually build those muscles back up.”

Exercising while breastfeeding

You can definitely exercise while breastfeeding. ACOG explains that regular exercise while breastfeeding has concrete benefits—specifically, improving cardiovascular fitness—and won’t negatively affect your milk supply, the composition of your breast milk, or your baby’s growth.²

ACOG recommends breastfeeding or expressing your milk before exercising to avoid overfull or engorged breasts. You should also make sure to hydrate frequently during and after exercising.

Keep in mind that you will need a good, supportive nursing bra if you are exercising while breastfeeding.

“Lactating breasts can feel heavy, sore, and leaky with movement or exercise, which can be a deterrent to exercising,” Spencer explains.

A word from Verywell

As you begin considering postpartum exercise, it’s important not to compare yourself to others. Everyone has different bodies, birthing experiences, and goals.

It’s also important to understand that the idea of “bouncing back” after having a baby is a bit of a myth. Most people find that it takes a while for their bodies to heal after giving birth, and that moving too quickly causes more harm than good.

The best advice is to listen to your body, set your own personal goals, and keep in mind that caring for a baby can be really hard. It’s OK if you don’t get in as many workouts as you might like. There will be time for everything soon enough.

SOURCES

1. American College of Obstetricians and Gynecologists. Exercise After Pregnancy.
2. American College of Obstetricians and Gynecologists. Physical Activity and Exercise During Pregnancy and the Postpartum Period.

A study shows that Black mothers are more likely to undergo unnecessary C-sections than mothers of other racial groups.¹

The study, published in August 2024, gathered information from nearly 1 million births at 68 hospitals in New Jersey and found that Black mothers were 25% more likely to deliver by C-section than white mothers. Essentially, doctors are more willing to do unnecessary C-sections on Black mothers when there is the capacity to do so.

This highlights the importance of doctors' discretion and reveals that many may set a lower threshold for performing unscheduled C-sections on Black mothers. Despite limited statistics, the study interestingly suggests Black doctors are less likely than white doctors to do additional C-sections on Black mothers.¹

The study controlled some of the factors that could make someone more likely to have a cesarean delivery, including medical risk factors, sociodemographic characteristics, hospital, and doctor or medical practice group. With all things being equal, Black women still had a higher rate of cesarean.

Medical Bias is the Basis for These Results

Jasmine Johnson, MD, says that in the absence of these medical risk factors, we are only left to attribute this inequity in cesarean delivery to bias and medical racism.

“For example, a medical team may inaccurately hold the belief that Black women are less likely to have successful vaginal deliveries (definitely not rooted in any medical fact), and so the implicit or explicit bias of the team may lead them to be less likely to give Black patients more time to progress in labor compared to their white counterparts,” she explains.

Irogue Igbinosa, MD, agrees, acknowledging that the causes of racial disparities in C-sections and maternal care in the U.S. are complex and multifactorial. “Race is a social phenomenon and construct (not biologically defined), and often, racial disparities in pregnancy outcomes reflect racism instead of race.”

Igbinosa goes on to explain that the disproportionate C-sections among Black mothers could be a result of implicit and/or explicit bias, and that multiple studies have underscored that Black mothers often felt their concerns had been ignored or dismissed during labor.

“In this new study, the authors noted the reasons for C-section were not listed and they could not rule out the presence of 'unmeasurable factors,' such as interpersonal interactions, bias, and discrimination," adds Igbinosa.

The Risk to Black Mothers

Igbinosa considers the fact that the vaginal birth after cesarean calculator previously made Black women less eligible for a trial of vaginal labor post-cesarean.²

“Therefore, a mother who received an unnecessary C-section may have been more likely to have a repeat C-section with future pregnancies," she concludes. "In 2021, the American College of Obstetrics and Gynecology VBAC calculator was modified to remove racial bias.”

Johnson notes that once someone has a cesarean delivery, it makes future deliveries more complicated, whether vaginal or via C-section. And with each subsequent cesarean delivery, there is a higher risk of life-threatening pregnancy complications such as placenta accreta.³

She also explains that while cesarean deliveries can be a safe way to deliver a pregnancy when needed, it is a major abdominal surgery with risks such as more bleeding compared to a vaginal delivery, risk of wound infections, and increased pain compared to a vaginal birth.

A study from the Canadian Medical Association Journal found that those who had C-sections were more likely to have complications than those who delivered vaginally and suffer potentially life-threatening maternal health problems.⁴

C-sections aren’t just a risk for those giving birth—they also pose a potential risk for their children. One study found that children delivered by cesarean delivery had an increased risk of asthma up to the age of 12 and obesity up to the age of 5.⁵

What Can Be Done?

Johnson says studies like these are so important because they allow the medical community to evaluate their own personal biases and make sure that systems are in place to promote equity, such as tracking cesarean delivery rates at hospitals and disaggregating the data by race and ethnicity so trends like this can be identified and corrected.

“For Black mothers, I do not think that it is on us to fix the system, but it never hurts to equip yourself with strategies to advocate for equitable care during your prenatal care and labor,” she advises. 

Igbinosa recommends: 

• Create a birth plan. Working with your obstetrician/midwife/prenatal care provider on a plan before delivery allows you to ask questions about the different hypothetical options in labor. Several templates and apps are available online, and your health care provider's office may also have examples. 
• Consider labor/doula support. Research suggests that support during delivery is helpful to many mothers. Look into the options available through community-based organizations, hospitals, and prenatal/birth clinics near you. Some insurance companies have doulas as a partially/covered benefit, and non-profit organizations offer doulas at no cost/low cost to those meeting eligibility criteria. 
• Ask questions throughout. Some may need a C-section, particularly if there is an urgent issue affecting either the pregnant person or the baby. It's OK to ask your health care team questions about your care and for understanding (or the rationale) of any decisions or procedures.
• Know the urgent maternal signs. Familiarize yourself with national campaigns, including the CDC's Hear Her Campaign, and local advocacy efforts from community-based organizations, such as Black Mamas Matter Alliance. These resources educate parents about the symptoms of urgent maternal warning signs.
• Tell your story. Consider adding your voice to provide input on the future of maternity care with community advisory boards at your local hospital, research committees, and non-profit organizations.

Igbinosa observes that there is a growing recognition that more can be done to reduce the C-section rates among Black people. She explains that currently, there are quality initiatives at the local, state, and national levels working to reduce not just the C-section rate, but also the evident disparities.

“In order to specifically address the racial disparities, you first have to be aware that the problem exists," she says. "It’s even more important to partner with the communities most affected to achieve safer birth experiences.“

SOURCES

1. Drivers of Racial Differences in C-Sections. National Bureau of Economic Research. 2024.
2. Challenging the Use of Race in the Vaginal Birth after Cesarean Section Calculator. Women's Health Issues, Jacobs Institute of Women's Health. 2019.
3. Placenta accreta spectrum-a catastrophic situation in obstetrics. Obstet Gynecol Sci. 2021.
4. Risk of severe maternal morbidity associated with cesarean delivery and the role of maternal age: a population-based propensity score analysis. Canadian Medical Association Journal. 2019.
5. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. National Center for Biotechnology Information. 2018.

The racial disparities Black birthing parents face today have deep roots in American history.  Some, if not all, of the disparities leave many of these women in poverty, with limited access to education, employment discrimination, and inadequate housing. But our country’s history of slavery, segregation, and systemic racism toward the Black community still shapes healthcare access, quality of care, and health outcomes. Here are five historical eras and policies in American history that continue to have poor lasting effects on Black maternal health, contribute to mistrust of the healthcare system, and fuel intergenerational trauma.

Slavery (1619-1865)

During slavery, Black women in America were subjected to reproductive exploitation. In the slave system, Black women were used to reproduce the next generation of enslaved labor, feed enslaved and white infants, test medicines, and perform risky surgeries related to obstetrics and gynecology. 

Jim Crow Laws (1865-1968)

Jim Crow laws were a collection of state and local laws that legalized racial segregation. The laws denied Black women the right to vote, hold jobs, get an education, or have other opportunities. This included unequal access to healthcare services for Black mothers. Segregated healthcare facilities often provided inferior care, and discriminatory practices limited Black women's access to prenatal and maternity care.

The Eugenics Movement (1907-1978)

Black women have been subjected to unethical medical experimentation, including legalized forced sterilization during the eugenics movement. From 1929 to 1974, a disproportionate number of those who were targeted for forced or coerced sterilization were Black women. In fact, the practice grew so common among poor Black women in the South that it came to be known as a “Mississippi appendectomy.”

Social Security Act (1935)

During the Great Depression, many agricultural and domestic workers were Black women. This act excluded those types of workers from social insurance, limiting their access to healthcare services, including maternal care.

The Hyde Amendment (1980)

Historical and ongoing efforts to restrict reproductive rights, including access to contraception and abortion, disproportionately affect Black women. The Hyde Amendment is one of those efforts, prohibiting the use of federal funds for abortion services, except in cases of rape, incest, or endangerment to the life of the mother. It restricts Black women's access to reproductive healthcare, increasing the likelihood of them facing poverty or unemployment after that.

Attempts to Course Correct

In recent decades, the federal government has sought to course correct, taking responsibility to address health disparities and promote the well-being of all citizens, including Black birthing people. Over time, our nation has realized that healthy parents mean reduced healthcare costs and increased productivity, contributing to a stronger, more resilient economy for all. Their well-being directly impacts the health of their families and communities. By ensuring that Black birthing people receive the care they need, we're investing in the future of our nation. 

Here are four examples of legislative and policy choices that have profoundly impacted the health of Black birthing people:

1. Civil Rights Act (1964)

While primarily focused on ending segregation and discrimination based on race, this act indirectly impacted healthcare access for Black mothers. Title VII of the act was amended to prohibit discrimination based on pregnancy, childbirth, or related medical conditions (the Pregnancy Discrimination Act).

2. Medicaid (1965)

Before Medicaid, many Black mothers lacked health insurance coverage due to systemic inequalities, financial constraints, and discriminatory healthcare practices. With its introduction, suddenly, millions of low-income Black mothers gained access to comprehensive healthcare coverage. This included access to essential maternal health services, such as screenings for gestational diabetes, high blood pressure, and other pregnancy-related conditions. By covering the costs of childbirth and postpartum care, Medicaid relieved the financial burden on Black mothers and ensured that they could receive adequate support throughout the entire maternity journey.

3. Healthy Start Program (1991)

This program aims to reduce infant mortality and improve perinatal outcomes in high-risk communities, including those with significant Black populations. Local projects provide prenatal and post-partum care, screening, referral to services for depression and interpersonal violence, outreach and case management, and public health services such as immunizations and health education.

4. Affordable Care Act (2010)

The Affordable Care Act (ACA) has played a crucial role in expanding access to affordable, high-quality maternal health care for Black women, thereby reducing racial disparities. The ACA focuses on improving maternal health outcomes through increased access to maternity and newborn care, preventative screenings, and other essential services. It expands access to health insurance coverage for millions of Americans, including many Black birthing people who were previously uninsured or underinsured.  It even provided federal funding for home-visiting programs that support pregnant women and families with young children through the Maternal, Infant, and Early Childhood Home Visiting Program.

Influencing Federal Change

Even as our country champions progress, the stark reality remains: Black birthing people continue to endure unequal treatment compared to their white counterparts. Racial disparities permeate their every facet of life, from economic status to housing opportunities, societal treatment, and safety. 

Implicit biases and a lack of culturally congruent care among healthcare providers cast a shadow over the quality of care received, perpetuating disparities in maternal mortality and morbidity. Stereotypes and prejudices seep into medical decision-making, eroding trust and widening the gap in healthcare outcomes. The fear of violence and interactions with law enforcement, coupled with disproportionate rates of incarceration and police violence, inflict further trauma on Black women. Even environmental injustices, from pollution to inadequate access to nutritious food and clean water, cast a long shadow over maternal health.

Historically, federal change has been influenced solely by collective action, spanning from legislative measures to investments in public health. As citizens, we have the power to shape government priorities, to hold our elected officials accountable, and to advocate for meaningful reform. Plus, by joining forces with advocacy organizations, we can amplify our voices and effect real change. Whether through voting, contacting representatives, or participating in public advocacy campaigns, each of us has a role to play in the fight to address racial disparities in Black maternal health. 

Our time to do so is now because a groundbreaking piece of American legislation is currently being discussed. The Black Maternal Health Momnibus Act stands as a beacon of hope, mandating multi-agency efforts led by the Department of Health and Human Services to tackle social determinants of maternal health like childcare, housing, and food security. Among other things, the Act calls for the diversification and expansion of the maternal health workforce, includes initiatives to bolster access to maternity care, mandates programs to improve maternity care in prisons, and addresses climate change's impact on maternal health. 

The history of American society is woven with inequity, but it doesn't have to remain this way. Every Black parent deserves more than just access. She deserves dignity, respect, and the assurance that her health matters. Their health is not merely a matter of public policy—it's a fundamental human right.