The abdominal muscles undergo incredible changes during pregnancy, labor, and after delivery.  Their function - and their appearance - is of utmost importance to us as new mothers as we take on the responsibilities of childcare and as we try to regain our pre-pregnancy level of fitness.

            The abdominal muscles are actually four layers of muscles which span from the breastbone and ribs to the pelvis.  Working together these muscles function as a corset to support the lower spine and pelvis.  In addition to flexing and rotating the trunk, the abdominal muscles are your primary “core muscles”:  they stabilize the lower back during all movement.

            During pregnancy, the tremendous elasticity of the abdominal muscles allows for significant lengthening to occur in order to accommodate the increasing size of the uterus.  Stretched taut over your growing uterus, the abdominals help to support the uterus and can help to stabilize the pelvis.

            After delivery, although your uterus immediately begins to shrink back to its pre-pregnancy size, your abdominal muscles remain in their over lengthened state.  In this weakened condition they are unable to function as adequate stabilizers.  This increases the potential for lower back injury, especially when coupled with the physical demands of caring for an infant.  Unless active abdominal muscle exercises are initiated, these muscles will remain over lengthened and weak.

            It is important to begin abdominal exercises that are graded to your level of recovery.  Each woman varies in her rate of recovery and her pre-delivery level of fitness.  Generally speaking, however, gradual abdominal muscle strengthening is safe and effective.  By starting an exercise routine geared toward postnatal strengthening you can expedite the process of abdominal muscle tightening.  This not only helps with your physical appearance; it keeps your back healthy.  Strong abdominals create a stable core to support your lower back during daily activities like lifting your baby up from his crib, placing him into his high chair, or loading the stroller in and out of the car.  With a good strengthening program you can safely rebuild these core muscles as you regain your pre-pregnancy appearance and meet the demands of carrying and lifting your baby.

Exercise is the only way to get your muscles back in shape. No amount of dieting is going to do that for you! Give yourself time - it took nine months to grow your baby, allow yourself at least that much time to restore your body.

Do:

• Start kegels and pelvic tilts immediately. As soon as 12 hours after giving birth you can begin these exercises.
  
   
• Check with your physician before beginning any aerobic postnatal exercise program. Most women are able to resume aerobic exercise within 6 weeks postpartum; however, in some cases it may be longer.
  
   
• Resume exercise gradually. The first months with a newborn are hectic. Making lunch seems like a big accomplishment! Although exercise after childbirth is important, it won't help you if you over do it. Avoid exercising to fatigue.
  
   
• Exercise regularly. You need to include aerobic activity for at least 20 minutes 3 - 4 times per week to burn fat.
  
   
• Listen to your body. If it doesn't feel right, modify the movement or eliminate it. Modify or stop exercise if you experience extreme fatigue or discomfort.
  
   
• Include muscular endurance exercises. Specifically, strengthen the thighs, chest, shoulders, upper and lower back, buttocks, abdominals and pelvic floor muscles.
  
   
• Include stretching. Specifically stretch the inner thighs, lower back, hamstrings, and chest.
  
   
• Intake adequate calories. The demands of breastfeeding require 500 extra calories per day.
  
   
• Stay well hydrated. Drink plenty of fluids before, during, and after exercise to help prevent dehydration.
  
   
• Wear a supportive bra during exercise. Breasts can be especially tender in the early postpartum months.

Don't:

• Don't begin abdominal reconditioning work until sutures have healed, if you had a cesarean birth. The sutures generally heal within 4-6 weeks, but make sure to check with your doctor and get approval before starting abdominal work.
  
   
• Don't do advanced abdominal exercises (e.g., crunches and reverse curls) if you have abdominal separation. Separation of the abdominal muscles, called diastasis recti, is a condition that can occur during pregnancy or during childbirth. If you have this separation, then avoid advanced abdominal exercises until the muscles have closed and the pelvic floor is strong, and always use splinting techniques during exercises.
  
   
• Don't use jerky, jarring and twisting movements. This type of activity puts additional stress on joints and body areas already overloaded by the increased weight of pregnancy and affected by hormonal changes.
  
   
• Don't make quick directional changes. Your body shape and center of gravity is returning to pre-pregnancy state; however, you may still experience reduced balance in the early postpartum months.
  
   
• Don't exercise if you experience any of the following: Bright red vaginal discharge, sharp pains in hip or pubic joint, breathlessness or lightheadedness, extreme discomfort anywhere in the body, or breast infection or abscess.