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Light activity can usually begin early when the mother is medically stable and feels ready, but the timeline depends on the type of birth, complications and symptoms. After a C-section, recovery needs particular attention because the abdominal tissues are healing from surgery.
WHO recommends starting with small amounts of activity and gradually increasing frequency, intensity and duration. After a caesarean birth, return to activity should be gradual and discussed with an appropriate health professional.
The important principle is progression based on healing and symptoms rather than a fixed deadline.
The first two weeks are primarily about recovery, mobility and adapting to life with a newborn.
A physiotherapist can educate the mother about:
● Comfortable bed mobility and getting up safely
● Gentle walking and regular position changes
● Breathing and relaxation exercises
● Gentle pelvic-floor activation when appropriate
● Feeding and lifting positions that reduce unnecessary strain
● Basic abdominal support during coughing or movement
For a C-section, the incision should be monitored carefully. Increasing redness, swelling, discharge, wound opening, fever, or worsening pain requires medical assessment rather than routine physiotherapy progression.
At this stage, the objective is not abdominal strengthening or weight loss. It is helping the mother move comfortably while tissues heal.
As recovery progresses, walking can gradually increase according to symptoms and tolerance. Gentle functional exercises can be introduced, including pelvic-floor work, posture exercises and low-load strengthening.
Pelvic-floor rehabilitation is particularly important when there is urinary leakage, urgency, pelvic heaviness or difficulty controlling the muscles. Recent evidence supports postpartum pelvic-floor muscle training for reducing the odds of urinary incontinence, although programmes should still be individualised.
For mothers recovering from C-section, abdominal loading should progress carefully. Pain, pulling around the scar, increasing bleeding or pelvic symptoms are signs to reduce the workload and reassess.
WHO also recommends that postpartum women gradually build physical activity where there are no contraindications, rather than remaining unnecessarily sedentary.
Diastasis recti abdominis (DRA) is common after pregnancy and involves separation and altered tension of the abdominal wall.
Assessment should not focus only on the width of the gap. A physiotherapist should also consider:
● Inter-rectus distance
● Abdominal wall tension
● Trunk control
● Breathing strategy
● Functional tasks such as rolling, lifting and sit-to-stand
● Pelvic-floor function
● Pain and movement limitations
● The mother’s goals and symptoms
Current research shows that postpartum abdominal exercise can reduce inter-recti distance, but studies use different assessment methods and exercise protocols, so there is no single universally accepted “best” DRA programme.
Therefore, treatment should focus on function and progressive loading, rather than promising to simply “close the gap.”
A progressive programme may include breathing coordination, deep and superficial abdominal activation, pelvic-floor training and functional strengthening.
The physiotherapist can gradually progress from low-load exercises to movements such as bridges, squats, controlled carries and other functional resistance exercises, depending on symptoms and recovery.
The key is to observe how the abdominal wall responds to loading. Excessive doming, pain, pressure or loss of control may indicate that the exercise needs modification.
Evidence supports abdominal exercise for improving inter-rectus distance, but the overall evidence base remains heterogeneous.
Scar management should not begin with aggressive massage over a fresh incision.
Once the incision is appropriately healed and medical clearance is obtained when necessary, physiotherapists may assess scar mobility, sensitivity and restrictions in the surrounding tissues.
Progressive scar mobilisation can include:
1. Gentle skin contact and desensitisation.
2. Light movements of the skin around the scar.
3. Gentle multidirectional mobilisation once healing permits.
4. Progression according to tissue tolerance and symptoms.
The aim is to improve comfort, tissue mobility and confidence with movement—not to forcefully “break” scar tissue.
C-section wound healing should remain part of routine postpartum assessment, and persistent or worsening wound symptoms warrant medical review.
A mother should demonstrate appropriate healing and functional tolerance before progressing to higher-impact exercise.
Useful clinical milestones include:
● Walking comfortably without increasing symptoms
● No concerning increase in vaginal bleeding with activity
● Healed C-section incision or perineal injury
● Good pelvic-floor control
● Ability to perform basic strength exercises without pain or pressure
● No significant urinary or faecal leakage during loading
● No persistent pelvic heaviness or dragging sensation
Recent postpartum activity guidance supports gradual progression from light activity toward moderate-to-vigorous activity once surgical or perineal healing is adequate and symptoms do not worsen.
Return to running should be treated as a progression, not a single clearance date. Walking, strength training and lower-impact loading can provide the foundation before impact is reintroduced.
Some symptoms require medical assessment rather than routine exercise progression.
These include:
● Heavy or suddenly increasing bleeding
● Fever or signs of infection
● Worsening C-section wound pain, redness or discharge
● Chest pain or difficulty breathing
● Severe headache or neurological symptoms
● Significant calf pain or swelling
● Severe or worsening abdominal or pelvic pain
● New or worsening pelvic-floor symptoms
WHO specifically recommends educating postpartum women about danger signs and seeking qualified medical care when they occur.
A structured postpartum programme can be divided into four practical stages:
Stage 1 – Recovery: education, breathing, mobility, positioning and gentle activity.
Stage 2 – Foundation: pelvic-floor rehabilitation, abdominal control, walking and basic strengthening.
Stage 3 – Reconditioning: progressive resistance training, functional movements, cardiovascular conditioning and scar management where appropriate.
Stage 4 – Return to Goals: running, gym training, sport, work demands or higher-level fitness based on individual goals.
This approach gives the mother measurable milestones rather than simply telling her to “wait six weeks.”
Yes. Physiotherapy can support mobility, pelvic-floor and abdominal rehabilitation, scar management after appropriate healing, and gradual return to exercise.
Not necessarily, and treatment should not be judged only by the size of the gap. Improving abdominal-wall function, strength, pressure management and symptoms can be more clinically meaningful.
Not every mother requires formal rehabilitation, but assessment can be particularly useful when there is pain, urinary leakage, pelvic heaviness, abdominal-wall concerns, C-section discomfort or difficulty returning to normal activities.
Light activity may begin earlier when medically appropriate. The six-week mark should not be treated as a universal switch from “no exercise” to “full exercise.” Recovery should be gradual and individualised.
Postpartum recovery is a process, not a six-week deadline. A good physiotherapy programme starts with healing and basic movement, progresses through pelvic-floor and abdominal rehabilitation, addresses concerns such as diastasis recti and C-section scars, and eventually prepares the mother for her normal exercise and lifestyle goals.
For physiotherapists, learning how to assess these changes and build a structured, symptom-guided programme can make postpartum care safer and more effective.
Want to develop specialised skills in postpartum rehabilitation? Explore our Postnatal Care course to learn practical approaches for supporting mothers through recovery.