Postpartum Running: When Can You Start Running After Giving Birth?

Postpartum Running: When Can You Start Running After Giving Birth?

Postpartum running is a hot topic on social media. It is a question that a majority of female runners asks at some point in her life. How long should you wait until running after giving birth? Must you wait twelve whole weeks before you can run again? Or are you clear at six weeks? Ultimately, postpartum running is highly individualized, not just woman to woman, but pregnancy to pregnancy. 

This is part one of a two-part series. Part one explores how long you should wait to resume running postpartum. Part two delves into how to safely return to running after giving birth. 

Postpartum Running: When Can You Start Running After Giving Birth?

How Long Should I Wait to Run After Giving Birth?

Generally speaking, six to eight weeks is a common recommendation for returning to exercise (but not necessarily running). By six weeks postpartum, your uterus has returned to normal size (if breastfeeding) and lochia (bleeding) has likely stopped. However, not every woman is ready to run at six weeks – nor does clearance for exercise equate to clearance for running for every woman.

The timeline for return to running varies widely. Some women will be ready to start run-walk intervals at six to eight weeks, while others may need to spend more time on rehabilitation and wait until approximately twelve weeks or longer. (Do not run prior to six weeks postpartum, unless discussed with your OB.)

Talk to your OB before resuming exercise. Don’t make an impulsive decision based on a desire for normalcy. A multitude of factors – your labor and delivery experience, postpartum complications, fitness prior to and during pregnancy, etc – determine the duration of your postpartum recovery. You do not want to resume running if you are still experiencing postpartum bleeding or if any incisions have not fully healed. 

If in doubt, wait. If you do not feel ready upon clearance from your doctor, listen to your body. It is more than okay to wait 8 weeks or 12 weeks before you start to run! If you are experiencing issues at six weeks postpartum, ask your doctor for a referral to a pelvic PT.

Some physical therapists suggest waiting until 12 weeks postpartum to resume running. A white paper published in the British Journal of Sports Medicine suggests a 12-week timeline, with a focus on cross-training and weight lifting for weeks 6-12. (I need to emphasize here that this recommendation is the lowest level of evidence.) The paper notes that this 12-week waiting period is a level-4 recommendation; it is an opinion, not a conclusion from any randomized controlled trial, systematic review, or meta-analysis. Twelve weeks is not the definitive timeline for every runner. 

(This does not discredit the paper; there is fantastic information in the BJSM paper that encourages us to think more critically about postpartum running. However, this is simply encouraging mindfulness of how to understand the information you encounter. Simply because something is published in a journal does not mean it is a definitive conclusion. Guidelines are not a strict rule nor are they a study; they are a consensus from a group of experts. A study involves controlling trials and reducing the risk of confounding variables, bias, etc.)

While not every woman must wait twelve weeks, the recommended guidelines encourage every postpartum runner to assess their physical readiness. Simply being six or twelve weeks postpartum does not equate to clearance if evidence of prolapse or musculoskeletal pain is present.

The twelve-week timeline is ideal for women suffering from prolapse, incontinence, diastasis recti, or other pelvic floor issues. If you are also injury-prone or did not run in your pregnancy, this timeline may be more prudent for you. It is also worth noting that if you have pelvic floor issues, you may be off of running for longer than 12 weeks – 12 is not some magical point. For women who had a smooth delivery and quick recovery without issues, they may be ready to run sooner than twelve weeks (but no earlier than six to eight weeks).

Your OB is a doctor; do not let anyone on social media convince you otherwise. It may seem like a “short visit” but they do check indications of healing. Ultimately, follow the suggestions of your OB combined with how your own body feels. Every postpartum runner operates on a different timeline once they are out of the subacute phase (six weeks postpartum). 

Contraindications for Resuming for Running

Running before six weeks postpartum is not recommended. In the first six weeks postpartum, your uterus is still healing from the removal of the placenta and still shrinking. Resumption of running too early risk pelvic prolapse.

There are physical contraindications to returning to running after giving birth. Your OB may address these at the six week appointment; if not, advocate for yourself with your doctor. If you experience any of the following, hold off on running and seek help from a pelvic PT.

  • Sensation of heaviness or dragging in pelvic area
  • Noticeable gap in abdominal wall
  • Pelvic pain
  • Low back pain
  • C-section scar that is not fully healed
  • Bleeding beyond six weeks (that is not resumption of menses)
  • Urinary incontinence (including leakage when sneezing, laughing, or hopping)
  • You mentally do not feel ready

If any of these occur after the commencement of running, cease running until you can speak to your OB or a pelvic floor PT. For example, if you pee yourself on that first run, don’t just slap a pantyliner on next time. Switch to cross-training or walking and devote time to pelvic floor rehab. 

What Else Affects Postpartum Recovery?

In addition to the above considerations, other factors affect individual recovery. Once you are cleared by your doctor and possess no counterindications, you still must consider your previous fitness level and activity during pregnancy.

 While labor and delivery are not an injury, one must always consider the time off during pregnancy and postpartum like the time off for an injury. The longer you are off, the more cautious a return must be. (This is not a reason to rush back to running though!)

If you ran through the end of your pregnancy, you will likely be able to resume running sooner and rebuild at a quicker rate. If you stopped running partway through pregnancy, you may need to approach your return to running as you would for any prolonged layoff. An athlete who did not run after the first trimester, for example, should spend more time cross-training and strength training before returning to running. 

Likewise, your level of muscular strength during pregnancy contributes to your ability to resume running after childbirth. A 2017 study in Sports Health (Byholder et al) concluded that women who strength trained prior to childbirth (including during pregnancy) experienced less musculoskeletal pain, lower rates of stress urinary incontinence, and diastasis recti. If you did not strength train during pregnancy, you may need to hold off running for longer as you build back strength. 

Finally, there is mental readiness. No study or coach can tell you when you will feel ready. Some women feel ready to run as soon as they are cleared. Others wait months until they physically and mentally are prepared to run. Embrace your own timeline and do not rush yourself. 

Running and Postpartum Depression/Anxiety

I feel it would be a disservice to women everywhere to ignore the topic of postpartum depression and anxiety. Every year, thousands of women struggle with anxiety, depression, and other mood disorders after delivery 

This is one of the reasons that I as a coach do not prescribe to the 12 weeks off of running recommendation for every single runner. Assuming the athlete has been cleared by her OB and does not demonstrate any contraindications, carefully resuming running starting at 6-11 weeks postpartum can have a positive effect on PPD/PPA. 

Research indicates that exercise has a powerful effect on depression and anxiety. A 2015 observational, cross-sectional study in Sports Health (Tenforde et al) found a statically significant difference in rates of postpartum depression between breastfeeding runners who resumed training and those who did not. 

Now it’s worth noting that heterogeneity and bias may affect those studies. However, research on depression and anxiety (not just postpartum in the context of postpartum) reinforces the likelihood that exercise can decrease depression and anxiety in general – and therefore in postpartum women.  

That does not mean you should rush back into exercise. Nor does it mean that exercise is a panacea for PPD/PPA. But if you are at risk for PPD/PPA or have a high Edinburgh score and have been cleared for return to exercise, carefully resuming running may be helpful.

Conclusion

The exact timeline will vary on when you can return to running postpartum; you may be ready at 6-8 weeks, or you may need to wait 12 weeks or more, depending on issues that arise. Be sure to get clearance from your doctor. Do not run if you have incontinence, pain, or other problems. See a PT if you experience contraindications. Once you are ready to start running, though, do not jump back into previous mileage. The second part of this series will cover how to safely resume running after giving birth.

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How long did you wait to run postpartum?

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21 Responses

  1. I have never been pregnant but I can imagine that it can difficult to know when it’s the “right” time to return to running.
    I like the point you make about how running can have a positive effect on PPD/PPA. I’m sure it’s a great way for new mothers to get some exercise and me-time.

  2. After my c-section I was cleared to run at 5 1/2 weeks, which seems so early now looking back on it. I didn’t try to run until 8 weeks, at which point I did 1 mile of run/walk, didn’t feel great, and waited another couple of weeks to try again.
    I ran up until the day I gave birth, which I do think helped with my return to running.
    I think the hardest part for me was mental and emotional. I struggled to make the time for myself and found it hard to be away from my baby, but once I got out there it was really good for me.
    And balancing running and breastfeeding was another whole issue! I’ve had a draft post about that for a long time that I just haven’t gotten around to finishing.

    1. 5-1/2 weeks seems so soon after a C-section! It sounds like you were really smart about when you felt ready to return to running after a big surgery. Running and breastfeeding is such a challenging (but worthwhile on both ends) balance!

  3. I had not started running yet when I had my kids. We have lots of pregnant and new moms in our running group that are itching to get back out there with their strollers (and without). I will be sharing your post with them thanks for the great tips

  4. Such a great, informative post! I wasn’t a runner until my youngest was in preschool, so I didn’t have any of these issues to deal with. I can emphasize, though, with the urge for things to return to normal…only things are never the same after having kids (and that’s all good!).

    1. Things are not the same – I like to think that having a child gives even more motivation for self-care and setting goals (to set an example for her). Although runs happen on much more of a schedule now – got to be done by the time she wakes up!

  5. What a great post- so detailed and informative. After each of my kids were born, I tried to run again after six weeks, got injured both times, backed off and then started again after doing some strength training. I probably should have followed the 12 week guideline. But like you said, everyone is different.

  6. I didn’t start running until a few years after giving birth. I had a good pregnancy, but A’s birth ended up being a little traumatic, with a stay at the NICU for him and an early discharge for me. With the stitches, and trying to recover physically and emotionally, I don’t know that I would have been ready at 12 weeks, but I can understand wanting to get back to that sense of “normalcy.”

    This is so valuable. Thank you for sharing.

    1. I’m so sorry to hear you had to go through that! I think that’s why mental readiness is so important; a guideline cannot predict how you will feel, especially with a harder birth. And no one should rush back!

  7. Pelvic prolapse is definitely no joke. My mom had it for years. finally having to get surgery at 86 (should’ve been done long before). She was so uncomfortable for so long, and at that age, her recovery was hard.

    I can absolutely see that returning to running could help with postpartum depression.

    1. I’m sorry to hear that! It worries me when I see women run back at three weeks…it’s not worth the risk of lifelong complications. (Although a majority of times, prolapse is not controlled by any actions of mother; the issue is being mindful to seek treatment first, especially with so many pelvic floor PTs nowadays). I hope your mom found relief after the surgery.

  8. This is wonderful information! I wish I had access to this a year ago, it would have taken away the pressure to get back to running. I had a C-section so my doctor said I had to wait 8 weeks, so hearing 12 weeks is actually so much more reassuring!

    1. It’s really hard coming back from a C-section – especially depending on the nature of the C-section (planned vs stat) and how far along you were in labor when having it. I do think these guidelines need to be communicated with less pressure! Mental readiness is as important as physical (so long as one is physically ready).

  9. This is great information. One of the problems with social media is that you see women returning way too soon. I know it’s very individualized but I think sometimes women feel they either need to keep up with others or they want to impress their “followers.”

    1. I agree! I see some women running at three weeks postpartum (or worse, 3 weeks PP after a C-section!) and it is just way too soon – but sends the message that this is okay. Even with individualized timelines, no one is ready at 3 weeks pp!

  10. Postpartum athletics should be traeted with a degree of sensitivity. As you said, everyone will be ready to get back into the fray at different times, meaning that one shouldn’t push themselves earlier than what’s ideal.

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