Written by Sarah Percy, Women’s Health Physiotherapist and Director, Female Physio Co.
As a Women’s Health Physiotherapist, I am a huge advocate for evidence-based and early movement in the fourth trimester. However, whilst movement is vital for recovery, there’s another piece of the puzzle that’s often overlooked: sleep
Quality rest in the postnatal period isn’t just about surviving the night feeds, it’s about giving your body the chance to heal, regulate hormones, and support your pelvic floor recovery. This article explores why sleep is just as important as exercise, what causes sleep deprivation after birth, and practical ways to optimise rest in those early months.
Why sleep matters when it comes to returning to exercise after childbirth
1. Sleep supports pelvic floor healing.
Your pelvic floor muscles undergo huge strain during pregnancy and birth. Sleep is the body’s primary time for repair. It helps reduce inflammation, restore muscle tissue, and improve circulation. Without adequate rest, the pelvic floor may take longer to recover, leaving mums more vulnerable to incontinence, feelings of vaginal heaviness (prolapse), or persistent discomfort.
2. Sleep helps balance postpartum hormones.
Hormones like prolactin (for milk supply), cortisol (stress), and oestrogen (linked to tissue healing) fluctuate significantly after birth. Poor sleep disrupts this delicate balance, impacting mood, energy, and recovery. Adequate rest helps regulate these systems, reducing the risk of postnatal depression, anxiety, or ongoing fatigue.
3. You can return to activity sooner
Exercise after birth is important, but progressing too quickly without the foundation of rest can increase the risk of injury or setback. When you’re well-rested, your body is better able to tolerate physical activity, rebuild strength, and respond positively to exercise programs - whether that’s gentle walking, postnatal Pilates, weight-based training or pelvic floor exercises.
What causes sleep deprivation after birth?
- Night feeds and cluster feeding: Babies often feed every 2–3 hours in the early weeks.
- Hormonal shifts: Major drops in oestrogen and progesterone can make it harder to fall and stay asleep.
- Hypervigilance: Many mums feel “on alert” listening for their baby’s every sound.
- Pain or discomfort: Perineal tears, caesarean scars, or engorgement can interrupt rest.
- Environmental disruptions: Light, noise, and changes in routine all play a role.
Practical strategies for better postpartum sleep
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Prioritise naps over tasks: Whilst easier said than done, short naps (20–40 minutes) can reduce sleep debt considerably.
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Share the load: If possible, alternate night shifts or ask your partner/support network for help with feeds and settling where possible.
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Optimise your sleep environment: Keep the room cool, dark, and quiet; use white noise if needed.
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Bedtime routine: Even a 5-10 minute routine such as gentle stretches, breathwork, or a warm shower with the lights dimmed can signal your body it’s time to wind down.
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Feed-friendly setup: Keep everything you need for overnight feeds (water, snacks, nappies) within arm’s reach so you minimise disruptions.
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Balance exercise and rest: Gentle, low-impact movement during the day can improve sleep quality at night.
When to seek help
If sleep deprivation is leading to overwhelming fatigue, low mood, intrusive thoughts, or difficulty coping day-to-day, it’s important to reach out. Your GP, a Women’s Health Physiotherapist, or a Maternal Health Nurse can provide guidance. In some cases, referral to a Lactation Consultant, Psychologist, or Sleep Consultant may also help. Sleep is not a luxury, it’s a core part of your health and recovery.
Final thoughts
Postnatal recovery is about so much more than exercise alone. While moving your body is a powerful tool for healing, sleep is the foundation that makes exercise safe and effective. Prioritising rest supports your pelvic floor, balances your hormones, and gives you the strength to care for your baby and yourself.
If you’re struggling with sleep, remember: you’re not alone, and help is available. By valuing sleep as much as movement, you’re setting yourself up for a stronger, healthier postnatal journey.
Explore more articles on sleep in the first trimester.
About the author
Born and bred on the Gold Coast, Sarah completed her Doctor of Physiotherapy (DPT) and Bachelor of Exercise Science (BExSc) degrees on the Gold Coast at Bond University. Over the years, Sarah’s soul purpose has been to educate all women about their body.
Sarah believes knowledge is power and understands the importance of staying well informed when it comes to choosing the right, individualised healthcare. Sarah’s passion for Pelvic Health began when she was working on the Maternity and Gynaecological wards at Pindara Private Hospital.
Sarah was blown away at the information she was learning around the pelvic floor that we simply don’t get taught growing up.
Since then, Sarah has undertaken numerous post-graduate courses on Urinary Incontinence, Pelvic Organ Prolapse, Pessary fitting, Advanced Anorectal Dysfunction, Overactive Bladder, Genito-Pelvic Pain/Penetration Disorder (GPPPD) including Provoked Vulvodynia, Vaginismus, Endometriosis, Pregnancy-related Pelvic Girdle Pain and Diastasis Rectus Abdominis Muscle Rehabilitation post baby.
Sarah’s passion is Pelvic Girdle Pain during Pregnancy and Sexual Pain. Her aim is to provide holistic, evidence-based care to all patients to help them make the right choice when it comes to their health.
References
Khan-Afridi, Z., Ruchat, S. M., Jones, P. A. T., et al. (2024). Impact of sleep on postpartum health outcomes: A systematic review and meta-analysis. British Journal of Sports Medicine, 59(8), 584–600. https://doi.org/10.1136/bjsports-2023-107516
Resta, S., Facco, F., & Cipolla, C. (2024). The role of sleep protection in preventing and treating postpartum depression: A review. Sleep Medicine, 112, 231– 238. https://doi.org/10.1016/j.sleep.2024.06.010
Baker, F. C., & de Zambotti, M. (2023). Sleep in women: Hormonal influences, sex, and lifespan effects. Frontiers in Sleep, 2, 1271827. https://doi.org/10.3389/frsle.2023.1271827
Ko, Y. H., Kim, E. Y., & Park, S. (2021). Sleep disorders during pregnancy and postpartum: A systematic review. Sleep Medicine Research, 12(2), 67– 77. https://doi.org/10.17241/smr.2021.00983