Penn Study: Childbirth used to be called the rebirth of the mother, just over a century ago. Not so much, anymore as advances in medicine and surgical procedures can rescue a mother and child in distress during delivery in most cases. Though most women keep hearing about the plus sides of a natural vaginal birth delivery, some women have to undergo Caesarean section (C-section) deliveries due to some medical complication or the other.


Caesarian may possibly save lives, but it does increase the woman’s bounce-back time post-delivery.


A study by the Penn State College of Medicine, Penn State University (USA), published in the Science Direct Journal under “Obesity Research & Clinical Practice”, and titled “Mode of first delivery and postpartum weight retention at 1 year”, has found that Caesarean delivery at first childbirth is associated with increased risk of weight retention of 10 pounds or more at 1 year postpartum.


Why Do Women Gain Weight During Pregnancy?  


Gaining weight is to be expected for most pregnancies. In addition to the baby’s weight, the scale will reflect extra pounds gained from:



  • The placenta

  • Amniotic fluid

  • Increased breast tissue

  • Increased fat

  • Increased fluids

  • Increased blood


According to Cleveland Clinic, it adds up to an average weight gain of 15-40 pounds during pregnancy, though that can (and should) vary from person to person.


The Penn University study cited above finds that the prevalence of obesity has increased markedly in women in their reproductive years over the past three decades, partially due to higher rates of postpartum weight retention. The paper declares that the focus in this prospective cohort study was on investigating whether the mode of delivery proved to be an independent risk factor for postpartum weight retention at 1 year postpartum.


What Did The Study Find?


Data from 2,500 first-time mothers, aged 18–35 with singleton pregnancies, were included in this analysis. Postpartum weight retention was measured at 1 year after delivery, and the postpartum weight was defined as weight at 1 year compared to weight just before becoming pregnant.


The study did factor in variables like what was the BMI of the mother before pregnancy, the gestational weight gain, age, education, poverty status, smoking, race/ethnicity, gestational age, pregnancy complications, and breastfeeding and exercise habits during pregnancy and in the first year after delivery, etc.


At 12 months after delivery, the women who had delivered by Caesarean were more likely to have a postpartum weight retention of 10 pounds or more than those who had delivered vaginally. Even after controlling for confounding variables, mode of delivery remained significantly associated with postpartum weight retention of 10 pounds or more.


Cesarean delivery requires more time for convalescence than vaginal delivery and there is some evidence that women are less likely to engage in regular exercise after cesarean delivery.


Why Do These Findings Matter?


In the past two decades, experts say, obesity has disproportionately affected reproductive-aged females. Current data put together by the US Health authorities suggests that greater than nearly 7 out of 10 women over the age of 35 are overweight or obese. 


It has been noted that 1 in 5 women who start at a normal pre-pregnancy BMI will transition to an overweight or obese BMI status by the time of their second pregnancy.


The sad and alarming part is that this excess weight gain does not disappear or recover in the long term, and postpartum weight retention has been found to correlate with weight gain 15 years later. Why this is bad is because this predisposes women to the associated metabolic and cardiovascular consequences of chronic obesity, such as diabetes, high blood pressure, thyroid dysfunction, other heart related matters, arthritis, and respiratory problems.


Tips For Weight Loss While Breastfeeding


Ob/Gyn Kelly Buchanan shares a few tips to shed postpartum weight in an article on the Cleveland Clinic website. Here's the gist of what she advises. However, take the advice of your doctor and do not make any changes to your health and medicine routines without your doctor’s nod.


Roughly, here’s how to navigate weight loss safely:


Losing weight while breastfeeding requires patience and a balanced approach. Restricting calories isn’t advisable as breastfeeding demands about 300 extra calories daily.


Start with Gentle Exercise


Kegels: Begin strengthening your pelvic floor muscles soon after delivery to improve bladder control.


Walking: Short walks can boost circulation, mood, and fitness without overexertion.


Core Strengthening: Around a month postpartum (longer after a C-section), work on core exercises like planks and bridges to rebuild abdominal strength. Save intense workouts like running or weightlifting for later.


Eat Nutrient-Dense Foods: Follow a Mediterranean-style diet rich in fruits, vegetables, lean proteins, and plant-based options to sustain energy without crash dieting.


Prioritise Sleep: Though challenging with a new-born, adequate sleep supports weight loss by regulating metabolism.


Be Patient: Breastfeeding often aids initial weight loss, but plateaus are normal as your body retains reserves for milk production. When your baby transitions to solids, further weight loss may occur.


Stay Healthy: Restricting calories too much can reduce milk supply, cause fatigue, and affect nutrient intake for you and your baby.

“You’ll want to take your time getting into an exercise and diet routine after giving birth,” Dr Kelly Buchanan says. “Your body needs time to heal. Between delivery and having a baby to take care of, be gentle on yourself as you work on getting to a healthy weight.”


Remember, every postpartum journey is unique—focus on realistic goals, and consult a healthcare provider if needed.


The author is an independent journalist.


Disclaimer: The information provided in this article is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern and before you make any changes to your medicines, exercises, nutrition, or any health-related routine.