Baby and You

Exercising safely after giving birth

Looking for some postnatal exercise advice? Fitness expert, Jane Wake, explains the importance of exercising safely after giving birth, including when and how to exercise, top tips and resources

Mention exercise post having a baby and it conjures up images of celebrities snapping back into shape. The reality of exercising post birth however is far from this.

Through pregnancy and birth our bodies do the most incredible thing… growing, carrying and birthing a baby! Only mothers possess this strength and power. But we also have to consider how we need to replenish our body and mind after something so physically demanding as birth.

True mother strength is the one that enables you to grow and birth a child, not regain a flat tummy or trim figure – these are side distractions that we need to ignore! When you make true mother strength your focus, you become kinder to yourself and can start to consider the changes that matter most. These changes are ones that involve our joints, muscles, ligaments and hormones and they continue to change well into the postnatal period. There is no snap back! But there is another amazing stage post birth from which we can learn so much about ourselves, and in doing so, harness that incredible power we have.

A study from Michigan University* found that the toil on the body and potential injury after birth is equal to that of running a marathon. On the basis that some births end up being much longer and more traumatic than others – I would say at least a marathon, maybe an ultra marathon or more!

Our experiences post birth can vary dramatically but it doesn’t matter how you give birth or for how long. Whether you have had a caesarean birth or a vaginal birth, laboured for 1 hour or 40 hours, your body will have gone through one hell of a climb and now it needs some time and thought to recover. 

Never underestimate yourself and your ability to heal post birth. The right guidance, support and advice however is crucial here – it’s why in countries such as France, all women are automatically given post-birth physiotherapy treatment, pretty much like the athlete who gets specific treatment post an event. The difference is, rather than a sports physiotherapist, you need one that specialises in pelvic health. This is available via referral from your doctor in the UK or you can consider seeing one privately. You also don’t have to wait to have an issue to be seen. Many provide a postnatal health check or “Mummy MOT’ which is well worth considering and can save you a lot of trouble down the line. If you are experiencing any kind of back pain, hip pain, heaviness in the vagina or vaginal pain, incontinence (bladder or bowel) or simply want to know what’s going on down there, then a visit to a women’s health physiotherapist is paramount.

Moving post having a baby though is VITAL! And this is why…

By being active you are able to

  • De-stress
  • Boost energy levels
  • Sleep better
  • Manage weight better
  • Improve posture
  • Relieve back ache
  • Aid recovery of key muscles such as the pelvic floor
  • Improve your confidence and self esteem
  • Help with mental health issues such as the baby blues and postnatal depression
  • Have a positive effect on your family – exercising mums tend to have more active, healthier children.
  • Connect to your true strength and discover how feeling strong both mentally and physically can help you on your motherhood journey.

How to harness your true mother strength post birth

The following timelines are a guide and it’s important to recognise that everyone is different, and the type of birth you have had and the severity of your injuries from birth will mean everyone recovers at slightly different rates. There should never be any pressure to do anything by a certain time. Listen to yourself, seek advice and get the right support.   

Weeks 0 – 2

Rest, recover and connect to your pelvic floor – the only movement you should do now is healing exercises that aid recovery. Just focusing on your breath can do wonders here. And as you breathe out, try to feel your pelvic floor. The only other movement you should do is that of caring for your baby and, when you feel up to it, some gentle walks with the pram. Take your time and listen to your body – rest is important here for you to be able to heal.   

Weeks 2 – 4

Start to consider more pelvic floor and deep core exercises – these can be gentle Pilates style exercises plus yoga stretches to relieve hip and back pain. You can also start to increase your walking gently here. If any movement increases your lochia – this is the bleeding you experience for weeks post birth i.e., you’re having to change pads more frequently or you notice a sudden change in flow – then you need to lessen what you do. If you’ve had a C-section, your normal daily movement will need to be less – so no lifting and carrying, other than your baby, until after your 6 week check.

TOP TIPS

  • Understand how your pelvic floor works in conjunction with the rest of your body (see opposite for resources to help).
  • Do pelvic floor and deep core exercise, every day based on tip above.
  • Start with short duration 5 – 10 minute sessions and build until you can be active for at least 150 mins per week (30 mins daily).
  • Balance mind and body with relaxing, releasing exercise – you need to slow down, before you can speed up.
  • Listen to your body – never sacrifice sleep for movement.
  • Nourish yourself always – your body will be depleted of nutrients post birth so place care and attention into what you eat as well as how you move. Use the 80/20 rule, eating as healthily as you can 80% of the time.
  • Exercise doesn’t affect breastfeeding, but you must stay well hydrated. Drink more water than usual – 2 – 3 litres per day.
  • If you cannot control your bladder or bowel, experience pain or pressure in your perineum and pelvic area, don’t delay – go straight to your doctor.

Weeks 4 – 6

Start to introduce more functional movements that help with everyday life – from squatting to lunging and lifting and carrying, this means strength exercises that also help you to work on your posture and core control as well as strengthen your outer muscles. You can also start to introduce more regular cardiovascular exercise here, but it must remain low impact – so simply increase your walking or try stationary cycling or x-trainer (watch intensity here though – keep it moderate, at a level where you can always talk). Be careful of seated positions that could put pressure on the perineum – you need a comfortable saddle and pad protection. Think about posture and keep the duration short – start with 5 – 10 minutes and gradually build.

Weeks 6 – 8

Some women are ready here to increase their exercise, some are not. Ask your doctor specific questions at your 6 week check and consider physio support (this is the time to ask your GP for a referral if not before).

If you feel ready, you can start to increase the load for your strength exercises, for example by adding weights or resistance, and increase your cardiovascular activity by going for slightly longer walks or trying cycling outside. High-impact activities should still be avoided unless they are part of your daily living and of short duration (no more than a few seconds), such as running after a toddler. Consider how this makes you feel – do you need more support?

Weeks 8 – 12

This is the period when you can return to activities such as swimming, but this is dependent on scar tissue healing and lochia having stopped. Start to increase the intensity of core, functional strength training and low impact forms of cardiovascular exercise. Any runners should be thinking about how they now need to train with an awareness of their core during more vigorous/faster movement. This doesn’t mean running yet, just preparing yourself to do so. Only introduce running or impact activity with a full understanding of your core control and any birth injuries that may affect your ability to run. Having a balance of movement is important, and this is why physio-led or yoga and Pilates style movement with a pre and postnatal specialist is essential here.

HOW TO BUILD YOUR SUPPORT TEAM

*Ref; Miller JM, Low LK, Zielinski R, et al. Evaluating maternal recovery from labor and delivery: bone and levator ani injuries. Am J Obstet Gynecol 2015;213:188.e1-11.

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