As you may have noticed, there is a lack of information and education on this topic. The available guidelines on exercise post-baby are incredibly vague and most do not take into consideration the pelvic floor, which if you’ve been following me for a while, you will know is an oh so important consideration!
The short answer to this question is that there is not a one-size fits all answer for each and every new mama. Damn! BUT, before you lose hope, I have some good news! I have compiled a set of principles and guidelines on safely returning to exercise post-baby that you need to be educated on.
First things first, as part of your journey to returning to exercise post-baby, it is ESSENTIAL that every new mama understands the following.
- Your safe return to exercise post-baby will depend on:
- Your birth experience. Whether you have a vaginal birth or caesarian (elective or emergency); length of second stage; perineal tearing or episiotomy; forceps or suction; immediate recovery; any other complications.
- Recovery of your pelvic floor and abdominal muscles. This is influenced by your birth, your birth preparation, the pelvic floor and core exercises you did during pregnancy, the general exercise you did during pregnancy, genetics, degree of abdominal muscle separation, your first 6 weeks postpartum.
- Whether you have pelvic floor dysfunction. Prolapse (vaginal heaviness); bladder leakage; bowel issues; pelvic floor overactivity or perineal/vaginal pain.
- Whether you have any musculoskeletal issues. Such as back, pelvic or coccyx pain, or carpal tunnel syndrome.
- Your energy levels. Sleep deprivation is a reality for most new mums. Each mum will have differing amounts of sleep, fatigue and energy levels, and this will impact their motivation to return to exercise. The good news is that exercise has been shown to increase energy levels postpartum. Yay!
- Your fitness levels and strength during pregnancy. Exercising safely and regularly during pregnancy will increase your baseline fitness, strength, and optimise your birth and postpartum recovery.
- Your exercise goals. Every woman will have different goals – for some it may be to get back to running, and for others it might be Pilates or the gym.
- Every new mum needs an appointment with a Women’s Health Physiotherapist.
Your appointment with a Women’s Health Physiotherapist will go through all of the above factors to establish a comprehensive plan for your safe return to exercise. This appointment should ideally be at 4-6 weeks postpartum.
The session with a Women’s Health Physio will involve:
- A comprehensive subjective assessment, covering all of the above points and more.
- An objective assessment of your pelvic floor and deep abdominal muscles either via internal examination (>6 weeks postpartum) or real-time ultrasound.
- Teaching you how to correctly activate your core muscles – your pelvic floor and deep abdominal muscles.
- Giving individualized core exercise program.
- Providing individualized management and advice regarding any symptoms you may have, such as pelvic floor dysfunction.
- Guidance on the safe return to exercise post-baby based on all of the above.
- Booking follow-up appointments to track your progress.
- Medical Clearance from your Obstetrician or GP.
To ensure you are medically safe to return to exercise post-baby, you need medical clearance from your Obstetrician or GP. At this appointment it is important that you obtain the following information:
- Details on your delivery if you didn’t at the time i.e. did you have a tear; if so, what grade of tear; did you have an episiotomy; did thy use forceps or vacuum.
- Ask them to do a vaginal examination and check your scar if you had stitches.
Please note that your appointment with your Doctor is for medical clearance only, as they do not specialise in the pelvic floor, postpartum recovery or safe return to exercise.
- The key factors you need to know before returning to exercise post-baby:
- You should not experience any vaginal heaviness (prolapse), bladder leakage, pain or abdominal doming with exercise. Your Women’s Health Physio will help treat any of these symptoms and guide you on a safe exercise plan.
- Slow and steady. Postpartum recovery is about gradual progression, and tuning into how your body responds. You can do damage to your body (especially pelvic floor) now or have symptoms in the future if you go too hard too soon.
- Strengthen your body from the inside out. Always start focusing on your core muscles, your pelvic floor and deep abdominal muscles, and your posture. As you strengthen your core, and improve your posture, you can work your way out to your superficial muscles. If you work the opposite way, you can worsen your pelvic floor, stomach separation, or injure yourself.
- Shift your mindset. Your body has just grown a human for 9 months and THEN given birth. Let this realllly sink in! Because of this, your body has changed. It may or it may not be the same again. Therefore you may not be able to do the same exercise as you did before, OR you may be able to do it even better!
- Be driven by the way you feel. Exercise is soooo good for us when we enjoy it. Exercise in ways that makes you feel good, rather than being driven out of fear-based motivation.
- Listen to your body. The priority is that you exercise safely, according to when your body is ready. Don’t push through any pelvic floor symptoms, abdominal separation, pain or anything else that doesn’t feel right in your body.
- Understand the effect of hormones. There are more factors affecting the way your body feels and looks right now, such as your hormones. Be kind to yourself, and allow yourself a whole 12 months to recover.
- Stay in your own lane. Don’t compare yourself to your friend’s post-baby body or that chick on Instagram, because guess what? They are not you. Your pregnancy, birth, body and baby are all unique. Don’t forget that!
- Energize yourself. The point of exercise is to energize yourself and make you feel stronger, not completely fatigued so you can’t take care of yourself or your baby. Tailor the frequency, time and intensity of your workouts to ensure you are rejuvenated, not fatigued.
- Maintain adequate and optimal nutrition. Eat nourishing wholefoods – veggies, fruits, good quality protein and good fats, which stabilize your blood sugars. Keep away from processed foods, refined sugar and any other inflammatory foods. If you are breastfeeding, increase your intake of wholefoods to keep energy supply up. It has been found that combination of nutrition and exercise shifts postpartum weight gain.
- Maintain adequate hydration. Drink 3L of fluid if you are breastfeeding, making the majority of that water. Make sure you drink before, during and after exercise.
- Breastfeed prior to exercising. Even though moderate-intensity exercise has not been found to have any effect on the quality of breast milk; feeding first is recommended to increase your comfort levels during exercise.
Ok, so I realize that was a lot of information to take in, so re-read it if you need and ask questions, because that is only part one!!!!
Part two is a FREE e-book on Postpartum Exercise Guidelines. Finally, you say! In this e-book, I will break down safe exercise guidelines for 0-6 weeks, 6-12 weeks, 3-6 months and 6+ months postpartum.
Berger et al (2014) Systematic review of the effect of individual and combines nutrition and exercise interventions on weight, adiposity and metabolic outcomes after delivery: evidence for developing behavioural guidelines for post-partum weight control. BMC Pregnancy and Childbirth 14:319.
Mottola M (2002) Exercise in the postpartum period: practical applications. Current Sports Medicine Reports 1:362-368.