Post-Partum Care: Tips and Tricks from one Mom to Another
Carrying a growing baby for 40 weeks is no easy task. As women, our bodies go through a tremendous amount of change and stress during that time. Typically, other than welcoming motherhood and being the best version of “mom” we can be, getting our bodies back to our pre-pregnancy form is set as a priority post-partum. Getting back into an exercise routine post-partum can be tricky and it needs to be done properly. Our body underwent significant changes over the course of the pregnancy, and 6 weeks is not enough of a window for those changes to have reverted or diminished fully. It takes about 40 weeks to form our pregnant body and we need to be patient with ourselves and allow time for the body to heal.
First Six Weeks
Most physicians restrict a mothers activity level during the first weeks to allow physical healing to occur. This time is well spent focusing on bonding with baby and recovering. During this time, it becomes apparent that not only physical changes and challenges have to be overcome. There are also a vast number of hormones will be circulating, paired with the stress of a sometime uncooperative baby. This can cause mood swings, crying (“the baby blues”), extreme fatigue/exhaustion, etc. Light physical activity can help with these hormonal mood swings. This would be the time to go on short walks. Start at 5 minutes, and if you have no adverse effects (increase in bleeding, cramping, pain), go for a 6 minute walk the next day. Your goal can be to increase by a minute each day. Now is also the time to work on activating the deep core muscles you have not been able to use for the last 40 weeks. Think of drawing your belly button to your spine, and then up toward your chest. While holding that contraction, BREATHE! Take 5 slow breaths and then release your contraction. This will activate the transversus abdominis, the main muscle that support your lumbar spine and core during movement. The goals of the first six weeks should be healing, bonding, and setting a safe foundation for the transition back to activity when provided physician clearance.
At about the six-week post-partum mark, women typically get clearance from the doctor to resume physical activity. It is always important to ease yourself back into activity. This is not the time to dive back into your same workouts that you were doing pre-pregnancy. All physical activity should be gradually re-introduced. There are many adverse effects of returning to too intense activity too soon. Things to be on the lookout for include onset of bleeding after bleeding previously stopped OR bleeding, pain/ cramping, leakage of bowel or bladder, etc. If these symptoms persist after physical activity, you should seek care from your OBGYN.
Aerobic exercise comes in many forms. Post-pregnancy benefits of aerobic activity include weight loss, boost of energy levels, toning core muscles, stress relief, improved sleep, reduced symptoms of post-partum depression, etc. Per ACSM guidelines, adults should perform 30 minutes of moderate physical activity 5 days/ week or vigorous physical activity 3 days/ week for 30 minutes. What is the difference? While completing moderate exercise you will be able to talk in complete sentences and sing. While completing vigorous exercises you will only be able to say a few words at a time. This is known as the talk test. What may have been any “easy” exercise routine prior to pregnancy will now most likely feel impossible to complete – THIS IS NORMAL. If you are breast feeding, studies show there are no adverse effects on aerobic activity and milk production. There is no “gold star” aerobic activity for post-partum, do what is comfortable for you, whether its walking, running, the elliptical, stair master, bike etc. Again, it is important to ease yourself back into these activities to, I cannot re-iterate this enough.
Strength training is another important aspect of well-rounded workout plan. After giving birth, the first and most important exercises are pelvic floor exercises. These should be started within the first day or two post-partum. At around 3 weeks you may be able to begin body weight exercises like squats, lunges, heel raises, etc. Again, you need to listen to your body. If you begin these body weight exercises and you experience pain or other symptoms, it was most likely too much too soon. At the 6-week post-partum mark, once cleared by your doctor, you will most likely be able to begin resistance training. Understanding that a level of deconditioning is involved during pregnancy. This paired with the adaptations the body makes to carry a baby means that a slow re-introduction of weight is important, “start low and go slow!” Continuing to focus on pelvic floor training, core setting, and adherence to mechanics as progressions are made is crucial.
Typically, at the three-month mark is when you can plan on returning to full previous activity. This includes HIIT workouts, running, heavy resistance training, etc. . This would be dependent upon you performing the adequate foundational progression over the previous 3 months. Time alone does not prepare the body for high intensity activities. If at this point you are experiencing pain or pelvic floor dysfunction, it would be beneficial to seek professional guidance.
I currently practice as a Doctor of Physical Therapy and have a great understanding of physical health and all its benefits. As an active mom of two young children, maintaining my physical health post-partum was always high priority. I also suffered from mild cases of post-partum anxiety/depression. I can attest to the fact that exercise helped me through this without needing medication. Overall, post-partum health can be complicated and should be dictated by how you feel. Rushing back into exercises incorrectly following delivery can cause further complications. A slow re-introduction to exercise is the best way to return to pre-partum health.
The information contained in cfaortho.com, somdortho.com, or caoperformanceandtherapy.com is neither intended as rendering medical advice nor as a substitute for seeking professional medical assistance. No relationship between The Centers for Advanced Orthopaedics and its practitioners may be created through cfaortho.com, somdortho.com, or caoperformanceandtherapy.com. Any individual with specific questions regarding his/her individual health or treatment options should contact The Centers for Advanced Orthopaedics and schedule an appointment with one of its practitioners