MegJitsu

Pregnancy and birth takes a substantial toll on your body (and mind) and the conventional wisdom is that it takes a year to fully recover from the experience. Keeping active through your pregnancy can help you to perform well during the birth as well as to maximise your recovery postpartum. In the UK, the guidance for the first 6 weeks postpartum is to undertake light exercise such as short walks and to rehab the core and pelvic floor with pelvic tilts, Kegels and belly-button-to-spine; at your 6 week appointment, all going well you’ll be cleared for more rigourous activity. How much and how quickly you can return to your desired activity levels will depend on your fitness before and during pregnancy, the support you have for being apart from your baby and the sort of postpartum complications your body may experience.

Getting It Back Together

In my case, I was comfortable with reasonably long but slow walks from the day after the birth; since we got home, the boy and I have been doing 50-60 minute walks on a close to daily basis. During the first few weeks, these were very slow and as long as I didn’t show signs of over doing it (such as increased bleeding), I felt comfortable with this level of activity; 9 weeks in and the boy and I are power-walking all over the neighbourhood most days. Walking is my main form of exercise at the moment, and UK-women might be interested in an organised walking fitness program such as Pushy Mothers. Walks with the pram are a good option for new mothers as it is free, gets you out of the house, can be performed pretty soon after getting home (assuming a complication-free birth) and doesn’t rely on childcare, not to mention getting out and about stimulates and entertains your little one while helping him to learn day from night. In addition to the health benefits, it can offer an opportunity to meet other new mothers and babies in your neighbourhood and thus build up your local support system.

In addition to daily walks, I’ve been working my core rehab since the day after the birth:

• Kegels or pelvic floor exercises are vital to your postpartum rehab. These exercises should have been part of your pregnancy regime, but if not, it is never too late to start. The pelvic floor muscles support your internal organs, help with bladder control, and work with your abs for core stability. These little guys take a beating and after the birth you may have trouble activating them, but stay persistent; for me, within a few days I felt I had the same control of the muscles as before the birth. In the short term, working the pelvic floor can help increase blood flow and speed healing of any stitches, while in the medium and longer term an investment in your pelvic floor will help you to get back to your regular activity and regain your core control.
• Pelvic tilts help to rehab your abs and mobilise your back.
• Belly-button-to-spine practiced in combination with pelvic tilts will help to knit your abs back together and ready your body for upping your activity levels.

I have performed 1-3 sets of these exercise everyday since the birth and after about 4 weeks of consistent effort I felt I’d started to get the abs knitted together and working properly. Immediately after the birth, don’t be alarmed if you feel a couple inches gap running down the middle of your abs. While in extreme cases the separation of the abs can be so severe that an operation will be needed to bring them back together, for many women rehab should allow you to get them back in shape. Over the first few weeks of working my basic exercises, gradually, I was able to activate more of the abs working from the obliques to the middle. From 7 weeks postpartum I started Pilates classes and now at 9 weeks postpartum I can confidently activate the abs and they feel firm (under the baby-flab).

Complicating Factors

Breastfeeding is great for mother and baby in all sorts of ways. From a getting fit point of view, in the early days it is integral to helping your uterus shrink back to its pre-natal proportions and in the medium term it helps you to burn calories and the fat stores accumulated during pregnancy. However, it can complicate your postpartum fitness regime.

1 Relaxin

Some women feel comfortable taking the walking to the next level and running soon after the birth. This isn’t an option for me. For women choosing to breastfeed, as I am, your body will continue to be flushed with the relaxin hormone well after the birth. Relaxin helps to soften the ligaments in preparation for the birth and, if like me, you’ve had ‘issues’ with your knees, running or other high impact work may not be an option for you until you’ve weaned and worked the relaxin out of your system. Indeed, at 7 weeks postpartum I lightly ran 50 feet to catch the bus and caused an ‘acute flare up’ in my knee (readers may recall I had ACL reconstruction in Sept 2011). I’ve been able to reduce the irritation using a neoprene brace for compression and stability, plenty of icing, elevation and rest. After a week and half of TLC, the knee can take ‘power walks’ again, and I often use the brace to give that little bit of added support during walks. However, for me, running and impact work is going to be out of bounds while nursing.

2 Feeding

Breastfeeding is particularly demanding for the first 6 months and before you’ve introduced some solids. Your baby will need you close at hand and this can make getting out to the gym problematic, hence why walks with the buggy are such a good option. For my family, we’ve had mixed results with getting the boy to take a bottle of expressed milk; without the option of having someone else offer some of the baby’s feeds you’re going to find it crazy-difficult to do much self-care. We’re persisting and at the moment I can make a Saturday morning Pilates class; we’re also starting mommy and baby yoga next week. Over time, the baby will be less reliant on me, and while I love taking care of him, it is important to take time out to work on my own bod. One Pilates session a week is much less than I’d like, but it is a start and if we can crack this bottle thing I can take that up to 2-3 depending on childcare.

3 Childcare

You may be lucky enough to have loads of family and friends near by to help care for your baby, or you may, like me, be pretty much on your own. My partner is great and is a very proactive dad, but he’s out of the house for work most days, which really reduces my options during these early months. Evening classes are a possibility, once the little lord will consent to bottles of expressed milk on a regular basis, but then evenings are also the ‘witching hour’ when baby is most upset and needs his mommy. Again, opportunities to take time out will become more available over time, but if you’re finding that your workout schedule isn’t very ambitious, don’t beat yourself up about it – you and your family will find a rhythm and little by little you’ll get where you’re going.

If you like fighting, you’ll love giving birth. Like a competition setting, birth is 90% mental, 5% doing what your body knows what to do, and 5% respecting the advice of the people coaching you from the sidelines. As with competition, you’ve got a ‘burn down’ to the big day, during which time you can prepare yourself physically and mentally with regular training and lots of visualisation. To me, the hallmarks of a natural active birthing experience and of competition are strikingly similar:

• Physical and mental endurance
• Mental toughness and positive self-talk
• Internal monologue to keep ‘fighting’
• Trust the technique
• Trust coaches

The big difference with birth, to my mind, is the length of time you’re ‘fighting’ and the level of sensation; we’re talking hours of active labour, not to mention the preceding contractions to bring you to active labour, not a few matches counted in minutes, all while in a state of increasingly intense discomfort. The long timeline and the pain are not insignificant factors as they require that much more mental toughness, positive self-talk and physical endurance.

BJJ and Natural Birth

As my pregnancy was ‘normal’ and low risk throughout, I opted for a natural active birth at a standalone midwife led unit called the Barkantine Birth Centre; for my American readers, in the UK midwives handle deliveries in and out of hospital – doctors only get involved for interventions such as C-sections. As soon as I learned I was pregnant, I checked out birthchoice.co.uk to investigate the stats for my local hospitals and so discovered that the Barkantine had, by far, the best stats for outcomes and the lowest rates of interventions; as a person all too familiar with operations, I was very keen to avoid interventions where possible in order to maximise my ability to recover post partum. While it can be a little scary to choose a midwife led unit rather than a hospital with consultants on-call for emergencies, I took the decision early on to be led by the evidence rather than my fears. In my case, this worked out better than I could have hoped.

The Barkantine is set up for an active, non-medicalised birth and each birthing room includes a big double bed for the parents, a balcony, an ensuite, a little sofa and tele, as well as a massive birthing pool, birthing ball and birthing stool. The midwives at the Barkantine will work with you to facilitate your natural birth using this equipment and pain relief is available with ‘gas and air’/nitrous oxide and/or opiate injection. For pain relief I progressed from paracetamol, to the birthing pool and finally to gas and air in the pool, but what made the real difference to my ability to cope with the contractions was my training and my physicality.

Five hours after my waters broke and the contractions began, I was headed to the Barkantine and the contractions were coming at regular intervals and geting stronger and longer. At this point, it was all getting a bit scary and I started to get nervous and upset on the journey to the birthing centre, but I had such a long way to go! Time to spool up the old training. While breathing into the contractions I would positive self-talk my way up the incline of the contractions, recognise when I was at the crescendo and keep strong until back at the bottom and waiting for the next one. I used this tactic of a strong internal monologue throughout the process and kept up a steady chant of: ‘You’re a warrior, you can do this, fight – fight – fight, don’t stop, the mind always quits before the body, fight – fight – fight’. With the support of the midwives, my husband and the nitrous (love that stuff!) I was able to fight through the heavy fatigue – man it is tiring! – and cope with the pain and after 3 hours managed to dilate from 4 to 10 cm. While the pushing phase, for me, wasn’t particularly painful (I used no pain relief during this portion of the birth and remember my tattoo being more painful than this part of the labour), it was a real test of endurance. As can often happen for first time mothers, my contractions slowed down and weakened as the labour went on; contractions are necessary for pushing so this resulted in a rather long 2.5 hour pushing phase. This part of the birth was even more tiring than the contractions – between each contraction all I could think was how much I’d like to sleep – and it is the fatigue that chips away at the mental toughness and the capacity to endure. Ultimately, the boy was delivered safely and mommy, daddy and baby went home the next evening to enjoy a blissful 2 weeks of paternity leave together.

Fitness and a Happy Birth

My BJJ training and pregnancy exercise regime directly contributed to my very positive birthing experience. On the one hand, as an amateur athlete (even one that’s been benched with knee rehab and pregnancy for much of the last year) and a martial artist with 14 years of experience under my belts, I’ve regularly experienced pushing my body out of its comfort zone, keeping calm under pressure and getting ‘into the zone’ with what my bod is doing. From pushing myself to run that little bit harder or lift a little bit more when conditioning off the mats, to learning to not be bothered when a 90 kilo dude is crushing me while I make my escape on the mats, as a BJJer I’m pretty familiar with keeping the mind strong so the body can work the technique. On the other hand, as reported in my third trimester round-up, I was working out and ‘pumping iron’ until the day before the birth. Labour is a physically demanding experience and I was on hands and knees for much of the time, either in the pool on on the birthing ball; the good level of fitness I started pregnancy with and the upper body strength I was able to maintain during pregnancy made a big difference to my ability to keep at it; my upper bod was seriously aching the first few days of post-partum recovery!

An active natural birth isn’t for everyone and we’re very lucky in the West to have such fantastic facilities for mothers-to-be; giving birth is no longer the life threatening experience it once was and continues to be for many women. From water births and hypnobirthing to epidurals and C-sections, there’s a wide range of choices to suit the circumstances of each individual pregnancy. For me, I was fortunate enough to be in a position to enjoy an active birth and had access to people and facilities to help make that happen; it isn’t for everyone, and nor should it be, but it was right for this pregnancy and I look back on the experience with a lot of happiness and I am convinced that my commitment to exercise during pregnancy and my years of martial arts, especially BJJ, were integral to making the birth what it was.

I’m six weeks postpartum, now, and recovering well while juggling the baby and work; we’re a very happy if somewhat tired and disheveled new family. Stay tuned for a report on my early postpartum recovery and the plan rehab the abs and get back to the mats!

While I enjoyed a wide range of activity during the second trimester, including BJJ training, the final stage of my pregnancy presented greater challenges to staying active; by the start of the third trimester the bump was becoming extremely unwieldy. During the final phases of the pregnancy I found my mobility went way down as I lost more and more core control. The last 9 weeks also saw me short of breath and by week 31 my exertion levels had to be reduced further from an already modest point. I did hit twice weekly gym sessions and short daily walks pretty consistently during the last weeks. This included weekly personal training which focussed on conditioning. We used bodyweight exercises, work on the suspension trainer and with cable machines; cable machines are great as they require more core activation than conventional weight machines but less than free weights, so a safer alternative in my distended state. We worked upper and lower body which benefited my overall fitness, my preparation for the birth as well as my knee recovery.

While I’d been swimming a lot through pregnancy I stopped this at 30 weeks. Up until this point I’d been able to whack out 30-50 laps of front crawl (with flip turn, cuz I’m bad like that) at a decent clip without feeling run down or out of breath. Suddenly, at 30 weeks, I felt really out of breath during my swim and reduced the intensity and the number of laps. Nevertheless, when I got out of the pool and the warm air hit me I felt very dizzy and nearly fainted. I recovered quickly and felt fine after some cold water, but felt uncomfortable getting back in the pool after this incident so I restricted myself to weights and walking from then on. While my weights sessions alone and with my trainer were at a good level of intensity, my walks were very slow and short as by this stage walking could cause a reasonable amount of pain and discomfort.

My last weights session was on Thursday 16 August as my little boy was delivered safely into the world on Friday 17 August after 37 weeks + 2 days of pregnancy, but more about that in my forthcoming posts on birth and post-partum rehab.