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).
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.
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.
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.
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.