Returning to exercise after childbirth

In the age of Instagram and Facebook, and with celebrities like Miranda Kerr and Gisele Bundchen flaunting their post baby bodies on social media, there seems to be increasing pressure on new mums to get back into exercise soon after childbirth.

But did you know that participating in sport, running and other high-impact exercise too early after childbirth can reduce pelvic floor strength and cause long-term bladder and bowel problems or pelvic organ prolapse?!

There are however, many benefits to postpartum exercise for both mum and baby. Here are some tips for new mums or soon-to-be mummas on how to return to their normal exercise regime safely.

Benefits of postpartum exercise

  • Facilitates recovery after delivery
  • Increases cardiovascular fitness
  • Facilitates postpartum weight loss
  • Improves energy levels
  • Improves mood
  • Reduces anxiety and depression
  • Improves muscle strength and posture
  • Increases joint and muscle flexibility.
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Exercise considerations

Pregnancy and childbirth place enormous physical stress on the body. Your pelvic floor muscles weaken during pregnancy and are further stretched during childbirth, your muscles and ligaments are looser due to the effect of Relaxin and your abdominal muscles are stretched due to your expanding belly.

All of these changes have occurred over 9 months and it is likely to take at least that long before your body gets back into its pre-pregnancy form. It is therefore important to be patient and realistic about your return to a fitness regime.

Please consider the following factors prior to getting back into exercise. Failure to address these issues before returning to moderate-to-high intensity exercise can cause incontinence, pelvic organ prolapse, abdominal hernias and back pain:

  • Pelvic floor muscle dysfunction- signs and symptoms of this include difficulty getting to the toilet on time, frequent urination, leakage of urine or stool when you cough, sneeze and/or laugh, a sensation of heaviness or dragging in the vagina or lower pelvis, painful intercourse
  • Musculoskeletal aches and pains such as lower back pain, coccyx pain and pubic pain
  • Abdominal separation- otherwise known as Rectus Abdominis Diastasis.

It is also important to consider the time since your delivery, the type of delivery that you had and how you have recovery since your delivery before deciding when to return to exercise. If you have had a Caesarean section, the assistance of forceps or a vacuum in your delivery or a tear or episiotomy, your recovery is likely to be slower, therefore delaying your return to exercise.

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Pelvic Floor First Australia’s recommended exercise guidelines

0-6 weeks

  • Pelvic floor exercises - commence 24 hours after a vaginal delivery and 3 days after a Caesarean section
  • Gentle abdominal bracing - this involves very gently engaging your deepest abdominal muscle by drawing in your lower tummy just above your pubic bone. Commence 24 hours after a vaginal delivery and 3 days after a Caesarean section
  • Walking - when your body feels ready. Start with short walks on a flat surface without a pram and slowly increase the distance and difficulty as your body allows
  • Swimming (once bleeding has stopped).

6-12 weeks

  • Low impact exercise - walking on increasingly challenging terrain, cycling, cross-trainer (if no low back pain or pelvic pain)
  • Light resistance - light hand weights or Therabands/tubes but nothing that causes you to hold your breath or strain, body weighted exercise, low intensity water aerobics
  • Continue with pelvic floor exercises and abdominal bracing
  • Be aware of good posture, form and quality of the exercise
  • Invest in a supportive bra!

12-16 weeks

  • Consider visiting a physio for an abdominal muscle check and pelvic floor muscle testing before returning to high impact exercise, running, sport or abdominal exercise programs
  • Slowly increase resistance, intensity and impact of exercise.

16 weeks+

You can return to your previous activity levels if your pelvic floor muscles have returned to normal and you are not experiencing back pain or signs of pelvic floor weakness such as incontinence or a sense of heaviness in the vagina during or after exercise. If your symptoms persist, seek the advice of your obstetrician or a physiotherapist with experience in Women’s health and continence.

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Remember that everyone’s birth experience is unique and we all recover at different rates. Return to exercise only when you feel ready - it should be an enjoyable experience so there is no point pushing yourself when you’re sleep deprived or achy and sore!!